Estate Clean-Out Form | JunkOnJunkOff

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206.799.JUNK

Your Connection to the Property*

If Other, What is Your Connection to the Property?

Are You Authorized to Approve Removal of These Items?*

Yes

No

Will You Be On-Site During Removal?*

Yes

No

First name*

Last name*

Company name

Email*

Phone*

Can we text you regarding your pickup?

Yes

No

Street Address*

Address Line 2

City*

Zip Code*

Property Type*

If Other, Describe Property Type:

Gate/Lockbox/Door Code or Where Key is Hidden

Where are Items Located?*

Will our staff be using stairs?*

Yes

No

If Yes, How Many Flights of Stairs? (Enter 0 if you answered No)*

Distance from Items to Truck:*

Up to 50 Feet

51 - 100 Feet

101 - 200 Feet

Over 200 Feet

Other

Truck Parking Availability*

If Other, Describe Parking:

We aim to be at location within 6 hours of booking. This is not always a possibility due to prior bookings.

First Choice for Pickup Date & Time*

Month

Day

Year

Time

:HoursMinutes

Second Choice for Pickup Date & Time

Month

Day

Year

Time

:HoursMinutes

Truck Selection

How Many Trucks Needed

Photo Upload (Up to 8 Photos - JPG, JPEG and PNG only)*

Worker Safety & Regulatory Info

Does your pickup contain chemicals, oil-based paint, fuel, automotive fluids, unidentified liquids, propane or pressurized cylinders, asbestos, medical waste, explosives, roofing, rocks, dirt, concrete or asphalt.*

Yes

No

Conditions on Arrival*

None

Bed Bugs or Other Infestation

Rodents or Animal Waste

Needles or Sharp Objects

Bodily Fluids

Significant Mold

Unsafe Flooring or Blocked Exits

Other

Sign to Validate You Answered Truthfully to the Best of Your Ability.*

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