ELITE MOVING Pay Invoice Please fill out the form below to make a payment on an invoice. "*" indicates required fields Client Name* Job / Invoice Number Primary Phone*Secondary PhoneEmail* Please choose an option*Select an option...Deposit - LocalDeposit - Long DistanceMove - BalanceStorageOtherMoving From* Street Address Unit Number City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Pickup Entrance*Please selectHouseGround LevelStairsElevatorNumber of Floors12345Number of Bedrooms* PLEASE NOTE: IF you have not spoken with our representative AND your move is from or to a 3rd floor walkup: an additional mover will be required at an additional $35.00 per hour over the quoted rate. By checking this box, you agree to the terms below PLEASE NOTE: IF you have not spoken with our representative AND your move is from or to a 3rd floor walkup: an additional mover will be required at an additional $35.00 per hour over the quoted rate. We are booking up quickly. If your moving date is flexible, please add 2nd and 3rd options as a backup.We are booking up quickly. If your moving date is flexible, please add 2nd and 3rd options as a backup.PLEASE NOTE: If the pickup location is over 5 hours away from Chicago, we will assign a 3 day pickup window that will start with the date you have provided belowHiddenDesktop or MobileDesktopMobilePickup Date (1st choice)* MM slash DD slash YYYY Pickup Date (2nd choice) MM slash DD slash YYYY Pickup Date (3rd choice) MM slash DD slash YYYY Preferred Time (1st choice)*TimeAnytimeAMNoonPMPreferred Time (2nd choice)TimeAnytimeAMNoonPMPreferred Time (3rd choice)TimeAnytimeAMNoonPMPickup Date (1st choice)* MM slash DD slash YYYY Preferred Time (1st choice)*TimeAnytimeAMNoonPMPickup Date (2nd choice) MM slash DD slash YYYY Preferred Time (2nd choice)TimeAnytimeAMNoonPMPickup Date (3rd choice) MM slash DD slash YYYY Preferred Time (3rd choice)TimeAnytimeAMNoonPMWill you be present at pickup? Yes No Name Please give us the name and number of the person who will be presentPhoneIf known, List the 1st day you are available to receive your items MM slash DD slash YYYY Delivery window: The delivery window starts from the first date that you are able to receive the shipment. Your shipment can be delivered any day on or after that date within the window listed below. East to East, East to Midwest, Midwest to Midwest, Midwest to West, Midwest to East, West to West, West to Midwest - 1 to 14 business days from the first available delivery date. West to East, East to West - 1 to 21 business days from the first available delivery date. Exceptions: all deliveries to NH, VT, ME, South TX, West TX, MN, SD, ND, WY, MT, ID, OR, WA, Keys in FL - 1 to 21 business days from the first available delivery date.Our basic price is based on delivery to a ground level, elevator building or up to 7 steps up or down. The cost is also based on us being able to deliver with a 53' trailer (72' bumper to bumper) that can access the area and park within 75' from your apartment / house door.Do you know your delivery address? Yes No Delivery City* Delivery State* Delivery City* Delivery State* Moving To:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Moving To* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Delivery Entrance*Please selectHouseGround LevelStairsElevatorNumber of Floors12345PLEASE NOTE: IF you have not spoken with our representative AND your move is from or to a 3rd floor walkup: an additional mover will be required at an additional $35.00 per hour over the quoted rate. By checking this box, you agree to the terms below PLEASE NOTE: IF you have not spoken with our representative AND your move is from or to a 3rd floor walkup: an additional mover will be required at an additional $35.00 per hour over the quoted rate. Do you have an extra stop? Yes No Pickup or delivery? Pickup Delivery Please provide address of the additional stop* Street Address Unit City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Extra Stop Entrance*Please selectHouseGround LevelStairsElevatorNumber of Floors12345Number of Bedrooms PLEASE NOTE: IF you have not spoken with our representative AND your move is from or to a 3rd floor walkup: an additional mover will be required at an additional $35.00 per hour over the quoted rate. By checking this box, you agree to the terms below PLEASE NOTE: IF you have not spoken with our representative AND your move is from or to a 3rd floor walkup: an additional mover will be required at an additional $35.00 per hour over the quoted rate. Will you be present at delivery? Yes No Name Please give us the name and number of the person who will be presentPhoneCan we access and park 53' trailer (72' bumper to bumper) within 75' from your apartment door / house door?* Yes No Please list here any special instructions or description of a special items that we need to handle (example: if you need to reserve an elevator, provide COI, grand baby piano, item that weighs over 400 lbs…)Mobile Number*Alternative PhonePlease describe the service Payment Amount* Billing Address My Billing Address is the same as Pickup LocationBilling Address*Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name I agree to the followingPayment Terms 1* Credit Card Slip*This card must be present at the pickup for a credit card slip. Send us copy of the card (back and front) to [email protected] only if this card will not be present.Payment Terms 2* Payment Method & Schedule*The full balance is due at delivery by cash, money order or cashier's check. 3% convenience fee will be added if you choose to use a credit card (card must be present) . No personal checks are accepted.Payment Terms 3* Cancellation Policy*This deposit is fully refundable until 3 business day before the pickup. If you cancel or change the dates within the 3 business days before the pickup – this deposit will be forfeited.Payment Terms 1* Credit Card Slip & Cancellation*This card must be present at the pickup for a credit card slip. Send us copy of the card (back and front) to [email protected] only if this card will not be present.This deposit is fully refundable until 3 business day before the pickup. If you cancel or change the dates within the 3 business days before the pickup – this deposit will be forfeited.Payment Terms 2* Payment Schedule*50% of the total move cost shall be paid at the time of pickup by cash, cashier's check, postal money order. Credit card accepted if present with 3% convenience fee added. The Final Balance should be paid upon the arrival at the delivery location by cash or postal money order. Credit card is accepted only if paid 48 hours in advance with 3% convenience fee. Copy of the card must be emailed to [email protected].Payment Terms 1* Credit Card Slip*To complete the payment, please email the copy of this card (front and back) to [email protected] (unless we already have it on file for you).NameThis field is for validation purposes and should be left unchanged. Δ
