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* 1. What would you like to move?

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* 2. Moving From (Origin)

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* 3. Moving To (Destination Country)

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* 4. When do you want to move?

Date
Time

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* 5. Moving Items(What goods you would like to move)?

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* 6. Do you have any other comments, questions, or concerns?

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* 7. Your Contact Details?

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* 8. Ho Do You Know About ShoppRe?

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