Step 1 of 4

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Data for evacuation

Do you know when you want to vacate the premises?(Required)YesYes, and I'm flexible
No, but I can give an estimate
new
Date(Required)

DD slash MM slash YYYY
Choose the date you want to vacate
Start time09:0009:3010:0010:3011:0011:3012:0012:3013:0013:3014:0014:3015:0015:3016:0016:3017:0017:3018:3019:00Choose the time you want to start

Contact gegevens:

E-mail(Required)

Telephone number(Required) If you want to indicate additional telephone numbers or contact details, you can do so in step 5 in the comments field.
Company name Please leave empty if not applicable.
Contact person
Please leave empty if not applicable.

Address:

Country(Required)NederlandBelgiëDuitslandFrankrijkOverigeAddress(Required) House number(Required) Postcode(Required) Place name

Information clearing address:

Deeper(Required)Select a floorGround Floorbasement1st floor2nd floore3rd floor4th floor or higherClearance technology(Required)Choose a relocation techniqueNot applicableStairsHoistingInternal liftRemoval liftDistance between parking space and front door(Required)Select a distance0 Meter10 Meter20 Meter30 Meter40 Meter50 Meter75 Meter100 Meter150 metres or more

Invoice data:

Invoice address(Required)Clearance addressAlternative addressCountryNederlandBelgiëDuitslandFrankrijkStraat House number Postcode Venue

Extra information:

Number of square meters of property
(Required) Are there people who help?(Required)no (none)
1234Would you like to help with the eviction? Here you can indicate how many helpers you have ready on the evacuation day, we will include this in the estimate and also for the composition of the evacuation team.

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CommentsThis field is for validation purposes and should be left unchanged.