Boutique Pick-Up Request

Name *

First

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you the homeowner? *

If you are not the homeowner please provide further contact information.

Is your neighborhood gated? *

Is your house easily accesible with a box truck? *

Pick-up Details

Items *

Please list all items that you would like picked-up.

Item(s) Condition (Please select any that apply to any items. ) *

Smoking Home
Pet Hair
Stains
Broken
Tears/Rips
Other Damage
None Apply

If you selected any of the above please clarify.

Where is the item located? *

Is the item(s) easy to get to? *

Anything else we should know about the pick-up?

Pictures of Items

Click or drag a file to this area to upload.

Please use this space to upload pictures of the furniture items you are having picked up. Please include pictures of any wear or defects on the items

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Contact BASCA

BASCA INC.

352 Stowe Ave. Orange Park, FL 32073

O: 904-541-1742

F: 904-278-6686

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION FOR BASCA, INC., (REGISTRATION NO. CH26530), MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.