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SCHEDULE °A" SECURITY L~ST Branch Address Stamp
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Describe furniture by color and style: ~ ~
Abbreviations - Mod. , Trad. , Col . , Medi . , Fr. P. ~ ~
Describe appliance by size and brand. V rbal List?
~es I 1 No
/ St le ~ Cl-~-v TV .
Sofas 1~ Color `1s~a~-.-c~ Siz _S Brand /
~ Lounge Style~~ Er-~-4c_. - TV
O Chairs Color c Size Brand
o Occ. ~
~ Chairs ~ Color Size E3rand
End Stereo - _
c~ Tabies N St ie v~ T ~t~ ~ Brand
z Coffee W Room Ai r
- Tables ~t St le U Conditioners / Si2e Brand ~
~ ! Rugs z Range ~ i ~ ~
- Size Color Q Brand ~y
~ - Refrigerator _ ~
S Ze~t Color Brand i.~
~~S ~ ' a Dishwashe
f T e C _-c c~ - a Brand
Dinette Set a Freezer
~ Z, ~1 Pieces St le Brand
~ W End Washer
~ ~ i Tables ~k St le i Brand
~ o; Chairs N Style Dryer
I w ~ Color Brand
E ~ F- i Sofa Style Sewing Machine
' z F... ! Color Brand
~ - Vacuum
. Z W i Desk Brand
Z T
~ o _ i ~ Power ~ ' TYPQ
p , Lawn Alower ~ Brand -'~f~
• - Suite t = Piano
# Pieces ' C, St ~ i"1~~-0~'3 W T Brand
Suite Organ
v~ Z T e Brand
4 Pieces St le Q
~ Suite J Major
~ ~ i 1~ Pieces St le J Power Tools
~ i Suite ~ w
°C # Pieces St le ~ +--;,y~}£0
U ~~~Z :
~ Rugs or Size N _ ~F:~._ r' 'RAS ;
W Car ts ~1 Color - .
m Chairs ~k ~ oFrr,Yi. ; ~ ~r~
~ Color
~ Lamps A
~ p~ 1 ID o9 AH'7
T
~ When and VYhere was furniture purchased ? 5 ,
r- ~
Customer's estimate of value - ~
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With what company is the furniture insured: Name
Addre :
~ Policy fi _
~ ~ , 19 S
- Schedule " of Security Agree a the day of '
~ O na Loan ~ ,
~ i~ ~ ~ z
_ ' ' ~ ~ ea I
~ ~ (Date) ~
~ (Witne
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~ (Seal)
e~ (Witness) (Date)
~ - itness a e ea
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