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SCHEOULE ".4" SECURITY LIST Br ess Stamp '
Describe furniture by color and styte: ' ~
.
Abbreviations - Mod.. Trad.. ~ot., Medi., Fr. P.
Qesc~ibe appliance by size and brand e~ ist~
Yes No
Style
Sofas . Color r s~ TV Size Brand
Style ~
L Loun Chairs . Color 3~ TV Size 6rand
~ . -
V Occ. Chairs . l Color ~ A T\~ Size Brand
I P
N End Tables . St le P Stereo T e Brand
~ ~ Room _
Coffe~ Tables . St le 1 Airconditioners . Size Brand
R A ~
0 Ru Size Cofor N Ra e: Brand -
0 - C :
M Car et Size Colar E Ref~i rator: 8rand
S
Lam s. e 0lshv~asher: Brand
D
~ D Dinett~ Set . Pieces St le Freezer: Brared
N ~
~ N End Tables . St le Washer: Brand
N E Style
G T Chairs . Color D~ er: B~and
j T
' R E Sofa St le Color Sewin Machine: Brand ~
k ~
~ 0 Desk T e M Vacuum: Brand ~
, ~ E ~ Ty~ '
° ~v S Power Lawn Mower: Brand ;
C TYPe ~
Suite . Pieces S~ St le E Piano: Brand ~
L TYPQ
B Suite . Pcs. St le l Oraan: Brand
E A -
D Suite . Pcs. St le ! N Ma"or Power Tools
R . E `
0 Suite . Pcs. St ~e ~
p Site U ST.~lfCtE COUNTY flA.
~•.i Ru or Car ts . Color $ ROC~R POtTRAS
~ECOR~ YERJFIED ~
S
Chairs . Color
. 44
Lam s . Tv~e ~ ~
ti"~hen and Where was furniture purchased _ ~~~~a3 Cosi S
r
2 ~ ee p`_
Customsr's estimate of Value
With what company is the furniture insured: IVame
i
Policy . Address
Schedule A of Secvrity Agreement dated the day of , 19 , Orioinal loan
No. - ~
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qy yG ~
r . l- Q~
) 1 Seal )
( ~'Vitness 1 ( 0 te ~
~ ~
( Witn~ss ~ ( Oate ? ( Scal ) :
t
( ~"1~tness ) ( Date ) ~ ( Seal )
L-48
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