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SCHEDULE "A" SECURITY LlST ' Bre~ch Address Stamp
Describe furniture by color and style:
Abbreviations - Mod. , Trad. , Col Medi Fr. P. ~
Describe appiiance by size and b~and. ~ Verbal List?
[J Yes (_I No
Sofas # Style TV i.
" Color Size .Z G- Brand ~ G~
4 ~ Loun Style ° T~
' ~ Size i$ Brand '
! O Chairs # Color Oc.~
~ O Occ. N
~ a: Chairs f Color Size - Brand
! End Stereo
i v Tables # S le v? T Brand
~ Z ~Otfee w Room Air
Tables # ' St le U Conditioners Size Brand
' > Rugs , ~ z Range _
~ Size / 2 G Color TA Q Brand ~G~
- Refrigerator
~ ~~t J
` Size - Color - Brand HoT /yD/A/T
i ~~5 # a Dishwasher
~ z T a B~and -
i
I~ Dinette Set Q Freezer
I~ Z ~ Pieces 7 S Ie Brand ~ F
W End Washer
F~ ~ Tables # - S le Brand -
~ o Chairs # StY~e ~ryer _
ui - Color Brand
~ ~ o F- Sofa , Style Sewing Machine
~ ~ ~ Color Brand
',''r' w pesk Vacuum
R Z T Brand //y ~ - /1
r- _ Power TYPe
P p > lawn Mower y Brand
, Suite 7 0 Piano _
~ ~ Pieces .7 S le T Brand
W Organ
~ Suite Z
~ `n # Pieces S le T Brand
i g ~ Major
~ Suite ~
~ ~ # Pieces St le J Power Tools
~ ~ Suite w FILEp ~ND
' ~ # Pieces 5 le V
I~ Rugs or _ Size ,n C~ ROCER ppjTq~ FIA.
; W Car ts t Color - " ~
0° Chairs • g 0 VERIFIEp URT
~
' Color ~
i ~~5 ~ ~ ~ li ~ '
T
When and Where was furniture purchased ? ~t S ~ G`~"ll'
Custorr~er's estimate of value
~z
With what compa~y is the furniture insured: Name i-~sic ia ~'~~R v
po~~Cy * Address.
Schedule "A" of Security Agreement dated the day of . 19~
Original Loa o. .
p_ 1° t-~-
(Wit~ess) (Date) (Seal)
(Witness) lDate) (Seal)
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L-48
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