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SCHEDULE •A• SECURITY LIST ~ Branch Address Stamp i ~
Describe furniture by color and style: i
Abbreviations - Mod. , Trad. , Col Medi Fr. P. j
Describe appliance by size and brand. Verbal List? `
~j'Yes No ~
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Sofas ~f Style TV ~ /7 ~ / ~
Color b' Size ~ 1..~/~ Brand ~v
~ Lou~ge Style TV ti £ , `
~ Chairs ~ Color Size ~,lJ (~rand O~
o Occ. , ~
~ Chairs # Colo ~,s+r ~ Size Brand
End Stereo
v ( Tables i~ St le ~n T Brand ~
z Coffee W Room Air
- Tables • St le U Conditioners / Size Brand
~ Rugs z Range
~ Size olor Q Bra~d ~5
Carpet - . - Refrigerator -
Size O~//e Color ~ Brand s~/~ ~G -
~ # / a Dishwasher
T lQ a Brand
Dinette Set Q Freezer
~ Z # Pieces S le Brand
' ~ W End Washer ~
~ 'Q ~ Tables • St le Brand ~2 S~j s.~
~ ?Y o Chairs # Style Dryer ~
! + Color Brand
~ ;
I v o f- Sofa Style Sewing Machine
~ 2 F- Color Brand
~ W Desk Vacuum ~e'
~ Z z T Brand G~/~-~
~ Q a ~N~ l. bS~ ~ Ol.l~~ LawnrMower Br nd
~ w Suite / ;u 0 Piano _
~ #i Pieces t le ef~u W T Brand
~ Suite /„/~si y,~ Organ
, ~ ^ - ~ ~ ~ Pieces 5 le G • R ~ Z T Brand ~
~ ~ ~
G~~i;p ~ /1~_ f~ _~JSt J Major ~
~ ~ ~ ~ Pieces ~~~St I ,e J Power Tools
O ~ ~
Suite a ~ty ~ w
~ ~ Pieces St le
~ ~ Rugs or I_' ~lor ~ F~lEO AMD RECOROED
W Car ts ~i~~
~ ° Chairs ~ ~ j~( e~• ' ~ CLE KCCRiCUiT CO ~
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~ Color w 1 ;
~ Lamps A ~ ' ~
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When and Where was furniture purchased ? Cost S `
~ Customer's estimate of value f
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With what company is the furniture insured: Name
E- ~
r Policy # Address: "
~ Schedul ~pA of Security Agreement dated the day ot~ - , 19 i
~ Ori inal oan No. - ~
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~ ~ y~ ~S .
~ (Witness) - (Dat (Seal)
~ (Witness) (Date) (Seal)
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