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SCHEDULE "A" SECURITY LIST Branch Address Stamp ~
Describe furniture by color and style: ;
Abbreviations - Mod. , Trad. , Col. , Medi Fr. P. `
Describe appliance by size and brand. i Verbal List? j ~
Yes 1-_~ No j z
' Sofas # ' Style TV ?
Color Size .`U1 p~~ Brand
~ Lounge Style f TV
0 Chairs ~ Color ~ Size Brand
o j Occ. TV
~ f Chairs Color Size Brand
r E~d ~ I I Stereo
! Tables # St le ` u~ ~ T e Brand
Z Coffee ' 1 w Room Air _
- Tables ~t St le = U Conditioners # Size Brahd
~ i Rugs z ~ Range
J Size Color Q Brand yj{~j/-~
j Carpet - Refrige~~ S , _
~ Size Color Brand ~ ~
Lamps ~ ~ j Dishwasher ~
~ Type ~ a Brand Z
' Dinette Set ~ Q Freezer
Z # Pieces ~ St le Brand /GG•"~~
I~ c o ~ End Washer
! ~ Tables t1 Style i Brand
` ~ o ~ Chairs ~ Style ~ Dryer ~
i W Color ~ Bra~d
; o F- ~ Sofa Style ( ~ Sewing Machine ,
~ Z F- ; Color , Brand ~
W ; Desk ~ Vacuum
; Z z ~ Type ~ Brand
~ - ~ Power Type
~ G ~ ~ ~ Lawn Mower /~'"y Brand
~ ' Suite ` p Piano
` # Pieces Style ! . Type Brand
? ' Suite A~ ~ ; Organ
~ `n ` ~t Pieces ~ Style i Q ~ T e Brand
? L Suite 1 J Major
~ ~ ~ Pieces ~ Style J Power Tools
~ l Suite ~ ~
~ ~ k Pieces St le ~ w
~ ~ Rugs or Size ; ~ ST. LUClf ~~UhTY FLA.
t~ u+ i ! ROC~R F ~lTRAS
~ Carpets # Color ,
~ ~ Chairs # ~ '
~ Color ~ ~ ~FCORD vF': 4~(~ °
~ i ~
~ ~~5 ~ ~
~ ' Mut 19 10 a6 AN'T5 `
s~ ~ Ty pe '
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~ When and Where was furniture purchased ? Cost 5
Customer's estimate of value ~~f Q Q -J'
- 1Yith what company is the furniture insured: Name
Policy ~ Address: _ ~
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- Schedule "A" of Security Agreement dated the day of , 19 x
, ri oan No. ~ '
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ate~ ~ (Seal) '
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(Witness) (Date) (Seal)
~tness ate ea
~ L 48
Y£ BOOK237 PA~1573
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