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SCHEDULE "A" SECURITY LIST ~ Branch Address Stamp (
Describe fur~iture by color and style: ~
Abbreviations - Mod. , Trad. , Col. , Medi Fr. P. (
Describe appliance by size and brand. Ve I List? ~
' ~ [ Yes ~=1 No i
Sofas Style TV t' R~ _ ~ ~
Color _ ~ Size 0 Brand ~
~ l.~ounge Sty le ~ 0O N . ~ ~
0 Chairs ~ L' lor Size ~and ~
o Occ. . N . •
~ Chairs # ~ Color d lA~ Size Brand
End Stereo ~
v Tables # S le v? ' T Brand
Z Coffee A' W Room Ai r
° Tables t ~ St le /V~~~ U Conditioners # Size Brand
~ Ru s / ~ ~ z Ran ~
~ Si e ~ ~olor SS fi / h~ a Br d i
~~t - Refrigerator ,
Size ` Color ~ Brand -e /
Larnps # / Dishwasher
T a Brand '
inette Set ~j ~ a Freezer
~ Z? 1~ Pieces St le V Brand
~ W End -Washer }
a Tables t 5 te Brand i
~ o; Chairs 1~ Style Dryer 3
W # Color Brand ~
~ o~'- Sofa Style Sewing Machine
z I- f Color Brand ~
' W Desk Vacuum / r
~ z z T • Brand '
;
p - J n N Power Type ~
~ R > Lawn Mower Brand
' Suite / ) Piano ~
~ , Pieces St le W T Brand
~ ~ ~ Suite z Organ ~
~ ~ # Pieces ~ St le Q T B ~
Suite J Major CI~ G4 M 1' 4A, ¢
~ ~ Pieces St le J Power Tools ~$Gi ii ~
s Suite u, R~~nfiy V~~, ~ C~T COURT ti
# Pieces St le v .
~ ~ Rugs or Size • i!„ S~ '
WfL L !
~ Car ts # Color _ ~
0° Chairs # g ~ ~
Color B
' ` Lamp t
~ ; T
s
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~ When and Where was furniture purchased ? Cost S ~ ~ O~
~ Customer's estimate of value
~ With what company is the furniture insured: Name
~ Poiicy ~1 Address: ?
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~ Schedul A of Security Ag ement dated the day of , 19
~ Or ginat n No. ~ ~
~ ~ r ~ !
~ i: , (Witness) ~ ate (Seal) .
~ ~
~ (Witness) (Date) (Seaq "
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~ " ~ ess a e ea
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