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SCNEDULE "A• SECURITY LIST ~ Branch Address Stamp
~escribe furniture by oolor and style:
Abbreviations - Mod. , T~ad. , Col Medi Fr. P.
Describe appliance by size and brand. I Verbal List? .
[j Yes No
, Sofas # Styte TV ~y
( Color Size a Brand ~ •
~ L.ounge Style N
~ ~ Chairs # Color • Size Brand
i O Occ. TV ' .
I ~ Chairs ~ - Color Size 6ra~d
I End Stereo
~~7 Tables i S le v? T Brand
; Z Coffee W Roont Air
T~les # St le V Conditioners # Size Brar~d
i >
~ Rugs 2 Range
~ - Size w ~ Color ~ Brand ~
J
Carpet - Refrigerator
Size Color ~ Brand
; Lamps # ~ Dishwasher
' T Brand
i Z ~ Dinette Set F~ee:er
~ # Pieces S le Brancl
W End Washer
~ Tables # 5 le Brand
o Chairs # ~ Style ~ Dryer
W Color Brand
o F- Sofa Style Sewing Machine 4-
~ F- Color Brand
Desk Vacuum !
~ ~ z ~ T ~ Brand
i - N Pawer TYPe
i p
; l.awn Mower Brand
~ Suite 0 Piano
! I ~ Pieces ~ S le W T Brand
i ~ Suite Organ
t Pieces S le ~ T Brand
~ O Suite Major • ~
i ~ Weces S le J Pawer Tools
' ~ Suite W .
~ # Pieces St le FiLED 4?;~ aECORDEO
0 U ,
~ Rugs or Size ~ R4CE~ ?OtTRAS
LL' Ca ts ~ Color ,
j Chairs # ~ RECO~f~ V~P.tf!E4
~ ~ " Color j
I ~"~'s ~ T 40
~ T
~ When and Where was furniture purchased ? Cost S
~ Customer's estimate of value oo ~
i
~ With what company is the furniture insured: Name
~ Policy ~ Address:
~ Schedule "A" of Security Agreement dated the day of , 19 ~eS ;
~ Origi 1 No.
~ ~ .Ci /o 7~ .
~ (VYitness) (Date) (Seal~
~ (Witness) (Date) (Seal)
~ i ss a e ea ~
~ 1
~ L-48 Bo~245 ~i04~
~ .
~ 4 , _
, : . ....E _ _ _ ,q~.~ _
ly..'~R' fi-e°'tY.~.MS
~r.sii 4-: ~ ~ . ~ r
~ . . _ . . . ''d"
. . . :Svi . .