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SCHEDl1LE °A• SECURITY L1ST ! Branch Addresi Stamp
Describe furniture by color and style: ~
/lbbrevistions - Mod., Trad. , Cof . , Medi . , Fr. P. _ ~ ~
Oescribe apptlance by size ar~d brand. ~ Verbal List? - ~
~ [J Yes No - '
; Safas ~ Sty e N _
~ " Coto~ Site Srand . ~ ` ~ ~
~ Lounge ~n Style T/ p~ s
~ I 0 Chairs # d~.. Color Si:e Brand
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f C~ _ Occ. . TV _
Chairs Color Slze Brand -
~ ~ Stereo
f v Ta61~ ~ Style v? T ' Brsnd ~/~,7 /
i Z Coftee tu Rown ni r 7
~ Tables # -1 ~ S le U Conditioners / Size ~~~Brand
' , R~3 z R~ lt
! ~ Size . Color d ~ Brand _ -
' ~~t _ - Refrigerator . - ~
; Size Color ~ 8rand
i ~mPs # t{ d Dishwasher
d'` T d Brand
~ Dinette Se:. Freezer , -
Z # Pieces S 1~
~ W Br~d _ -
-o End Washer e ~
~ T~bles { S 1~ Brand
o Chairs # Slyle Dryer
~ Cotor Brand
C' o f- Sofa Style _ Sewing Machine .
rr h Color Brand
~ desk . Vacuum ~ .
Z 8rand p
0 . - N Pawer ~a _ Y(x , ~
~ Lawn Mower Brand ~,O , `s'
Suite piano • _
( # Pieces ~ 5 le W T Brand
i N Suite Z. pryan .
~ # Pieces S le T Brartd
~ ~ Suite- `t Major
~ Piece.s " S le J Power Tools -
' ~ Suite ~JL
i°C # Pleces S le ~ r luC~k~ ~E~OApE
i~ Rugs cr Size _ E~ P
°J Car 'ts # Color ~ ~p ~lERl~ ~i;;~Oi~R,s
i Chairs # ~ .
j Coior .
~ ~~S # a~ N '~6
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Whc~ and Wt~ere was furnilure purct~ased ? ~t g ~2~/Q~
Custaner's estimate of value
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With w~iat camRany is the furniture insured: Name
Polfry i Address: ~
Sched " of Security Agreement dated the day of , 19 ~ ;
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