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SCHEDULE "A° SECURITY ~IST : Branch Address Stamp I
Describe furniture by color and style: ~ ~
Abbreviations - Mod. . Trad. , Col. , Medi Fr. P. • ~ i
Describe appliance by size a~d brand. j~al List? ~
{ Yes i~l No ~
i
Sofas i Style TV ) ~ -
Color Size ~W. ~ ~ Brand i ~ ~
~ Lou~ge Style TV
o Chairs ~ Coior Size Brand
O Occ. ~
~ Chairs A f~ Color S+~re Brand ( G
End Stereo / i
v Tables ~ St le ' v? T Brand /C.~G~/Q d~~
Z Coftee . W Room Air
- Tables Ik St le ~ V Conditioners # Size Brand
~ Rugs z Range
~ Size Cofor Q Brand
Carpet - Refrigerator
Size Color Brand
Lamps ~ / a Dishwasher
T h.BO a Brand
inette Set Q Freezer.
~ Z R Pieces St te Brand
~ W End Washer
~ f Tables !k St le Brand
a o; Chairs # Style . - Dryrer
W ~ Color Brand
" o~ Sofa Style Sewing Machine /
z F- Color Brand x~G /'+~Q'/t"-~~
j ` W ~ Desk Vacuum
~ z ~ Type ~ Brand
~ A -j ~ Power Type
~ ~ Lawn Mower Brand
~ ~
~ , ; Suite ~~~y.~,u. / S -L C ~ Piano
f ~ # Piec Style ~ W T Brand
i ~ E
Sui~ te ~ Z Organ
t ~ # Pieces St le Q T Brand
~ ~ Suite J Major ~ / / -
~ ~ # Pieces Style f ~ Power Tools 9~M 1~~~ l~. ~I
~ ~ ~ Suite W A ' /
~ ~ # Pieces St te vl~.~ /Q~ l~
~ ~ Rugs or Size N ~ ~ ~
Car ts ~ Color
; - -
r i Chairs ~ g
~ ' Color
~ Lamps A - ~ i ~E~:
~ ~~y:lti: .
_ T ~ _
~ ~.~~r - _~4t
Whe~ and Where was furniture purchased ? Cost 5 'F r.': ~ ~ i^ ~
3 ~
~ Customer's estirr~te of value ~ ~`r ~
r With what company is the furniture insured: Name 4~.~"~ M A~ Ai~ ~
c
t Policy % Address: '
~ Schedu of Security Agreem t dated the ~ day , 19~~
~ O ginal Loan No.
2 , ~ ~
~
` / 7~
~
~ (Witness) (D e) ~ (Seal) ~r `
~ a~% . ~~f/'~
~ (Witness) (Date) (Seal)
~
~
~ ~tness . a e ea
k
L- YO
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~ ~ Rt 25~ f~~~ 44~