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SCHEDtJLE "A• SECURl7Y L15T ' Branch Address Stamp ~
Describe furniture by color a~d style: ~
Abbreviations - Mod. , Trad. , Col Medi Fr. P. ~
Describe appliance by size and brand. 'Verbal List? '
~ ('j Yes No ~ ~
.
Sofas • • Style TV
, Ccior Size •t~~~ Bra~d 1RuL /C G
, ~ Lounge Style 'ry
~ Chairs Color Size Brand
0 Occ. ,j,er,.,.. Ty
~ Chairs ~ Z Color ' Size Brand ~
End - Stereo
V Tables ;.'Z St le v? T Bra~d
Z W Room Ai r
' Tables ~,Z St le ~cs~y~- U Conditioners i Size Bra d
~ R~95 z Range
J Size Color a Brand s
Carpet - Refrigerator
Size Color -i Brand
LamPs ~'.4R~ r~s./~ a Dishwasher~ ~ COROED
T ~O Krl~ Brand s• WCIE COUNTY FCA.
~ Z i Dinette Set ~,'~QA~/ Q Free=er CIERK CIRCUIT
o W F A Pieces /L' St le iv Brand "~r^n- yFq~~. COURT :
i End Washer }
~ M Tables * St le Brand l ~
a o Chairs # 5tyle ~ Dryer ~
W = Color Brand ~
v o` Sofa Style Sewing Machine
~ f- Color . Brand
~ "i Desk Vacuum
Z T Brand ~
p ~ ~ Power Type -
' Lawn Mower ~ Brand
F Suite ~ Piano
! t Pieces S Style i W T Brand
~ ~ Suite Z Orga~ '
i Pieces 3 St le T ~ Brand
~ Suite a Major
~ ~ ~ Pieces •3 St le Power Tools
~ i Suite -
fY W ,
~ PIL'C85 St ~i ~ U
~ Rugs or Size
w ~
Car ts ~ Color 6r' _
~ Chairs !
~
Color
Lamps # z
T ~~4f? I ;
When and Where was furniture purchased ? C~~ $ ~
Customer's estimate of value %
With what company is the furn'rture insured: Name
Policy # Address:
Schedule "A" of Security Agreement dated the day of , 19 ;
Or' i I Loan No. -
- ~ ~ G%' ~-'p -
(Witness) ate) eal)
a
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(Witness) (Date) (Seal)
itness a e ea
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L-q8 S~X rr ~ Z~ ~
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