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SCHEDUIE "A" SECURITY LIST Branch AddKess:'~n~i ~
Describe furniture by color and style: , ~
Abbreviations - Mod. , Trad. , Col Medi Fr. P. ~~r ~1 ~
Describe appliance by size and brand. Verbal List? ! ~ ' 13
' ~ [j Yes Mo
' Sofas # Style Ty '~p
, Color Si:e ' ~ p~ Brand
~ ~ Lounge Style 'TN
~ Chai~s ! Color Size Brand
0 Occ. T/
, cr Chairs # Cotor Size Brand •
End - Stereo
v Tables # S le ~n T Brand
Z Coffee w Room Air . j
Tables ~ 5 le c) Conditioners ~ Size Brand
~ Rugs z Range
J Size Color Q g~~d
Carpet - Refrigerator
Size Color -i Brand
~mPs ~ a Dishwasher t
' a Brand
~ Z t Dinette Set a Freezer '
# Pieces St le Brand
~ W End Washer
~ Tables i ' Style - Brand
o ~ Chairs # Style ~ Dryer ~
W Color Brand - '
o?- Sofa Style Sewing Machine
~ F' Color Brand '
W Desk Vacuum L
~ Z T Brand i r V Acc v T^-
p o ~ Power Type
, ] Lawn Mower Brand
; Suite p~a~p
# Pieces S le W T Brand
Sui te Organ
i Pieces St le Z T Brand
~ Suite a Major
~ # Pieces St le ~ Power Tools.
~ ~ Suite
~ # Pieces St le W
p U y
Rugs or Size ~
W Car ts # Cotor
m Chairs ~
~
Color -
, l.amps t '
T
When and Where was furniture purchased ? Cost $ ~
Customer's estimate of value f,[~(~(~ ao ~
a
,
With what company is the fu ture insured: Name. - ;
Policy ~ Address:
Sch !e °A" Secu i A e ted the day of , 19
Origi n ~
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(Witn s) (Date) (Seal)
(Witne s) (Date) (Seai)
i ness a e ea
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BJOK~91 PACE ~
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