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SCHEDULE "A" SECURITY LIST ~ Branch Address Stamp
Describe turniture by color and style: ~ ;
Abbreviations - Mod. , Trad. , Col Medi Fr. P. ~
Describe appliance by size and brand. { Verbal List? I '
~ L j Yes 1 ~ No ~
Sofas ~ Style TV ~
Color~~OU~~ Si:e ~ r ~ Brand 0 r'OI~
~ Lounge 2 Style Mwh TV ~
O Chairs E J Color ? L Size Brand
O Occ. TV
~ Chairs ~ Color Size Brand
End Stereo
u Tables / S le v~ T _Brand
z Cof/ee 1~0~ W Room Air , -
- Tables / St le (~O V Conditioners / Size Brand
> qp~ z Range
J ~ ~COk)h Z Q Brand
- Refrigerator
Size Color J Brand t~Y~<..° ~~,~~G
~~S ~ n- Dishwasher
T a Brand
, Dinette Set a Freezer
~ Z # Pieces St le / ICa Branc! hL°'~ 4~' r\~
~ w ~ End Washer
~ ~ i Tabies i St le Brand -
i ?Y o, Chairs # Style ~ Dryer -
~ w ~ Color Brand
!
~ v ~ I-, Style ~O~+?~ h Sewing Machine
s ~ F- ~~A ~O~olor pOC Brand
1 ~ W Desk Vacuum
~ B rand
F z z T
T Power TYPe
€ ~ 0 > Lawn Mower Brand
~ Suite Piano
~ ~ ~ Pieces 3 ~h~ ~ T Brand
W Or an
~ Suite 1'p SSC Y' z 9
~ Pieces ~ ~ e Q T Brand
~ o Suite ~ J Power Tools L ~ A
~ Pieces ~ ~
~ Suite W - ' oG p rai R~s +
~ ~ Pieces ~ ~ScSC ~ V ^ 1
- R FrEo
~ Rugs or ~ ~ ~
Car ts ~ ~ -
~ Chairs ~I ~ 22.
g P
~ ~~S ~ 4132.92 '
~ T
~ ~ ,
~ When and Where was furniture purchased ? Cost 5
- Customer's estimate of value
With what company is the furniture insured: Name ~
po~i ~ Address:
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i Sche "A" ec it eem ted the day of . 19
rigina
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~ _ / 1
#
~ ( s (Date) (Seal)
(Date) (Seal)
~ (Witness)
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~ ness a e a
~
~ L-48
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SOOII ~G~7~? YM;f ~9
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