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SCHEDULE "A" SECURITY LIST ~ Brancfi Address Stamp ~
Describe furniture by cotor and styte: ~ `
Abbreviations - Mod. , Trad. , Col Medi Fr. P.
Describe appliance by size and brand. Verbal L.ist3 ~ ~
~ [j Yes ~ No ~ ~
T
Sofa~ # Style TV ~
a Color Size I ~ I !
Lounge Style N ^~`0 r Brand ~ s
#
' ~ Chairs / ' Color T A~ Size . Brand
; Q Occ. T/
~ Chairs # Color Size Brand
End Stereo ~ 3
V Tabtes ~ St le ~ O O~ ~ T rand
Z Cotfee w Room Ai r ~
- Tabies # St le C~- V Conditioners # Size Brand
~ Rugs z Range ~ '
~ Size Color < Brand
Carpet - Re(rigerator ~ '
Size Color Brand
LamPs # n' Dishwasher
~~q' a Brand ~
Dinette Set 1~ Q~CS Q ~freezer 1 _
~ Z t Pieces ~ St le- 1~. Brand f ..~5~~ h ll,p ttd a
~ W ~ Washer /
~ Tabtes ~ ~ St !e Brand v A ~c ~C~}-
a o Chairs # Style T71 ~ Dryer
'+i Color ~"`~t- ~ B rand ~ 1~e f R~ .
~ o~-' Sofa ' Style Sewing Machine
~ Color Brand ~t 1~ BY •
W Desk Vacuum
z z T Brand
ip - $ N Power Type
~ Lawn Mower Brand •
~ Suite G~,oa?- yS ~ Piano i
Pieces~ S le - 1~M1 ~ T Brand ~
~ N Suite ~ ~d Z Organ
3~ Pietxs~ S le If'~WfS T Brand
~ Suite a Major - ~
~ # Pieces St le ~ Power Tools
' ~ Suite
~ ~ ~ W f1~E0 ~Lt~.
~ t,~ vr~TY
~ Pieces St le v ;E CC
~ Rugs or Si ze ' ~ ~ n r~
W Car ts # Color ~ - ~ ~
0° Chairs
~
Color ~ ~2 : 43
La ~
- ~'n T I A~
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When and Where was furnitur urchased ? ~ ~ ~ ~ ~ '~~"K ~ {
Cost $ ~ ` t ~ v ~ • ~
Custort~er's estimate of value~, CL~
T'~~
With what company is the furniture iRSUred: Name
Poticy ~ Address:
Schedule "A" of ~ty eement dated the day of , 19 •
Ori ~ ~ i
_ ~?~i,~u ~
~ (Date) (Sea I )
( itness) (Date) (Seal) ;
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L-48
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