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HomeMy WebLinkAbout0440 ! i SCNEDULE •A" SECURITY LIST ~ Branch Address Stamp Describe furniture by color. and style: ~ Abbreviations - Mod. , Trad. , Col Medi Fr. P. i Describe appliance by size and bra~d. Verbai List? ~ [J Yes 1-I No i Sofas • Style N 4 d Color~~ Size I f ; ~ Lounge Style N . o Chairs # Color Size Brand ~ O Occ. N ~ Chairs ~ Color Size Brand ' End Stereo v Tables # St le ~n T Brand ; z Coffee w Room Afr - Tables # St le ~1 Canditioners Size Brand ~ Rugs z Range ~ Size Color a Brand ~~t - Refrigerator Size Color Brand - ~ ~~V~ v ' ~~ps # . a Dishwasher T Brand ~ Dinette Set a Freezer ~ Z ~ Pieces ' St le Qt Brand p W End . Washer ~ Tables # St le Brand ~ o Chairs Style ~ Dryer W Color Brand ~ v o?- Sofa Style Sewing Machine ' ~ i-- ~ Color Brand w pesk Vacuum i z Z T Brand i p Q N . Power Type , Lawn Mower Brand ° ~ Suite ~ Piano ~ i pie~es e W 'f Brand ~ ; Suite Z Organ s ~ ~ ~ Pieces S `j Q T - Brand ; Suite ~ 1 Major p ~ ~ Pieces J Power Tools OR~ ~ Suite W ' ~''•-=v~ - L~T~T • . ~ ~ # Pieces St le ~ - ~ ~ ; ~ Rugs or Si ze ~ ~ ~5 s j"' Car ts # Color _ ~ ~ ~ j °D Chairs # ~ - 1 Pl~ 1~ • ~ ; Colo~ ~ i , Lamps # ~ € T i- ; ~ ~ ~ • - . ~ When and Where was furniture purchased . ~R~~:_y 5 Custort~er's estimate of value ~ With. what company is the furniture insured: Name r = Policy ~ Address: - ~ ~ Schedu of Se ur' gre t dated the day of , 19 g rigi ~ . ~ ~ ~ ~ ~ ate) ~ (Seal) ~ ~ (Witness Dat (Seal) ~ i ess a e ea ~ a - ~ l- 48 UM~f r 4~ ~ DV{+7? ~ : ~ i . . - .~-'a-': _ . _ ~f+~~+, c*~+.'+.•~ t.a'v?-"~r' .y" ~ s.xA,^~~ . _ . au.~^ _'d~~...~'~"~.~.,~ .