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HomeMy WebLinkAbout0748 1 . _ ~ ' ~ ~_~__~~~t SCHEDUIE 'A" SECURIIY LIST ' Branch Address Stamp . I Describe turniture by color and style: i Nbbreviations - Mod. , Trad. , Col. , Medi Fr. P. i Describe applia~ce by size and brand. Verbal List? ' ' ~ Lj Yes No 1 ~ ~ i ~ Sofas i Style ' - TV s' ' Color a~-yv Size v~ y-~-. C~dZ. Brand ~~Q~„~ { i~ Lounge n Style ~ N r 0 Chairs i oC._ Color Size ~ .s;e,. Brand ~ ~ O Occ. 1`V , - ! i ~ Chairs f Color ~C.c<-cs-~ Size /C -4-~- Brand ~ ' End Stereo ~~7 Tables ! ~(i St le v~ T ~ - 8rand Jt¢-s~ l i z Coffee Room Air / o~ _ -~y,~ ~ Tables # St le C~ t~ V Conditioners~ ao~5ize Brand~ r~~ ~ ~ Rugs z Range . J Size Color ~ 8rand ; Carpet - Refrigerator ~ f Si:e L~ ~ Color ~ Brand ~ ; Lamps # ~ { a Dishwasher ~ j T •~~-~t~ a Brand r~ E ~ Dinette Set a Freezer ~ ~ Z # Pieces St le . Brand p ~ End Washer - ; - Tables # 5 le Brand t o Chairs ~ Style Dryer ~ ~ W Color Brand { a Sofa Style Sewing Machine ; F- Color 8rand ~ ~ w~~ ~ W Desk Vacuum t z ~ T ~ Brand t ~ Po~wer Type ~ , - tawn Mower Brand ~ Suite ~ 79?~~ 0 Piano ~ # Pieces St le ~ W T Brand ~ Suite '~i ~ Organ ~ # Pieces ~ S(e Q T Brand ' - Suite ~ Ma~or p _,n ~ ~ ~ Pieces S le'~11~ J Power Tools - Jr' ~-~J~t~C ~ ~ ~ Suite } ~ # Pieces St te W . ~ Q v - ~~~r-+a.ss.w - ~..-~-~'rc~' - e. ~ Rugs o~ Size ~ N ~2~~+*~ W Ca~ ts • / ~ ~ ~ ~L Color _ _ °Q Chairs # ~ Color ~~9 Lamps • ' - • ' ; i _ 7, •~l,.:T ?=L~:. .,c ~pn ; When and Where was furniture purchased ~ ~ Cost S 't/~+~)a7JLl ' Customer's estimate of value la ,r~ p ~ ~7,8 QC(, ~ 9• C2 ~ J With what company is the furniture insured: Name ; Policy # Address: ~ ~ Sched f Sec rit t dated the day of 19 ' . ~ Cl~~i' ~r i.., _~~J~ti ~ rigin ~ ~ y a ` O . - (D Seai) 3 ~ l ~ ~ ~ ( ' ess) (Date (Seal) ~ ess a e ea ! ; ~-,8 ~ 299 ~~E 748 ~ ~ l , _ . - ~M - - - - ~~~~~.z~i-=-~ x:.~ . . -