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SCHEDULE "A" SECURITY LlST ' B~anch Address Siamp
Describe turniture by color and style: ~ ~ ~
Abbreviations - Mod. , Trad. , Col Medi Fr. P. ;
Describe appliance by size and brand. ! Verbal List~ ~ ~
I Yes ? No !
Sofas f ~ Style M p 'ry „ a
Color Size Brand ~ •
~ l~ounge Style T/
i
~ Chairs f Color Size Brand
o Occ. 1'V - ~
~ Chairs # Color Size Brand '
E~d 5tereo /1 ~
v ~ Tables i St te v~ T ~~'1 ~ F/+~ C~s' Brand C~ ;
Z Coffee w Room Ai~ .
- Tabtes ~ St le U Cot~ditioners # Size Brand
~ i Ru95 . z Range '
~ Si:e Color ~i Q Brand =
Carpet Refrigerator i
' Size Color J Brand - f
~ LamPs ~ a' Dishwasher i
'f n' Srand '
~ Dinette Set Q Free=er ' i
~ Z~ ~ Pieces ' St le MO~• ~ Brand =
O W :
o ~ End Washer i
~ ~ Tables # St le 8rand ;
~ o~ Chairs ~ Style Mp Dryer
W ~ Color Brand ~
" o F- ~ Sota Style 5ewing Machine %
Z F- ' Color Brand - -
~ '~'i ' Uesk Vacuum
z z' T .
~ Brand
p 0 ~ Power TyRe .
_ ~ Lawn Mower Brand t
Suite + 0 Piano ' ;
: # Pieces S le W T Brand
Suite Organ
' # Pieces St !e Z T Brand
~ Suite ~ Major
~ ~ # Pieces Styl-~ Power Tools Fi~~`% .~CORCED
~ i Suite ~ • - ~ ~ ~ ~ i
i.,~ . ,
' # Pieats St le w ^ ~ . t
~ Rugs or Si ze V ~ 3
, u' Car ts • Cotor ~ ~
C0 Chairs #
~ L ~
ColOr -
Lamps ~ ~ . ~
` T , 9 ;
When and Where was furniture urchased ? t ~ ~ r '
~ ~A~'i~.XY. a.w C.. K Cost S `J ~~R~' - _ .
Customer's estimate of value . Q'a
With what company is the furniture insured: Name • . ?
Policy ~ Address:
Schedu( ec e nt datec! the day of ,]9 ~
gf na4 ~ t
. . c
wi (Date) e I)
t
,
( ssj (Date) (Seal) ~
i
s a e ea ~
l.- 48 !
80GK ~,a7y PACE 7~2
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