HomeMy WebLinkAbout0404 I
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SCHEDULE "A" SECURITY L1ST , Branch Address Stamp ~
Describe (urniture by color and style_ ;
Abbreviations - Mod. , Trad. , Col. , Medi Fr. P, i
Describe appliance by si:e and brand. I Verba.l List?
I Lj Yes I_i No ~
Sofas 11 ) Style TV
Color ~ Size Iq 1 N~N Brand e 5
: ~ Lounge ~ Styte N .
~ Chairs tk Color ~ K~ Size Brand
O ~ Occ. TV
oC ~ Chairs i Color Size Brand _
` End Stereo
V ' Tables # St le ~n T e ( Brand
Z r Cof(ee u+ Room Ai r .
~ Tables # St le U Conditioners N Size Brand
~ i Rugs z Range
~ ~ Size ~ Color Q~ Brand
Carpet / - ~ Refrigerator `
Size ( Color ~e d Brand @~~eN,'i0U5C _
~ Lamps a Dishwasher
~ T ry t+~ a Brand
! Dinette Set Q Freezer
~ Z' i Pieces Style Brand
C WI End ~ Washer •
~ ~ i T a b l e s ~ t S t l e ~ B r a n d e S~ e ~ l~ P
~ o: Chairs R Styte • ~ Dryer
~ Color Brand ~ -
~ o F- ~ Sofa Style Sewing Machine
' 2 F ~ Color ~ Brand
' ~ u+ . Desk Vacuum
; z
; ` 2 ~ T ( Brand
Power Type
p N Lawn Mower Brand
i.' _ -
~ ~ ! Suite ~ Piaoo
t i ~ Pieces ~ St le W T Brand _ _
! ; , Suite ' Organ
~ ~ Pieces St le ~ Z T Brand
' ~ ~ Suite ~ Major
a ~ # Pieces ~ Style Re a. , ~ Power Tools RDED _
~ ~ ~ Suite ~ • ^ ~ ~~}F~Tv
? ' ~ ~ ~ Pieces Style ` V ~ _ . _ . ~ . . i;~
~ Q ~ Rugs or Si ze i ~ r 4~99
,
~ W i Car ts i Color _ _
~ m Chairs ! ~ At, ; 5
~ t Color z f 6 HTI
Lamps ~ O'
~ T
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~ When and Where was furniture p rchased ? Cost S~• ~
~ Customer's estimate of value _ ~Q . U~
; With what company is the furniture insured: Name
S -
Policy +1 _ Address: _ T - - - -
s Schedule "A" of Sewrity Agreement dated the day of ~1_ ,~~,y~, 19 ,
Origin I L bo. ~
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(W'tnes ) (Date) (Seal)
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~ (Witness) ` (Date) ~(Seal)
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