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SCHEDULE "A" SECURITY LIST ~ Branch Address Stamp
Describe furniture by Dolor and style: `
/lbbreviations -Mod.. Trad., Col., Medi., Fr.P.
Describe appliance by size and brand. Verbal List? , `
[J Yes CI No
S le TV 11 j
Sofas # I Color ~ ~ Size 't' W Brand ~
j ~ Lounge ` Style TV
• O Chairs # Color ~ ~ Size ~W B
O Occ. • ` ~ TV
~ Chairs LAVA r or Sire Brand
End Stereo
U Tables # S le a T Brand
z Coffee W Room Air
Tables # S le v Conditioners # Size Brand
> Rugs - z Range -
J Size Color < Brand ~ -
Carpet Refrigerator
Size Color -i Brand.% )
tamps # Dishwasher
T Brand
Dinette Set ~ Freezer
r`~ Z # Pieces S le ~ r Brand
P W End Washer
~ Tables # S le Brand-
o Chairs # Style Dryer
W Color Brand
c H Sofa Style Sewing Machine
~ F. Color Brand
i ~ W Desk Vacuum
T Brand
' F' ? - Power TYPe
A O > 'Lawn Mower Brand ~
I .I Suite C Piano -
#pieces ~ C, S le ~ ~ T Brand
W
Suite Z Organ
s ' # pieces G S le T Brand
~ ~ ~ Suite - ~ ~ Major
' O # pies S to J Power Tools Td R C b )
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~ Suite W S~. LUCiF Ci~ . /~?s
# Pieces i Il _~~?I; ~:%F~IF!FD ~
~ U
o Rugs or Size m #
W Car is # Color
~ Chairs # Color ~ '79 . f E8 5 AM ~ ~ ~ 36
Lamps # `3
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When and Where was furniture pur aced? CLE~tCSjRCU)T GOURT
Customer's estimate of value ht~ ~ L~
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With what company is the furniture insured: Name
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policy # Address: r
r 5ch~ Agreement dated the day of t9 j
g rigin ~
s (Date) (Seal)
1 G Mi T ;
(Witness) (Date) : ( 1)' h
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eooN ~2 Pats 2~~
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