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SCNEDULE "l~" SECURITY LIST ' Branch Address Stamp ~
Describe furniture by color and style: i•
Abbreviations - Mod. , Trad. , Col Medi Fr. P.
Describe appliance by si:e and brand. ~ Verbal Listt . ~
[j Yes (=1 No
So(as ~ - Style TV
Color N Size . Brand
g Low?yye Style TV
O Chairs t Color Size Brand
O Occ. N C- .
~ Chairs t Color Size Brand ~G ~-s {
End Stenw
u Tables i 5~e ~ ~ 'T Brand
2 Coffee W Room Air
- Tables # St te v Conditianers # Size Brand
~ 9 ^ 2 Range , :
- 5 ie ~d?- ~ Color a Brand ;
~ • - Retrigerator ~
Carpet -i Brand 1 \ Da~ =
Si ze Color '
~~S # a Dishwasher {
~ T Brand `
~ Z Dinette Set St le ~ ~ Br nd r w~U ~ ~
~ # Pieces J ' r h f `
W End Washer
;o
!o ~ ~ Tables # S le Brand n~ o r~
~ o Chairs # Style ~~'Ye~ ~ ~
W Color Brand t
~ o H Sofa . Style Sewing Machine ~
~z F.. Color Brand ~ C r
~ ` w ~ Desk Vacuum r~
~ z Z_ T Br~d
~ ~ Power TYPe
~ p a ~ Lawn Mower Brand ~
{ Suite ~ 0 Piano " '
i Pieces 5 le t~i~ W T Brand '
~ Suite Z Organ Brand
' # Pieces St le ~ T ;
~ Suite ~ Major F:~ED AtlO RECORDEO..
Power Tools
~ # Pieces St le J - - " ' ` •
~ Suite w - . . , 'rir':E=:' ~
~ ~ ~ Pieces St le V ~ ~
~ Rugs or n Size N - _ ~
Car ts t v~ Color f ~Or _ 'j
~ 00 Chairs ! ~ ~f • ~
~ Color `
Lamps ~ ~ s
~ . T t:L~ R•?t Ci~ ~U':' 'i.7t~r, • '
~ When and Where was furniture p rchased? _ Cost ~
~ Customer's estimate of value r~~V.L7~ -
- With what company is the furniture insured: Name
~ Policy ~ Address
~ Sch 'A" ec y ement dated the day of . 19
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~ Origina . ~
~ , ~ r0 I
~ (Date) ~
~ ~
~ (Wi ss) (Date) (Seal)
a e ~ ~I
~ i ness 'I
~ L-48
600K~ ~ ~
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