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SCHEDULE •A• SECURITY LIST Branch Address Stamp
Describe furniture by color and styla: -
Abbreviations -Mod. , Traci. , Col . , Medi . , Fr. P.
Describe appliance by size and brand. Verbs) list'
Yes ? No -
Sofas # / Style TV `
' Color Siz - Brand
~ ~ Lounge Style TV
{ O Chairs # Color Sire Brand
O Occ. TV ~ -
~ Chairs # Color Size Brand v
End Stereo
V Tables # 3 S to a T Brand -
z Coffee W Room Air T V
Tables # S le V Conditioners # Size Brand
~ Ru s ~ z ~^9e .
9
J Size J Color d Brand
Carpet - Refrigerator
Size 0 Color -i Brand
temps # ~ _ ~ a Dishwasher
' T Brand
Dinette Se ~ Freezer
z # Pieces le Brand
P W End Washer
O Tables # 5 le Brand '
o Chairs # / Style Dryer
' w l~ Color Brand
o ~ Sofa Style Sewing Machi
F Color Brand
w Desk Vacuum
~ z T Brand
Pawer ~ Ype
C m Lawn Mower Brand
Suite O Piano
i # Pieces S le W T Brand
~ Suite z Organ
I # Pieces S le < T Brand
~ Suite - Major
O # Pieces S le ~ Power Tools
~ O Suite W .
f °C i Pieces S le ~ E7 t•NC ZECORDED
O Rugs or Size a
i Ca is # Color _ ~ r
°D Chain # ~ "ta)a)~J
~ i
Color
Lamps # '-i9 FEB 26 Ah1 I i : 8
€ T
i When and Where was furniture purchased' Cost
g .
Customer's estimate of value O CL~~~M! ~;=•E:+:~T ~~J-J~i
With what company is the furniture insured: Name
# Address:
Sch a •A• Sec re men dated the day of , ' 19
Origi ~ ~ n~
" Sl/
(Date) (S I) a ~Q,,
(Witness) (Date) (Seal)
~ ss a e a
L-na
bOGM ~IVe2 P11G~~7~
t _ - Y. ..f-.~
_ .a".~ - - ~ -.~r