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SCHEDULE "A" SECURfTY UST Branch Address Stamp ~
D~scrlbe Wrnituro by color and sf~ tr;,~_ ~
/lbbrovistions - Mod. , Trsd. , Col . , Medi . , Fr. P. ; ~
D~sc~lbe appliance by size snd bra~d_ Verbal List? l; ~
I Lj Yes i- ~ No ~ _
; fas • S TV ~ - L ~
~ Color Size - Brand
; ~ Lounge Style N ~ ~t,
0 Chairs ! lor Size 8ran
O Occ. TV
oC Chairs ! olo Size Brand _ i
End ~ Stereo .
~ Tables • S te v~ T Brand _
, Z Coffee . W Room Ai
- Tables # St le V Conditioners i Size Brand _
~ Rugs z Range /f - / '
~ Size Color I Q Brand _ ~
~ ~ ~~~~J~ - Retrigerator ' ~
Siz ~~,ZL( Colo~ J Brand _
Lamps ~ Oishwasher :
T Brand _ ~
Olnette Set ~ a Freexer ~
~ Z ~ Pieces St le Brand
~ ~ End ~ i , Washer i
Tsbles ~ St le Brand _
a o Chairs f Styte ~ Dryer
W ~ Color Brand _ _
I~ U o Sofa Sty1e Sewing achine ;
~ ~ ' Color ~ Brand _ ~ ~
~ Oesk Vacuum
' z z ? T Brand
- -
p Q ~ Power YPe
~ ~ lawn Mower Brand ----i_-
~ , Sufte 0 - Piano
# Pietes St I W T Brand ~
Suf te O rgan
~ ! Pieces 3 St le ~ T Brand _ _ . _
Suite Q~ ~ J ~ Major ~
~ ~ i Pleces ~ Style v~~0-'~L ~ J Power Tools - , - - -
€ ' ~ i Suite ~ ` . ~ 448b94 ~ ~
~ • Pieces St 1~ V ~ _ i
~ ; ~ Rugs or Size , 1 ' :
W Ca ts R Color ~i^ ~979 J~J~~ Zt ;
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~ Chairs ~ ~ . fItE4 ANO FtCO~u"tD
Color ~ si t t1C~t~HTY•~A•
s ~~s # ROG UI ~R - -
~ ; T _ CLERK CIRCUIT CWR _
ReCCn3~=.~iJ"'.~-
~ When and Where was furniture purchased ? Cost 5 _ . _ _ _ _
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~ Gustaner's estimate of value ,
~ Wlth what company Is the furniture insured: Name
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€ Potley t Address: _ ~ _ _ _ _
Schedule "A" ot Seturity Agreemen d the day of 19 _
Orlgins n No.
~ ~ ~ - - - _G~-
~ itness) ,(Date)~' (Seal)
~ ' (Witne i~ateJ--- (Seall - - - -
~ ness a e T~a~ - - - - - -
L-~6 ;
F $~~K311 p~E 190 ~