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SCWEDULE "A° SECURITY LIST . ~ - Branch Address Stamp
Descrjkg; (urniture by color and style: -
A~fireviatio~s - Mod., Trad. , Col. , Medi. , Fr. . ' ~
- Describe appliance by size and brand. ~ erbal List?
Yes No
- Sotas # Style~040N/A~ TV ¢ . ,
a
_ Color GJ~C_ ~ Size ~ ~ Bra~d
' ~ Lounge ~ - Style TV j~ ~ _
0 Chairs ~ : Color Size Brand
. O Occ. . TV _ - '
~ Chairs Color ~ Size ~ Brand
~ End Stereo "
~ v Tables St le CO(,O~V/A~t~ -~n T - Brand ~
z Coffee w Room Air
- Tables # St le L U Conditibners ~ Site Brand ' ~
~ Rugs h, z _ Range~
~ Size Color • ~ Q Brand , " ~
. Carpet ~g ~ Refrigerator ~
Size ~ Color , hJ ~ Brand ~ G ,
Lamps # f Disnwash~r ' _ ~
- ~ T e GQ l OJL~ (r a Brand
Dinette Set Q Freezer t
Z # Pieces ~ St le Brand
~ End ' Wesher
. ~ Tables ~ St le Brand ~ ~ t~
o Chairs # Style Dryer
W Golor - - Brand ~ - - ~
o F' - Sofa Style S2wing achine ~
. h - Cotor _ Brand C, - ~
W Desk Vacuum _ -
z T e - ` Brand ~ L ~L - C rj~ !
- Power Type =
~ ~ ~ Lawn Mower ~ Brand ~
Suite ~j n ~ Piano ~ ~
. ~ Pieces -7 St te ~ • T e Brand i
Suite W Organ - `
~ ~ Pieces St le 1~ ' Z T e Brand `
~ Suite ~ Major - .~g
~ # Pieces 5e le J Power Tools D~ j C. S T~ (,cJ S - ~
~ Suite - W ~ _ ~
~ # Pieces St ie • '
0 V ~
m Car~sets # Co1or N R~E~ ~b ECQROE
- Chairs # _ ~ ~ROCEP P~71T~AE ~
C 1 r -
00
~amps # _ 0 VER+FlEp~.~,~ - -
T e i' ; - -
When and Where was furniture purchased ?a _ Cost $ -
Customer's estimate o~ value 8~ - -
With what company is the furniture insured: Name ~j# tu Cj„~
Policy # Address: -
Schedule "A" ~of Security Agreement dated the 4 dsy of , 19 • .
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(Wltness) Date) (Sea1) - -
(H'itness) - _ (Date) (Seal)
; itness a e . ea
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