Home Inventory PDF - COUNTRY Financial

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mirrors shelves books bookcases chests fireplace equipment musical instrument desk clocks radios stereo television ... p
Living Room Item

Original Cost Purchase Date

Den/Family Room Serial/I.D. Number

Current Value

sofa chairs tables lamps draperies area rugs mirrors shelves books bookcases chests fireplace equipment musical instrument desk clocks radios stereo television DVD player CD player MP3 player CDs DVDs home theater big screen TV tel. answ. mach. cell phone pager fine arts pictures ornaments collections

Item

Original Cost Purchase Date

Serial/I.D. Number

Current Value

Subtotal

0.00 $______________

sofa chairs tables lamps draperies area rugs mirrors shelves books bookcases chests fireplace equipment musical instruments office equipment desk clocks radios stereo television DVD player CD player MP3 player CDs DVDs home theater big screen TV tel. answ. machine auxiliary heat toys sewing machine game tables fine arts pictures ornaments

(coins, stamps, etc.)

other

Subtotal

0.00 $______________

Kitchen Item

Original Cost Purchase Date

Bathroom Serial/I.D. Number

Current Value

table & chairs refrigerator stove microwave oven freezer stove dishwasher appliances dishes glassware silverware pots & pans utensils cookbooks hutch curtains area rugs linens supplies clock radio tel. ans. machine fine arts pictures ornaments other

Item

Original Cost Purchase Date

Serial/I.D. Number

Current Value

Subtotal

0.00 $______________

mirrors scale clothes hamper medicine cabinet shelves electric appliances linens cosmetics medicines curtains area rugs lamps clock radio heater ornaments pictures supplies other

Subtotal

0.00 $______________

Dining Room Item

Original Cost Purchase Date

Bedrooms Serial/I.D. Number

Current Value

table & chairs buffet silverware glassware dishes draperies linens area rugs lamps clock fine arts lamps clock fine arts pictures ornaments other

Item

Original Cost Purchase Date

Serial/I.D. Number

Current Value

Subtotal

0.00 $______________

beds dressers chests dressing tables nightstands mirrors lamps clocks radios desks chairs draperies area rugs linens shelves books bookcases television stereo telephone toys nursery supplies fine arts ornaments pictures other

Subtotal

0.00 $______________

Basement/Garage/Attic Item

Original Cost Purchase Date

Clothing/Personal Effects (Women & Girls)

Serial/I.D. Number

Current Value

stored furniture washing machine dryer refrigerator deep freeze ironing board trunks/luggage work bench power tools hardware supplies cabinets lawn mower garden tractor snow blower grill humidifier dehumidifier boats/trailers motors sports equipment camping equipment photo equipment bicycles lawn furniture fuel cans garbage cans clocks radios telephone other

Item

Original Cost Purchase Date

Serial/I.D. Number

Current Value

Subtotal

0.00 $______________

suits jackets dresses skirts slacks blouses sweaters footwear outerwear hats gloves furs accessories robes pajamas lingerie uniforms jewelry other

Subtotal

0.00 $______________

Clothing/Personal Effects (Men & Boys) Item

Original Cost Purchase Date

Serial/I.D. Number

Miscellaneous Current Value

Item

Original Cost Purchase Date

suits sportcoats slacks shirts sweaters ties footwear hats gloves accessories robes pajamas underwear uniforms jewelry other

Serial/I.D. Number

Current Value

Subtotal

0.00 $______________

Summary Subtotals

Subtotal

0.00 $______________

Additional Notes/Comments:

Living Room

$

0.00

Den/Family Room

$

0.00

Kitchen

$

0.00

Dining Room

$

0.00

Bathrooms

$

0.00

Bedrooms

$

0.00

Basement

$

0.00

Clothing/Personal Effects

$

0.00

Miscellaneous

$

0.00

Total Content Value

$

0.00

Inventory Completed By: www.countryfinancial.com

S70-155-01 1/08

Date: