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: