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  1.  
  2.               [HOUSEHOLD GOODS AND PERSONAL EFFECTS INVENTORY]
  3.  
  4.  
  5.                                                   Date of inventory:
  6.                                                   ________________________
  7.                                                   Revised:________________
  8.                                                   Revised:________________
  9. Name______________________________________________Revised:________________
  10.                                                   Revised:________________
  11. Address___________________________________________Revised:________________
  12. ===========================================================================
  13. LIVING ROOM
  14. ===========================================================================
  15. | Number   |                   |    Date   |               |              | 
  16. | of Items |       Item        | Purchased |      Cost     | Present Value|
  17. |----------|-------------------|-----------|---------------|--------------|
  18. |__________| Books             |___________|_______________|______________|
  19. |__________| Bookcases         |___________|_______________|______________|
  20. |__________| Bric-a-brac       |___________|_______________|______________|
  21. |__________| Cabinets          |___________|_______________|______________|
  22. |__________| Chairs            |___________|_______________|______________|
  23. |__________| Clocks            |___________|_______________|______________|
  24. |__________| Couch             |___________|_______________|______________|
  25. |__________| Curtains          |___________|_______________|______________|
  26. |__________| Desk              |___________|_______________|______________|
  27. |__________| Fireplace equip.  |___________|_______________|______________|
  28. |__________| Lamps             |___________|_______________|______________|
  29. |__________| Mirrors           |___________|_______________|______________|
  30. |__________| Musical instrument|___________|_______________|______________|
  31. |__________| Stereo equipment  |___________|_______________|______________|
  32. |__________| Records, tapes    |___________|_______________|______________|
  33. |__________| Piano             |___________|_______________|______________|
  34. |__________| Radio             |___________|_______________|______________|
  35. |__________| Rugs              |___________|_______________|______________|
  36. |__________| Tables            |___________|_______________|______________|
  37. |__________| Television        |___________|_______________|______________|
  38. |__________| VCR               |___________|_______________|______________|
  39. |__________| Wallshelves       |___________|_______________|______________|
  40. |__________|___________________|___________|_______________|______________|
  41. |__________|___________________|___________|_______________|______________|
  42. |__________|___________________|___________|_______________|______________|
  43. |__________|___________________|___________|_______________|______________|
  44. |__________|___________________|___________|_______________|______________|
  45. |__________|___________________|___________|_______________|______________|
  46. |__________|___________________|___________|_______________|______________|
  47. |__________|___________________|___________|_______________|______________|
  48. |__________|___________________|___________|_______________|______________|
  49. |__________|___________________|___________|_______________|______________|
  50.  
  51. 
  52. ===========================================================================
  53. HALLS
  54. ===========================================================================
  55. | Number   |                   |    Date   |               |              | 
  56. | of Items |       Item        | Purchased |      Cost     | Present Value|
  57. |----------|-------------------|-----------|---------------|--------------|
  58. |__________|Bric-a-brac        |___________|_______________|______________| 
  59. |__________|Cabinets           |___________|_______________|______________|
  60. |__________|Chairs             |___________|_______________|______________|
  61. |__________|Clocks             |___________|_______________|______________|
  62. |__________|Closet/contents    |___________|_______________|______________|
  63. |__________|Curtains           |___________|_______________|______________|
  64. |__________|Lamps              |___________|_______________|______________|
  65. |__________|Mirrors            |___________|_______________|______________|
  66. |__________|Pictures           |___________|_______________|______________|
  67. |__________|Rugs               |___________|_______________|______________|
  68. |__________|Tables             |___________|_______________|______________|
  69. |__________|___________________|___________|_______________|______________|
  70. |__________|___________________|___________|_______________|______________|
  71. |__________|___________________|___________|_______________|______________|
  72. |__________|___________________|___________|_______________|______________|
  73. |__________|___________________|___________|_______________|______________|
  74. |__________|___________________|___________|_______________|______________|
  75. |__________|___________________|___________|_______________|______________|
  76. |__________|___________________|___________|_______________|______________|
  77.  
  78.  
  79.  
  80. ===========================================================================
  81. DINING ROOM
  82. ===========================================================================
  83. | Number   |                   |    Date   |               |              | 
  84. | of Items |       Item        | Purchased |      Cost     | Present Value|
  85. |----------|-------------------|-----------|---------------|--------------|
  86. |__________|Bric-a-brac        |___________|_______________|______________|
  87. |__________|Buffet             |___________|_______________|______________|
  88. |__________|Cabinets           |___________|_______________|______________|
  89. |__________|Chairs             |___________|_______________|______________|
  90. |__________|China              |___________|_______________|______________|
  91. |__________|Clocks             |___________|_______________|______________|
  92. |__________|Curtains           |___________|_______________|______________|
  93. |__________|Lamps              |___________|_______________|______________|
  94. |__________|Mirrors            |___________|_______________|______________|
  95. |__________|Pictures           |___________|_______________|______________|
  96. |__________|Rugs               |___________|_______________|______________|
  97. |__________|Silverware         |___________|_______________|______________|
  98. |__________|Tables             |___________|_______________|______________|
  99. |__________|Table linen        |___________|_______________|______________|
  100. |__________|Wallshelves        |___________|_______________|______________|
  101. |__________|___________________|___________|_______________|______________|
  102. |__________|___________________|___________|_______________|______________|
  103. |__________|___________________|___________|_______________|______________|
  104.  
  105.  
  106. 
  107.  
  108. ===========================================================================
  109. KITCHEN
  110. ===========================================================================
  111. | Number   |                   |    Date   |               |              | 
  112. | of Items |       Item        | Purchased |      Cost     | Present Value|
  113. |----------|-------------------|-----------|---------------|--------------|
  114. |__________|Cabinets           |___________|_______________|______________|
  115. |__________|Chairs             |___________|_______________|______________|
  116. |__________|Clocks             |___________|_______________|______________|
  117. |__________|Closets/contents   |___________|_______________|______________|
  118. |__________|Electric appliances|___________|_______________|______________|
  119. |__________|___________________|___________|_______________|______________|
  120. |__________|___________________|___________|_______________|______________|
  121. |__________|___________________|___________|_______________|______________|
  122. |__________|___________________|___________|_______________|______________|
  123. |__________|___________________|___________|_______________|______________|
  124. |__________|___________________|___________|_______________|______________|
  125. |__________|___________________|___________|_______________|______________|
  126. |__________|___________________|___________|_______________|______________|
  127. |__________|___________________|___________|_______________|______________|
  128. |__________|Floor covering     |___________|_______________|______________|
  129. |__________|Utensils           |___________|_______________|______________|
  130. |__________|Radio              |___________|_______________|______________|
  131. |__________|Refrigerator       |___________|_______________|______________|
  132. |__________|Stove              |___________|_______________|______________|
  133. |__________|Tables             |___________|_______________|______________|
  134. |__________|Television         |___________|_______________|______________|
  135. |__________|___________________|___________|_______________|______________|
  136. |__________|___________________|___________|_______________|______________|
  137. |__________|___________________|___________|_______________|______________|
  138. |__________|___________________|___________|_______________|______________|
  139.  
  140. 
  141.   
  142. ===========================================================================
  143. MASTER BEDROOM
  144. ===========================================================================
  145. | Number   |                   |    Date   |               |              | 
  146. | of Items |       Item        | Purchased |      Cost     | Present Value|
  147. |----------|-------------------|-----------|---------------|--------------|
  148. |__________|Bedding            |___________|_______________|______________|
  149. |__________|Beds               |___________|_______________|______________|
  150. |__________|Books              |___________|_______________|______________|
  151. |__________|Bookcases          |___________|_______________|______________|
  152. |__________|Bric-a-brac        |___________|_______________|______________|
  153. |__________|Bureaus/contents   |___________|_______________|______________|
  154. |__________|Chairs             |___________|_______________|______________|
  155. |__________|Chests             |___________|_______________|______________|
  156. |__________|Closets/contents   |___________|_______________|______________|
  157. |__________|Curtains           |___________|_______________|______________|
  158. |__________|Desk               |___________|_______________|______________|
  159. |__________|Dressers/contents  |___________|_______________|______________|
  160. |__________|Dressing tables    |___________|_______________|______________|
  161. |__________|Lamps              |___________|_______________|______________|
  162. |__________|Mattresses         |___________|_______________|______________|
  163. |__________|Mirrors            |___________|_______________|______________|
  164. |__________|Pictures           |___________|_______________|______________|
  165. |__________|Sound equipment    |___________|_______________|______________|
  166. |__________|Rugs               |___________|_______________|______________|
  167. |__________|Springs            |___________|_______________|______________|
  168. |__________|Television         |___________|_______________|______________|
  169. |__________|VCR                |___________|_______________|______________|
  170. |__________|Tables             |___________|_______________|______________|
  171. |__________|Wallshelves        |___________|_______________|______________|
  172. |__________|___________________|___________|_______________|______________|
  173. |__________|___________________|___________|_______________|______________|
  174. |__________|___________________|___________|_______________|______________|
  175. |__________|___________________|___________|_______________|______________|
  176.  
  177. 
  178. ===========================================================================
  179. BEDROOM TWO
  180. ===========================================================================
  181. | Number   |                   |    Date   |               |              |
  182. | of Items |       Item        | Purchased |      Cost     | Present Value|
  183. |----------|-------------------|-----------|---------------|--------------|
  184. |__________|Bedding            |___________|_______________|______________|
  185. |__________|Beds               |___________|_______________|______________|
  186. |__________|Books              |___________|_______________|______________|
  187. |__________|Bookcases          |___________|_______________|______________|
  188. |__________|Bric-a-brac        |___________|_______________|______________|
  189. |__________|Bureaus            |___________|_______________|______________|
  190. |__________|Chairs             |___________|_______________|______________|
  191. |__________|Chests             |___________|_______________|______________|
  192. |__________|Clocks             |___________|_______________|______________|
  193. |__________|Closet/contents    |___________|_______________|______________|
  194. |__________|Curtains           |___________|_______________|______________|
  195. |__________|Desk               |___________|_______________|______________|
  196. |__________|Dressers/contents  |___________|_______________|______________|
  197. |__________|Dressing table     |___________|_______________|______________|
  198. |__________|Lamps              |___________|_______________|______________|
  199. |__________|Mattresses         |___________|_______________|______________|
  200. |__________|Mirrors            |___________|_______________|______________|
  201. |__________|Pictures           |___________|_______________|______________|
  202. |__________|Stereo equipment   |___________|_______________|______________|
  203. |__________|Rugs               |___________|_______________|______________|
  204. |__________|Springs            |___________|_______________|______________|
  205. |__________|Tables             |___________|_______________|______________|
  206. |__________|Wallshelves        |___________|_______________|______________|
  207. |__________|___________________|___________|_______________|______________|
  208. |__________|___________________|___________|_______________|______________|
  209. |__________|___________________|___________|_______________|______________|
  210. |__________|___________________|___________|_______________|______________|
  211. |__________|___________________|___________|_______________|______________|
  212.  
  213. 
  214.  
  215. ===========================================================================
  216. BEDROOM THREE
  217. ===========================================================================
  218. |  Number  |                   |    Date   |               |              | 
  219. | of Items |       Item        | Purchased |      Cost     | Present Value|
  220. |----------|-------------------|-----------|---------------|--------------|
  221. |__________| Bedding           |___________|_______________|______________|
  222. |__________| Beds              |___________|_______________|______________|
  223. |__________| Books             |___________|_______________|______________|
  224. |__________| Bookcases         |___________|_______________|______________|
  225. |__________| Bric-a-brac       |___________|_______________|______________|
  226. |__________| Bureaus/contents  |___________|_______________|______________|
  227. |__________| Chairs            |___________|_______________|______________|
  228. |__________| Chests/contents   |___________|_______________|______________|
  229. |__________| Clocks            |___________|_______________|______________|
  230. |__________| Closet/contents   |___________|_______________|______________|
  231. |__________| Curtains          |___________|_______________|______________|
  232. |__________| Desk              |___________|_______________|______________|
  233. |__________| Dressers/contents |___________|_______________|______________|
  234. |__________| Dressing table    |___________|_______________|______________|
  235. |__________| Lamps             |___________|_______________|______________|
  236. |__________| Mattresses        |___________|_______________|______________|
  237. |__________| Mirrors           |___________|_______________|______________|
  238. |__________| Pictures          |___________|_______________|______________|
  239. |__________| Stereo equipment  |___________|_______________|______________|
  240. |__________| Rugs              |___________|_______________|______________|
  241. |__________| Springs           |___________|_______________|______________|
  242. |__________| Tables            |___________|_______________|______________|
  243. |__________| Wallshelves       |___________|_______________|______________|
  244. |__________|___________________|___________|_______________|______________|
  245. |__________|___________________|___________|_______________|______________|
  246. |__________|___________________|___________|_______________|______________|
  247. |__________|___________________|___________|_______________|______________|
  248.  
  249.  
  250.  
  251. ===========================================================================
  252. BATHROOM
  253. ===========================================================================
  254. |  Number  |                   |    Date   |               |              | 
  255. | of Items |       Item        | Purchased |      Cost     | Present Value|
  256. |----------|-------------------|-----------|---------------|--------------|
  257. |__________|Cabinets/contents  |___________|_______________|______________|
  258. |__________|Appliances         |___________|_______________|______________|
  259. |__________|Linens             |___________|_______________|______________|
  260. |__________|Scales             |___________|_______________|______________|
  261. |__________|Toilet articles    |___________|_______________|______________|
  262. |__________|Towels             |___________|_______________|______________|
  263. |__________|Health equipment   |___________|_______________|______________|
  264. |__________|___________________|___________|_______________|______________|
  265. |__________|___________________|___________|_______________|______________|
  266.  
  267.  
  268.  
  269. 
  270. ===========================================================================
  271. BASEMENT
  272. ===========================================================================
  273. |  Number  |                   |    Date   |               |              | 
  274. | of Items |       Item        | Purchased |      Cost     | Present Value|
  275. |----------|-------------------|-----------|---------------|--------------|
  276. |__________|Food stores        |___________|_______________|______________|
  277. |__________|___________________|___________|_______________|______________|
  278. |__________|Mangle             |___________|_______________|______________|
  279. |__________|Washer/dryer       |___________|_______________|______________|
  280. |__________|Other laundry equip|___________|_______________|______________|
  281. |__________|Dehumidifier       |___________|_______________|______________|
  282. |__________|___________________|___________|_______________|______________|
  283. |__________|Hand tools         |___________|_______________|______________|
  284. |__________|Power tools        |___________|_______________|______________|
  285. |__________|Workbench          |___________|_______________|______________|
  286. |__________|Other equipment    |___________|_______________|______________|
  287. |__________|Supplies           |___________|_______________|______________|
  288. |__________|___________________|___________|_______________|______________|
  289. |__________|Chairs             |___________|_______________|______________|
  290. |__________|Piano              |___________|_______________|______________|
  291. |__________|Radio              |___________|_______________|______________|
  292. |__________|Rugs               |___________|_______________|______________|
  293. |__________|Tables             |___________|_______________|______________|
  294. |__________|___________________|___________|_______________|______________|
  295. |__________|Fuel               |___________|_______________|______________|
  296. |__________|Heating units      |___________|_______________|______________|
  297. |__________|___________________|___________|_______________|______________|
  298. |__________|Trunks and contents|___________|_______________|______________|
  299. |__________|Other storage      |___________|_______________|______________|
  300. |__________|___________________|___________|_______________|______________|
  301. |__________|___________________|___________|_______________|______________|
  302. |__________|___________________|___________|_______________|______________|
  303.  
  304.  
  305.  
  306. ===========================================================================
  307. ATTIC
  308. ===========================================================================
  309. |  Number  |                   |    Date   |               |              | 
  310. | of Items |       Item        | Purchased |      Cost     | Present Value|
  311. |----------|-------------------|-----------|---------------|--------------|
  312. |__________|Furniture          |___________|_______________|______________|
  313. |__________|Trunks and contents|___________|_______________|______________|
  314. |__________|Other storage      |___________|_______________|______________|
  315. |__________|___________________|___________|_______________|______________|
  316. |__________|___________________|___________|_______________|______________|
  317. |__________|___________________|___________|_______________|______________|
  318.  
  319. 
  320.  
  321. ===========================================================================
  322. GARAGE
  323. ===========================================================================
  324. |  Number  |                   |    Date   |               |              | 
  325. | of Items |       Item        | Purchased |      Cost     | Present Value|
  326. |----------|-------------------|-----------|---------------|--------------|
  327. |__________|Auto equipment     |___________|_______________|______________|
  328. |__________|Garden tools       |___________|_______________|______________|
  329. |__________|Lawn furniture     |___________|_______________|______________|
  330. |__________|Other tools        |___________|_______________|______________|
  331. |__________|Storage            |___________|_______________|______________|
  332. |__________|___________________|___________|_______________|______________|
  333. |__________|___________________|___________|_______________|______________|
  334. |__________|___________________|___________|_______________|______________|
  335.  
  336.  
  337.  
  338.  
  339. ===========================================================================
  340. MISCELLANEOUS
  341. ===========================================================================
  342. |  Number  |                   |    Date   |               |              | 
  343. | of Items |       Item        | Purchased |      Cost     | Present Value|
  344. |----------|-------------------|-----------|---------------|--------------|
  345. |__________|___________________|___________|_______________|______________|
  346. |__________|___________________|___________|_______________|______________|
  347. |__________|___________________|___________|_______________|______________|
  348. |__________|___________________|___________|_______________|______________|
  349. |__________|___________________|___________|_______________|______________|
  350. |__________|___________________|___________|_______________|______________|
  351. |__________|___________________|___________|_______________|______________|
  352. |__________|___________________|___________|_______________|______________|
  353. |__________|___________________|___________|_______________|______________|
  354. |__________|___________________|___________|_______________|______________|
  355. |__________|___________________|___________|_______________|______________|
  356. |__________|___________________|___________|_______________|______________|
  357. |__________|___________________|___________|_______________|______________|
  358. |__________|___________________|___________|_______________|______________|
  359. |__________|___________________|___________|_______________|______________|
  360. |__________|___________________|___________|_______________|______________|
  361. |__________|___________________|___________|_______________|______________|
  362. |__________|___________________|___________|_______________|______________|
  363. |__________|___________________|___________|_______________|______________|
  364. |__________|___________________|___________|_______________|______________|
  365. |__________|___________________|___________|_______________|______________|
  366. |__________|___________________|___________|_______________|______________|
  367. |__________|___________________|___________|_______________|______________|
  368. |__________|___________________|___________|_______________|______________|
  369. |__________|___________________|___________|_______________|______________|
  370. |__________|___________________|___________|_______________|______________|
  371. |__________|___________________|___________|_______________|______________|
  372. |__________|___________________|___________|_______________|______________|
  373. |__________|___________________|___________|_______________|______________|
  374.  
  375.  
  376.  
  377.