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