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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. «PG»
  51. ===========================================================================
  52. HALLS
  53. ===========================================================================
  54. | Number   |                   |    Date   |               |              |
  55. | of Items |       Item        | Purchased |      Cost     | Present Value|
  56. |----------|-------------------|-----------|---------------|--------------|
  57. |__________|Bric-a-brac        |___________|_______________|______________|
  58. |__________|Cabinets           |___________|_______________|______________|
  59. |__________|Chairs             |___________|_______________|______________|
  60. |__________|Clocks             |___________|_______________|______________|
  61. |__________|Closet/contents    |___________|_______________|______________|
  62. |__________|Curtains           |___________|_______________|______________|
  63. |__________|Lamps              |___________|_______________|______________|
  64. |__________|Mirrors            |___________|_______________|______________|
  65. |__________|Pictures           |___________|_______________|______________|
  66. |__________|Rugs               |___________|_______________|______________|
  67. |__________|Tables             |___________|_______________|______________|
  68. |__________|___________________|___________|_______________|______________|
  69. |__________|___________________|___________|_______________|______________|
  70. |__________|___________________|___________|_______________|______________|
  71. |__________|___________________|___________|_______________|______________|
  72. |__________|___________________|___________|_______________|______________|
  73. |__________|___________________|___________|_______________|______________|
  74. |__________|___________________|___________|_______________|______________|
  75. |__________|___________________|___________|_______________|______________|
  76.  
  77.  
  78.  
  79. ===========================================================================
  80. DINING ROOM
  81. ===========================================================================
  82. | Number   |                   |    Date   |               |              |
  83. | of Items |       Item        | Purchased |      Cost     | Present Value|
  84. |----------|-------------------|-----------|---------------|--------------|
  85. |__________|Bric-a-brac        |___________|_______________|______________|
  86. |__________|Buffet             |___________|_______________|______________|
  87. |__________|Cabinets           |___________|_______________|______________|
  88. |__________|Chairs             |___________|_______________|______________|
  89. |__________|China              |___________|_______________|______________|
  90. |__________|Clocks             |___________|_______________|______________|
  91. |__________|Curtains           |___________|_______________|______________|
  92. |__________|Lamps              |___________|_______________|______________|
  93. |__________|Mirrors            |___________|_______________|______________|
  94. |__________|Pictures           |___________|_______________|______________|
  95. |__________|Rugs               |___________|_______________|______________|
  96. |__________|Silverware         |___________|_______________|______________|
  97. |__________|Tables             |___________|_______________|______________|
  98. |__________|Table linen        |___________|_______________|______________|
  99. |__________|Wallshelves        |___________|_______________|______________|
  100. |__________|___________________|___________|_______________|______________|
  101. |__________|___________________|___________|_______________|______________|
  102. |__________|___________________|___________|_______________|______________|
  103. «PG»
  104. ===========================================================================
  105. KITCHEN
  106. ===========================================================================
  107. | Number   |                   |    Date   |               |              |
  108. | of Items |       Item        | Purchased |      Cost     | Present Value|
  109. |----------|-------------------|-----------|---------------|--------------|
  110. |__________|Cabinets           |___________|_______________|______________|
  111. |__________|Chairs             |___________|_______________|______________|
  112. |__________|Clocks             |___________|_______________|______________|
  113. |__________|Closets/contents   |___________|_______________|______________|
  114. |__________|Electric appliances|___________|_______________|______________|
  115. |__________|___________________|___________|_______________|______________|
  116. |__________|___________________|___________|_______________|______________|
  117. |__________|___________________|___________|_______________|______________|
  118. |__________|___________________|___________|_______________|______________|
  119. |__________|___________________|___________|_______________|______________|
  120. |__________|___________________|___________|_______________|______________|
  121. |__________|___________________|___________|_______________|______________|
  122. |__________|___________________|___________|_______________|______________|
  123. |__________|___________________|___________|_______________|______________|
  124. |__________|Floor covering     |___________|_______________|______________|
  125. |__________|Utensils           |___________|_______________|______________|
  126. |__________|Radio              |___________|_______________|______________|
  127. |__________|Refrigerator       |___________|_______________|______________|
  128. |__________|Stove              |___________|_______________|______________|
  129. |__________|Tables             |___________|_______________|______________|
  130. |__________|Television         |___________|_______________|______________|
  131. |__________|___________________|___________|_______________|______________|
  132. |__________|___________________|___________|_______________|______________|
  133. |__________|___________________|___________|_______________|______________|
  134. |__________|___________________|___________|_______________|______________|
  135. «PG»
  136. ===========================================================================
  137. MASTER BEDROOM
  138. ===========================================================================
  139. | Number   |                   |    Date   |               |              |
  140. | of Items |       Item        | Purchased |      Cost     | Present Value|
  141. |----------|-------------------|-----------|---------------|--------------|
  142. |__________|Bedding            |___________|_______________|______________|
  143. |__________|Beds               |___________|_______________|______________|
  144. |__________|Books              |___________|_______________|______________|
  145. |__________|Bookcases          |___________|_______________|______________|
  146. |__________|Bric-a-brac        |___________|_______________|______________|
  147. |__________|Bureaus/contents   |___________|_______________|______________|
  148. |__________|Chairs             |___________|_______________|______________|
  149. |__________|Chests             |___________|_______________|______________|
  150. |__________|Closets/contents   |___________|_______________|______________|
  151. |__________|Curtains           |___________|_______________|______________|
  152. |__________|Desk               |___________|_______________|______________|
  153. |__________|Dressers/contents  |___________|_______________|______________|
  154. |__________|Dressing tables    |___________|_______________|______________|
  155. |__________|Lamps              |___________|_______________|______________|
  156. |__________|Mattresses         |___________|_______________|______________|
  157. |__________|Mirrors            |___________|_______________|______________|
  158. |__________|Pictures           |___________|_______________|______________|
  159. |__________|Sound equipment    |___________|_______________|______________|
  160. |__________|Rugs               |___________|_______________|______________|
  161. |__________|Springs            |___________|_______________|______________|
  162. |__________|Television         |___________|_______________|______________|
  163. |__________|VCR                |___________|_______________|______________|
  164. |__________|Tables             |___________|_______________|______________|
  165. |__________|Wallshelves        |___________|_______________|______________|
  166. |__________|___________________|___________|_______________|______________|
  167. |__________|___________________|___________|_______________|______________|
  168. |__________|___________________|___________|_______________|______________|
  169. |__________|___________________|___________|_______________|______________|
  170. «PG»
  171. ===========================================================================
  172. BEDROOM TWO
  173. ===========================================================================
  174. | Number   |                   |    Date   |               |              |
  175. | of Items |       Item        | Purchased |      Cost     | Present Value|
  176. |----------|-------------------|-----------|---------------|--------------|
  177. |__________|Bedding            |___________|_______________|______________|
  178. |__________|Beds               |___________|_______________|______________|
  179. |__________|Books              |___________|_______________|______________|
  180. |__________|Bookcases          |___________|_______________|______________|
  181. |__________|Bric-a-brac        |___________|_______________|______________|
  182. |__________|Bureaus            |___________|_______________|______________|
  183. |__________|Chairs             |___________|_______________|______________|
  184. |__________|Chests             |___________|_______________|______________|
  185. |__________|Clocks             |___________|_______________|______________|
  186. |__________|Closet/contents    |___________|_______________|______________|
  187. |__________|Curtains           |___________|_______________|______________|
  188. |__________|Desk               |___________|_______________|______________|
  189. |__________|Dressers/contents  |___________|_______________|______________|
  190. |__________|Dressing table     |___________|_______________|______________|
  191. |__________|Lamps              |___________|_______________|______________|
  192. |__________|Mattresses         |___________|_______________|______________|
  193. |__________|Mirrors            |___________|_______________|______________|
  194. |__________|Pictures           |___________|_______________|______________|
  195. |__________|Stereo equipment   |___________|_______________|______________|
  196. |__________|Rugs               |___________|_______________|______________|
  197. |__________|Springs            |___________|_______________|______________|
  198. |__________|Tables             |___________|_______________|______________|
  199. |__________|Wallshelves        |___________|_______________|______________|
  200. |__________|___________________|___________|_______________|______________|
  201. |__________|___________________|___________|_______________|______________|
  202. |__________|___________________|___________|_______________|______________|
  203. |__________|___________________|___________|_______________|______________|
  204. |__________|___________________|___________|_______________|______________|
  205. «PG»
  206. ===========================================================================
  207. BEDROOM THREE
  208. ===========================================================================
  209. |  Number  |                   |    Date   |               |              |
  210. | of Items |       Item        | Purchased |      Cost     | Present Value|
  211. |----------|-------------------|-----------|---------------|--------------|
  212. |__________| Bedding           |___________|_______________|______________|
  213. |__________| Beds              |___________|_______________|______________|
  214. |__________| Books             |___________|_______________|______________|
  215. |__________| Bookcases         |___________|_______________|______________|
  216. |__________| Bric-a-brac       |___________|_______________|______________|
  217. |__________| Bureaus/contents  |___________|_______________|______________|
  218. |__________| Chairs            |___________|_______________|______________|
  219. |__________| Chests/contents   |___________|_______________|______________|
  220. |__________| Clocks            |___________|_______________|______________|
  221. |__________| Closet/contents   |___________|_______________|______________|
  222. |__________| Curtains          |___________|_______________|______________|
  223. |__________| Desk              |___________|_______________|______________|
  224. |__________| Dressers/contents |___________|_______________|______________|
  225. |__________| Dressing table    |___________|_______________|______________|
  226. |__________| Lamps             |___________|_______________|______________|
  227. |__________| Mattresses        |___________|_______________|______________|
  228. |__________| Mirrors           |___________|_______________|______________|
  229. |__________| Pictures          |___________|_______________|______________|
  230. |__________| Stereo equipment  |___________|_______________|______________|
  231. |__________| Rugs              |___________|_______________|______________|
  232. |__________| Springs           |___________|_______________|______________|
  233. |__________| Tables            |___________|_______________|______________|
  234. |__________| Wallshelves       |___________|_______________|______________|
  235. |__________|___________________|___________|_______________|______________|
  236. |__________|___________________|___________|_______________|______________|
  237. |__________|___________________|___________|_______________|______________|
  238. |__________|___________________|___________|_______________|______________|
  239.  
  240.  
  241. ===========================================================================
  242. BATHROOM
  243. ===========================================================================
  244. |  Number  |                   |    Date   |               |              |
  245. | of Items |       Item        | Purchased |      Cost     | Present Value|
  246. |----------|-------------------|-----------|---------------|--------------|
  247. |__________|Cabinets/contents  |___________|_______________|______________|
  248. |__________|Appliances         |___________|_______________|______________|
  249. |__________|Linens             |___________|_______________|______________|
  250. |__________|Scales             |___________|_______________|______________|
  251. |__________|Toilet articles    |___________|_______________|______________|
  252. |__________|Towels             |___________|_______________|______________|
  253. |__________|Health equipment   |___________|_______________|______________|
  254. |__________|___________________|___________|_______________|______________|
  255. |__________|___________________|___________|_______________|______________|
  256. «PG»
  257. ===========================================================================
  258. BASEMENT
  259. ===========================================================================
  260. |  Number  |                   |    Date   |               |              |
  261. | of Items |       Item        | Purchased |      Cost     | Present Value|
  262. |----------|-------------------|-----------|---------------|--------------|
  263. |__________|Food stores        |___________|_______________|______________|
  264. |__________|___________________|___________|_______________|______________|
  265. |__________|Mangle             |___________|_______________|______________|
  266. |__________|Washer/dryer       |___________|_______________|______________|
  267. |__________|Other laundry equip|___________|_______________|______________|
  268. |__________|Dehumidifier       |___________|_______________|______________|
  269. |__________|___________________|___________|_______________|______________|
  270. |__________|Hand tools         |___________|_______________|______________|
  271. |__________|Power tools        |___________|_______________|______________|
  272. |__________|Workbench          |___________|_______________|______________|
  273. |__________|Other equipment    |___________|_______________|______________|
  274. |__________|Supplies           |___________|_______________|______________|
  275. |__________|___________________|___________|_______________|______________|
  276. |__________|Chairs             |___________|_______________|______________|
  277. |__________|Piano              |___________|_______________|______________|
  278. |__________|Radio              |___________|_______________|______________|
  279. |__________|Rugs               |___________|_______________|______________|
  280. |__________|Tables             |___________|_______________|______________|
  281. |__________|___________________|___________|_______________|______________|
  282. |__________|Fuel               |___________|_______________|______________|
  283. |__________|Heating units      |___________|_______________|______________|
  284. |__________|___________________|___________|_______________|______________|
  285. |__________|Trunks and contents|___________|_______________|______________|
  286. |__________|Other storage      |___________|_______________|______________|
  287. |__________|___________________|___________|_______________|______________|
  288. |__________|___________________|___________|_______________|______________|
  289. |__________|___________________|___________|_______________|______________|
  290.  
  291.  
  292.  
  293. ===========================================================================
  294. ATTIC
  295. ===========================================================================
  296. |  Number  |                   |    Date   |               |              |
  297. | of Items |       Item        | Purchased |      Cost     | Present Value|
  298. |----------|-------------------|-----------|---------------|--------------|
  299. |__________|Furniture          |___________|_______________|______________|
  300. |__________|Trunks and contents|___________|_______________|______________|
  301. |__________|Other storage      |___________|_______________|______________|
  302. |__________|___________________|___________|_______________|______________|
  303. |__________|___________________|___________|_______________|______________|
  304. |__________|___________________|___________|_______________|______________|
  305. «PG»
  306. ===========================================================================
  307. GARAGE
  308. ===========================================================================
  309. |  Number  |                   |    Date   |               |              |
  310. | of Items |       Item        | Purchased |      Cost     | Present Value|
  311. |----------|-------------------|-----------|---------------|--------------|
  312. |__________|Auto equipment     |___________|_______________|______________|
  313. |__________|Garden tools       |___________|_______________|______________|
  314. |__________|Lawn furniture     |___________|_______________|______________|
  315. |__________|Other tools        |___________|_______________|______________|
  316. |__________|Storage            |___________|_______________|______________|
  317. |__________|___________________|___________|_______________|______________|
  318. |__________|___________________|___________|_______________|______________|
  319. |__________|___________________|___________|_______________|______________|
  320.  
  321.  
  322.  
  323.  
  324. ===========================================================================
  325. MISCELLANEOUS
  326. ===========================================================================
  327. |  Number  |                   |    Date   |               |              |
  328. | of Items |       Item        | Purchased |      Cost     | Present Value|
  329. |----------|-------------------|-----------|---------------|--------------|
  330. |__________|___________________|___________|_______________|______________|
  331. |__________|___________________|___________|_______________|______________|
  332. |__________|___________________|___________|_______________|______________|
  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.