
              [HOUSEHOLD GOODS AND PERSONAL EFFECTS INVENTORY]


                                                  Date of inventory:
                                                  ________________________
                                                  Revised:________________
                                                  Revised:________________
Name______________________________________________Revised:________________
                                                  Revised:________________
Address___________________________________________Revised:________________
===========================================================================
LIVING ROOM
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| Number   |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________| Books             |___________|_______________|______________|
|__________| Bookcases         |___________|_______________|______________|
|__________| Bric-a-brac       |___________|_______________|______________|
|__________| Cabinets          |___________|_______________|______________|
|__________| Chairs            |___________|_______________|______________|
|__________| Clocks            |___________|_______________|______________|
|__________| Couch             |___________|_______________|______________|
|__________| Curtains          |___________|_______________|______________|
|__________| Desk              |___________|_______________|______________|
|__________| Fireplace equip.  |___________|_______________|______________|
|__________| Lamps             |___________|_______________|______________|
|__________| Mirrors           |___________|_______________|______________|
|__________| Musical instrument|___________|_______________|______________|
|__________| Stereo equipment  |___________|_______________|______________|
|__________| Records, tapes    |___________|_______________|______________|
|__________| Piano             |___________|_______________|______________|
|__________| Radio             |___________|_______________|______________|
|__________| Rugs              |___________|_______________|______________|
|__________| Tables            |___________|_______________|______________|
|__________| Television        |___________|_______________|______________|
|__________| VCR               |___________|_______________|______________|
|__________| Wallshelves       |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|



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HALLS
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| Number   |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Bric-a-brac        |___________|_______________|______________| 

|__________|Cabinets           |___________|_______________|______________|
|__________|Chairs             |___________|_______________|______________|
|__________|Clocks             |___________|_______________|______________|
|__________|Closet/contents    |___________|_______________|______________|
|__________|Curtains           |___________|_______________|______________|
|__________|Lamps              |___________|_______________|______________|
|__________|Mirrors            |___________|_______________|______________|
|__________|Pictures           |___________|_______________|______________|
|__________|Rugs               |___________|_______________|______________|
|__________|Tables             |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|



===========================================================================
DINING ROOM
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| Number   |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Bric-a-brac        |___________|_______________|______________|
|__________|Buffet             |___________|_______________|______________|
|__________|Cabinets           |___________|_______________|______________|
|__________|Chairs             |___________|_______________|______________|
|__________|China              |___________|_______________|______________|
|__________|Clocks             |___________|_______________|______________|
|__________|Curtains           |___________|_______________|______________|
|__________|Lamps              |___________|_______________|______________|
|__________|Mirrors            |___________|_______________|______________|
|__________|Pictures           |___________|_______________|______________|
|__________|Rugs               |___________|_______________|______________|
|__________|Silverware         |___________|_______________|______________|
|__________|Tables             |___________|_______________|______________|
|__________|Table linen        |___________|_______________|______________|
|__________|Wallshelves        |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|




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KITCHEN
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| Number   |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Cabinets           |___________|_______________|______________|
|__________|Chairs             |___________|_______________|______________|
|__________|Clocks             |___________|_______________|______________|
|__________|Closets/contents   |___________|_______________|______________|
|__________|Electric appliances|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|Floor covering     |___________|_______________|______________|
|__________|Utensils           |___________|_______________|______________|
|__________|Radio              |___________|_______________|______________|
|__________|Refrigerator       |___________|_______________|______________|
|__________|Stove              |___________|_______________|______________|
|__________|Tables             |___________|_______________|______________|
|__________|Television         |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|


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MASTER BEDROOM
===========================================================================
| Number   |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Bedding            |___________|_______________|______________|
|__________|Beds               |___________|_______________|______________|
|__________|Books              |___________|_______________|______________|
|__________|Bookcases          |___________|_______________|______________|
|__________|Bric-a-brac        |___________|_______________|______________|
|__________|Bureaus/contents   |___________|_______________|______________|
|__________|Chairs             |___________|_______________|______________|
|__________|Chests             |___________|_______________|______________|
|__________|Closets/contents   |___________|_______________|______________|
|__________|Curtains           |___________|_______________|______________|
|__________|Desk               |___________|_______________|______________|
|__________|Dressers/contents  |___________|_______________|______________|
|__________|Dressing tables    |___________|_______________|______________|
|__________|Lamps              |___________|_______________|______________|
|__________|Mattresses         |___________|_______________|______________|
|__________|Mirrors            |___________|_______________|______________|
|__________|Pictures           |___________|_______________|______________|
|__________|Sound equipment    |___________|_______________|______________|
|__________|Rugs               |___________|_______________|______________|
|__________|Springs            |___________|_______________|______________|
|__________|Television         |___________|_______________|______________|
|__________|VCR                |___________|_______________|______________|
|__________|Tables             |___________|_______________|______________|
|__________|Wallshelves        |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|


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BEDROOM TWO
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| Number   |                   |    Date   |               |              |
| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Bedding            |___________|_______________|______________|
|__________|Beds               |___________|_______________|______________|
|__________|Books              |___________|_______________|______________|
|__________|Bookcases          |___________|_______________|______________|
|__________|Bric-a-brac        |___________|_______________|______________|
|__________|Bureaus            |___________|_______________|______________|
|__________|Chairs             |___________|_______________|______________|
|__________|Chests             |___________|_______________|______________|
|__________|Clocks             |___________|_______________|______________|
|__________|Closet/contents    |___________|_______________|______________|
|__________|Curtains           |___________|_______________|______________|
|__________|Desk               |___________|_______________|______________|
|__________|Dressers/contents  |___________|_______________|______________|
|__________|Dressing table     |___________|_______________|______________|
|__________|Lamps              |___________|_______________|______________|
|__________|Mattresses         |___________|_______________|______________|
|__________|Mirrors            |___________|_______________|______________|
|__________|Pictures           |___________|_______________|______________|
|__________|Stereo equipment   |___________|_______________|______________|
|__________|Rugs               |___________|_______________|______________|
|__________|Springs            |___________|_______________|______________|
|__________|Tables             |___________|_______________|______________|
|__________|Wallshelves        |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|


===========================================================================
BEDROOM THREE
===========================================================================
|  Number  |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________| Bedding           |___________|_______________|______________|
|__________| Beds              |___________|_______________|______________|
|__________| Books             |___________|_______________|______________|
|__________| Bookcases         |___________|_______________|______________|
|__________| Bric-a-brac       |___________|_______________|______________|
|__________| Bureaus/contents  |___________|_______________|______________|
|__________| Chairs            |___________|_______________|______________|
|__________| Chests/contents   |___________|_______________|______________|
|__________| Clocks            |___________|_______________|______________|
|__________| Closet/contents   |___________|_______________|______________|
|__________| Curtains          |___________|_______________|______________|
|__________| Desk              |___________|_______________|______________|
|__________| Dressers/contents |___________|_______________|______________|
|__________| Dressing table    |___________|_______________|______________|
|__________| Lamps             |___________|_______________|______________|
|__________| Mattresses        |___________|_______________|______________|
|__________| Mirrors           |___________|_______________|______________|
|__________| Pictures          |___________|_______________|______________|
|__________| Stereo equipment  |___________|_______________|______________|
|__________| Rugs              |___________|_______________|______________|
|__________| Springs           |___________|_______________|______________|
|__________| Tables            |___________|_______________|______________|
|__________| Wallshelves       |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|



===========================================================================
BATHROOM
===========================================================================
|  Number  |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Cabinets/contents  |___________|_______________|______________|
|__________|Appliances         |___________|_______________|______________|
|__________|Linens             |___________|_______________|______________|
|__________|Scales             |___________|_______________|______________|
|__________|Toilet articles    |___________|_______________|______________|
|__________|Towels             |___________|_______________|______________|
|__________|Health equipment   |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|

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BASEMENT
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|  Number  |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Food stores        |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|Mangle             |___________|_______________|______________|
|__________|Washer/dryer       |___________|_______________|______________|
|__________|Other laundry equip|___________|_______________|______________|
|__________|Dehumidifier       |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|Hand tools         |___________|_______________|______________|
|__________|Power tools        |___________|_______________|______________|
|__________|Workbench          |___________|_______________|______________|
|__________|Other equipment    |___________|_______________|______________|
|__________|Supplies           |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|Chairs             |___________|_______________|______________|
|__________|Piano              |___________|_______________|______________|
|__________|Radio              |___________|_______________|______________|
|__________|Rugs               |___________|_______________|______________|
|__________|Tables             |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|Fuel               |___________|_______________|______________|
|__________|Heating units      |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|Trunks and contents|___________|_______________|______________|
|__________|Other storage      |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|



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ATTIC
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|  Number  |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Furniture          |___________|_______________|______________|
|__________|Trunks and contents|___________|_______________|______________|
|__________|Other storage      |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|

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GARAGE
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|  Number  |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|Auto equipment     |___________|_______________|______________|
|__________|Garden tools       |___________|_______________|______________|
|__________|Lawn furniture     |___________|_______________|______________|
|__________|Other tools        |___________|_______________|______________|
|__________|Storage            |___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|




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MISCELLANEOUS
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|  Number  |                   |    Date   |               |              | 

| of Items |       Item        | Purchased |      Cost     | Present Value|
|----------|-------------------|-----------|---------------|--------------|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
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|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
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|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
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|__________|___________________|___________|_______________|______________|
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|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|
|__________|___________________|___________|_______________|______________|



