INVENTORY OF HOUSEHOLD GOODS
PROPERTY OF FROM
INVENTORY OF HOUSEHOLD GOODS
HOME PHONE NUMBER
DUTY PHONE NUMBER
TO (Destination)
DATE
ARTICLE
LIVING ROOM Bench, fireside or piano Bookcase Bookshelves, sectional Cabinet Cartons, books Chair, arm Chair, occasional Chair, overstuffed Chair, rocker Chair, straight Clock, grandfather/grandmother Credenza Davenport, 2, 3, 4 cushions Day bed Desk, small or Winthrop Desk, secretary Footstool, hassock, ottoman Hideabed Lamp, floor, table Magazine rack Organ, electric Piano, baby grand or upright Parlor grand Spinet Radio, table or phonograph Sectional, 2, 3, 4 piece Stereo, Hi Fi Studio couch Tables, drop leaf or occasional Tables, coffee, end or nest Table, library Telephone stand and chair Television combination/color Television, table model/color 0 DINING ROOM Barrel, dishes Buffet Chair, arm Chair, straight China closet Server Table, dinette Table, extension 0 0 0 BEDROOM Bed, include. spring and mattress Double Single or Hollywood Bunk (set of 2) King size/Queen size Cartons, clothes Chair, boudoir Chair, straight or rocker Chaise lounge Chest, cedar Dresser, bureau, chest of drawers, chifrb. or chifnr. Dresser bench Dresser, double, triple Lamps, floor, table Table, night Wardrobe, small Wardrobe, large Wardrobe, carton 0 CHILDRENS ROOM Bathinette Bed, youth cartons, clothes Chair, child's Chair, high Chair, rocker Subtotal Column 1
CU FT. PER PC.
NO OF PCS
CU FT.
ARTICLE
0
0
5
20
5
10
2
10
15
25
12
5
20
35
35
30
22
35
0
50
3
2
60
70
80
60
2
50
10
50
12
5
20
5
25
10
0
0
15
30
8
5
25
15
15
30
0
0
0
0
0
60
40
70
70
10
10
5
25
15
0
25
3
50
3
5
20
40
10
0
0
5
30
10
3
5
3
1460
0
CHILDRENS ROOM (Con't)
Chest
Chest, Toy
Crib, baby
Play pen
Table, child's
0
KITCHEN
Boxes, pots/pans
Cabinet, kitchen
Cabinet, utility
Chairs, breakfast
Ironing board
Rotisserie
Stool
Table
Table, breakfast
Vegetable bin
0
0
0
APPLIANCES (Large)
Air conditioner, window
Dehumidifier
Dishwasher
Dryer, electric or gas
Freezer: (Cubic capacity)
10 or less
11 to 15
16 and over
Mangle
Range, electric
Refrigerator (cubic cap.)
6 cu. ft. or less
7 to 10 cu. ft.
11 cu. ft. and over
0
Vacuum cleaner
Washing machine
Washer/dryer combination
0
0
0
PORCH, OUTDOOR
FURNITURE & EQUIPMENT
bar
Bar stools
Bird bath
Chair, porch
Chair, lawn
0
Fireplace equipment
Garden hose
Glider
Grill, barbecue, portable
Gym, outdoor child's
Ladder, extension
Lawn mower (hand)
Mower, power
Picnic table
Picnic bench
Rack, outdoor dryer
0
Rocker, swing
Sandbox
Settee
Slide, outdoors, child's
Swings, outdoor porch
Table
TV antenna
Tool chest
Umbrella
Wheelbarrow
0
0
0
PROFESSIONAL ITEMS
Clothing, specialized
Instruments
MARS equipment
Subtotal Column 2
CU FT. PER PC.
NO OF PCS
CU FT.
ARTICLE
0
0
0
PROFESSIONAL ITEMS (Con't)
12
Reference material
5
Tools
10
Books
10
Papers
5
Equipment
0
0
5
30
MISCELLANEOUS
10
Ash or trash can
5
Auto tires
2
Basket, clothes
5
Bicycle
3
Bird cage and stand
5
Brooms and mops bundle
10
Cabinet, filing
3
Carriage, baby
0
Carriage, doll or folding
0
Chairs, folding
0
Clothes hamper
0
Cot, folding
30
Golf bag
10
Golf cart/go cart
20
Fan
25
Fernery or plant stand
0
Foot locker
30
Heater, gar or electric
45
Incinerator
60
Linens, cartons
12
Mirrors
30
Pictures
0
Power tools
30
Rollaway bed
45
Rugs, large roll or pad
60
Rugs, small roll or pad
0
Sewing cabinet
0
Sewing machine
0
Shop smith
Sled
Table, card
0
Tricycle
0
Trunk, steamer
15
Trunk, wardrobe
3
TV trays
5
Typewriter
10
0
5
OTHER ITEMS
5
5
20
10
20
10
5
15
20
5
5
15
10
CONTAINERS PREPACKED
20
BY OWNER, e.g.,
10
Footlockers or Trunks
30
10
5
10
5
3
0
Subtotal Column 3
0
0
TOTAL Column 1
0
TOTAL Column 2
0
TOTAL Column 3
0
0
GRAND TOTAL
793
Summary 0 cu. ft. @ 7 lbs. per cu. ft.
Estimated Total Weight
CU FT. PER PC.
NO OF PCS
CU. FT.
0
0
0
0
0
0
0
0
0 0 0 7 2 5 5 5 2 20 20 5 2 5 3 2 3 5 0 0 5 10 5 0 0 0 20 0 0 2 10 0 2 1 5 10 15 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180
1460 793 180
2433 0 lbs. 0 lbs.
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APPLIANCES TO BE SERVICED
TYPE (Place "X" in applicable boxes) CLOTHES DRYER
MAKE
GAS
ELECTRIC
WASHING MACHINE
AUTOMATIC IRONER
NON AUTOMATIC
YEAR
MANGLE FREEZER
CHEST REFRIGERATOR GAS
SINGLE DOOR TELEVISION TABLE
CONSOLE STOVE
UPRIGHT
ELECTRIC DOUBLE DOOR PORTABLE
GAS DISHWASHER
ELECTRIC
AIR CONDITIONER
STEREO
HI-FI RADIO
RECORD PLAYER
OTHER (Specify)
THE FOLLOWING ITEMS ARE TO BE WITHDRAWN AND PLACED IN NON-TEMPORARY STORAGE IN THE EVENT WEIGHT IS IN EXCESS OF THE ADMINISTRATIVE WEIGHT RESTRICTION:
1.
2.
3.
4.
5.
6.
Name
Grade
Service Number/SSAN
NOTE: Disconnecting or connecting of appliances to gas, water or electricity will not be performed by the carrier. Arrangements for disconnecting or connecting must be made by the owner. Carriers will not remove or install TV antennas or air conditioners.
INTERVIEWER'S NOTES
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