Country Financial
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|LIVING ROOM | | |Review this form with your Agent upon completion. | |
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|FAMILY ROOM | | | | |
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| |SUMMARY | | |
| | |Subtotals |
| | |Original Cost |Current Cost |
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| |Living Room | | |
| |Kitchen | | |
| |Family Room | | |
| |Dinning Room | | |
| |Basement-Garage--Attic | | |
| |Bathroom | | |
| |Clothing--(Male) | | |
| |Clothing--(Female) | | |
| |Miscellaneous | | |
| |Bedroom 1 | | |
| |Nursery | | |
| |Total Content Value | | |
| |Inventory Completed by: | |
| |Date: | |
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