| KITCHEN | No. | Original Cost |
Present Value |
| Stoves | |||
| Refrigerators | |||
| Freezers | |||
| Dish washers | |||
| Cookware | |||
| Cutlery | |||
| Utensils | |||
| Foods | |||
| Liquors, wines | |||
| Clocks | |||
| Decor | |||
| TOTALS | |||
| UTILITY | No. | Original Cost |
Present Value |
| Clothes washers | |||
| Clothes dryers | |||
| Irons | |||
| Sewing machines | |||
| Vacuum cleaners | |||
| Floor polishers | |||
| Rug shampooers | |||
| Cleaning supplies | |||
| APPLIANCES | No. | Original Cost |
Present Value |
| Rotisseries | |||
| Roasters | |||
| Coffee makers | |||
| Mixers, blenders | |||
| Toasters | |||
| Waffle irons | |||
| Grills, griddles | |||
| Fry pans | |||
| Knives | |||
| Sharpeners | |||
| Can openers | |||
| Elec. toothbrushes | |||
| TOTALS |
Fulmont Mutual Insurance
Company
Main Office: P.O. Box 487, Johnstown, NY 12095-0487
Page: __________ of __________