You are on page 1of 1

Home Inventory Contents List

TOTAL ESTIMATED VALUE OF ALL ITEMS:

$4,040.00

Insurance company:

NAME:

Jamie Stark

ADDRESS:

131 Orange Blossom Way, Apt 6

PHONE:

(435) 555-0187

Insurance company phone:

Make/
model

Living Room

Item 1

Manufacturer 1

Home Office

Item 2

Living Room

Item 3

Dining Room

Item 4

Family Room

Item 5

INVENTORY ITEMS: 5

Insurance agent:
Insurance agent phone:

Item/
description

TOTALS

Insurance company policy number:

Insurance agent address:

Room/
area

Item #

INVENTORY DATE:

Serial number/ Date


ID number
purchased

Where purchased

22/05/2016
Humongous Insurance
(800) 555-0123
PHO99H4
Rene Valdes
(800) 555-0156
6789 Palm Street, Moline FL 68897

Purchase
price

Estimated
current value

Notes

Photo?

33XCBH3

02/05/2010

Online

$2,000.00

$2,000.00

Yes

Manufacturer 2

55-678B

06/11/2010

Computer Store

$1,500.00

$1,000.00

No

Manufacturer 3

7865SS-J3

15/03/2011

Furniture store

$560.00

$550.00

No

Manufacturer 4

768087

01/06/2011

Online

$240.00

$200.00

Yes

Manufacturer 5

80-JBNR

19/08/2011

Computer Store

$300.00

$290.00

No

$4,600.00

$4,040.00

You might also like