Asset inventory form

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The undermentioned must represent replacement cost in order to ensure that the Average Clause will not apply in the event of a loss

BEDROOM 1 BEDROOM 2 BEDROOM 3 BEDROOM 4

Bed & Mattress R 0.00 Bed & Mattress R 0.00 Bed & Mattress R 0.00 Bed & Mattress R 0.00
Wardrobes R 0.00 Wardrobes R 0.00 Wardrobes R 0.00 Wardrobes R 0.00
Tables & Chairs R 0.00 Tables & Chairs R 0.00 Tables & Chairs R 0.00 Tables & Chairs R 0.00
Linen, Blankets & Bedding R 0.00 Linen, Blankets & Bedding R 0.00 Linen, Blankets & Bedding R 0.00 Linen, Blankets & Bedding R 0.00
Clothing & Footwear R 0.00 Clothing & Footwear R 0.00 Clothing & Footwear R 0.00 Clothing & Footwear R 0.00
Furs & Jewellery R 0.00 Furs & Jewellery R 0.00 Furs & Jewellery R 0.00 Furs & Jewellery R 0.00
Other R 0.00 Other R 0.00 Other R 0.00 Other R 0.00
Total R 0.00 Total R 0.00 Total R 0.00 Total R 0.00

BATHROOMS & TOILET STUDY LOUNGE FAMILY ROOM

Curtains & Carpets R 0.00 Desk & Bookcases R 0.00 Lounge Suite R 0.00 Tables & Chairs R 0.00
Towels & Toiletries R 0.00 Tables & Chairs R 0.00 Display Cabinet R 0.00 Hi-fi, Radios & Tapes R 0.00
Washing Machine R 0.00 Books & Manuscripts R 0.00 Tables & Chairs R 0.00 TV & Video R 0.00
Tumble Dryer R 0.00 Curtains & Carpets R 0.00 Curtains & Carpets R 0.00 Curtains & Carpets R 0.00
Shaving Equipment R 0.00 Paintings & Ornaments R 0.00 Paintings & Ornaments R 0.00 Paintings & Ornaments R 0.00
Hairdryer R 0.00 Sewing Machine R 0.00 Piano & other R 0.00 Lamps R 0.00
Other R 0.00 Cameras & Projectors R 0.00 Lamps R 0.00 Books R 0.00
Other R 0.00 Firearms & Binoculars R 0.00 Wine & Spirits R 0.00 Other R 0.00
Other R 0.00 Computer Equipment R 0.00 Other R 0.00 Other R 0.00
Other R 0.00 Sporting Equipment R 0.00 Other R 0.00 Other R 0.00
Other R 0.00 Other R 0.00 Other R 0.00 Other R 0.00
Total R 0.00 Total R 0.00 Total R 0.00 Total R 0.00

DINING ROOM KITCHEN & SCULLERY HALL & PASSAGE GARAGE & WORKSHOP
Dresser & Sideboard R 0.00 Stove R 0.00 Linen R 0.00 Power tools R 0.00
Tables & Chairs R 0.00 Fridge & Contents R 0.00 Tables & Chairs R 0.00 Hand tools R 0.00
Dinner Service R 0.00 Freezer & Contents R 0.00 Curtains & Carpets R 0.00 Workbench & Vice R 0.00
Cutlery & Silverware R 0.00 Dishwasher R 0.00 Paintings & Ornaments R 0.00 Bicycles R 0.00
Glassware R 0.00 Mixer & Blender R 0.00 All household heaters R 0.00 Lawnmower & Roller R 0.00
Hot Tray R 0.00 Vacuum & Polisher R 0.00 Other R 0.00 Garden Furniture R 0.00
Curtains & Carpets R 0.00 Electrical Appliances R 0.00 Other R 0.00 Garden Implements R 0.00
Paintings & Ornaments R 0.00 Cutlery & Crockery R 0.00 Other R 0.00 Braai Equipment R 0.00
Other R 0.00 Furniture & Curtains R 0.00 Other R 0.00 Camping Equipment R 0.00
Other R 0.00 Groceries R 0.00 Other R 0.00 Other R 0.00
Other R 0.00 Other R 0.00 Other R 0.00 Other R 0.00
Total R 0.00 Total R 0.00 Total R 0.00 Total R 0.00

OTHER ROOMS SUMMARY TOTALS NOTES

Additional Room 1 R 0.00 Bedroom 1 R 0.00
Additional Room 2 R 0.00 Bedroom 2 R 0.00
Additional Room 3 R 0.00 Bedroom 3 R 0.00
Additional Room 4 R 0.00 Bedroom 4 R 0.00
Additional Room 5 R 0.00 Bathrooms & Toilet R 0.00
Study R 0.00
Lounge R 0.00
Family Room R 0.00
Dining Room R 0.00
Kitchen & Scullery R 0.00
 Hall & Passages R 0.00
Garage & Workshop R 0.00
Other Rooms R 0.00
Total R 0.00 Grand Total R 0.00