HOUSEHOLD INVENTORY Name Street City & State Date Revised Insurance Co. Policy No. HOME INFORMATION Year Built Builder Square Footage Date Purchased Price Paid Previous Owners Mortgage Company Complete this form and file it in your safety deposit box or in a safe place away from your home. We also suggest you supplement this record with photos and receipts also stored off-premise. If a loss should occur, this record will help in settling your claim. 1
MEN'S CLOTHING Belts/Suspenders Gloves Handkerchiefs Hats & Caps Hosiery Overcoats Raincoats Shirts Shoes Sport Clothes Suits Sweaters Ties Trousers Underwear WOMEN'S CLOTHING Belts Blouses Coats Dresses Gloves Handkerchiefs Hats Hosiery Jackets Shoes Skirts Slacks Suits Sweaters Underwear 2
CHILDREN'S CLOTHING Belts Blouses Coats Dresses Hats & Caps Hosiery Shoes Skirts Suits Sweaters Trousers Underwear MISCELLANEOUS Bicycles Childrens Toys Porch Furniture Sewing Machine Umbrellas Vacuum Cleaners Fans Air Conditioners Food Freezers DVD/Blu Ray Computer Printer Tablets 3
Item & Description Bookcases Books Carpets & Rugs Clocks Curtains- Drapes Davenports Desks Fireplace Equip. Lamps Mirrors Pictures Radio Tables & Stands Television Set Stereo LIVING ROOM # of Year Purchased Price Paid FAMILY ROOM # of Year Purchased Price Paid 4
BATHROOMS Bath Mats Curling Iron Curtains Dressing Table Electric Razor Hair Dryer Hair Straightener Scales Suppl.- Med. Cab. Towels- Bath Towels- Guest Towels- Hand ATTIC AND BASEMENT Canned Goods Chests Clothes Dryer Electric Irons Ironing Boards Luggage- Trunks Tools Tubs Washing Machine Work Bench 5
DINING ROOM Buffet Candle Sticks Carpets & Rugs China Closet Chinaware Clock Curtains- Drapes Electric Appl. Glassware Mirrors Pictures Serving Table Silver Dishes Silverware Table Linens Tables KITCHEN AND PANTRY Clock Cookers Cutlery Dishes Dishwasher Electric Appl. Food Supplies Kitchen Utensils Linens Microwave Mops & Brooms Refrigerator Stove Table 6
HALLS Chests Clocks Curtains- Drapes Lamps Mirrors Pictures Tables & Stands RESERVE CLOSETS Blankets Pillows Pillow Cases Quilts Sheets Spreads Towels GARAGE AND OUTBUILDINGS Auto Accessories Auto Tools Garden Tools Lawn Mower Other Tools Work Bench HOBBIES Cameras Fishing Equip. Golf Equip. Guns Boats & Motors Stamps Coins Records 7
BEDROOM No. 1 No. 2 # of Year Purchased Price Paid Beds Bedding Carpets & Rugs Chests Curtain- Drapes Dressers Dressing Table Lamps Mattresses Mirrors Pictures Tables BEDROOM No. 3 No. 4 # of Year Purchased Price Paid Beds Bedding Carpets & Rugs Chests Curtain- Drapes Dressers Dressing Table Lamps Mattresses Mirrors Pictures Tables 8
JEWERY - FURS - CHINA Rings Watches Bracelets Necklaces Earrings Brooches Fur Coats Fur Jackets Fur Scarves Crystal China Dishes Candle Holders Miscellaneous MUSICAL INSTRUMENTS Piano Saxaphone Trombone Trumpet Vioin Organ Paintings Vases Antiques Statuary Flat Silver Trays Silver Service ART -SILVERWARE 9
SUMMARY SUMMARY ROOM OR GROUP ORIGINAL COST PRESENT VALUE Living Room Family Room Bedroom No. 1 Bedroom No. 2 Bedroom No. 3 Bedroom No. 4 Bathrooms Attic & Basement Dining Room Kitchen & Pantry Halls Reserve Closets Jewelry, Furs, China Musical Instruments Art & Silverware Garage & Outbuildings Hobbies Men's Clothing Women's Clothing Children's Clothing Miscellaneous You have a considerable amount of property in your home. By completing this Household Inventory, you will be able to determine just how much insurance you should purchase. The homeowner s policy only provides limited protection for certain property such as jewelry, furs, goldware, silverware, boats and motors, stamp and coin collections and guns. Depending on their values, it may be advisable to insure these items separately under a Personal Articles Floater or by special endorsement. 10