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SCHEDULED PERSONAL PROPERTY SUPPLEMENT
 
NAME _____________________________ POLICY # ___________________
   

This form is to be submitted only when additional space is required to schedule personal property. Subtotal by Class.

Circle all classes that apply:

1. JEWELRY 5. SILVERWARE 8. STAMPS
2. FURS 6. GOLF EQUIPMENT 9. COINS
3. CAMERAS 7.a. FINE ARTS (WITHOUT BREAKAGE 10.. FIREARMS
4.. MUSICAL INSTRUMENTS 7.b. FINE ARTS (WITH BREAKAGE)    
     
     
# & CLASS
DESCRIPTION
BRK
$ LIMIT
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    5261 (07/2005)