Living Room
  Year Purchased Amount Paid Estimated Replacement Cost
Television
Stereo/Cassette/CD Player
VCR/DVD
Sofas
Chairs
Bookcases
Table (Coffee, End)
Entertainment Center
Books
Records/Tapes/CDs
Art/Collections
Drapes/Blinds
Rugs/Carpets
Lamps
Floor Coverings
Other
Total Living Room
   

 

Bedroom / Bathroom
  Year Purchased Amount Paid Estimated Replacement Cost
Television
Bedding/Linen
Dresser/Chest of Drawers
Night Tables
Lamps
Radio/TV
Suits
Coats
Formal Attire
Shoes/Boots
Sweaters
Slacks/Jeans
Skirts
Dresses
Other Clothing
Ties/Scarves/Accessories
Purses
Jewelry
Drapes/Blinds
Rugs/Carpets
Grooming Appliances
Towels
Other
Total Bedroom/Bathroom
   

 

Kitchen / Dining Room
  Year Purchased Amount Paid Estimated Replacement Cost
Table/Chairs
China Closet/Hutch
Major Applicances
Toaster/Microwave
Mixers/Processors
Pots & Pans
Kitchen Utensils
Dishes
Glassware
Silverware
Linens, Napkins, Towels
Other
Total Kitchen/Dining Room
   

 

Sports/Hobby Equipment
  Year Purchased Amount Paid Estimated Replacement Cost
Golf Clubs
Fishing Tackle
Guns
Bicycles
Tennis Eqiuipment
Camera & Accessories
Exercise Equipment
Ski Equipment
Other
Total Sports/Hobby Equipment
   

 

Other Items
  Year Purchased Amount Paid Estimated Replacement Cost
Telephones/Answering Machine
Fans
Heaters
Desks
Computers
Luggage
Musical Instruments
Sewing Machine
Tools
Lawn & Garden
Other
Total Miscellaneous
   

 

Totals
Living Room
Bedroom/Bathroom
Kitchen/Dining Room
Sports/Hobby Equipment
Miscellaneous
Grand Total