Form Dfs-Up-155 - Safe Deposit Box Inventory Form Of Property Presumed Unclaimed (Page 3 of 4) in pdf

OWNER’S NAME_____________________________________________________ SAFE DEPOSIT BOX # _______________________ PAGE________ OF________

SB 07-MISCELLANEOUS

QTY

SB 02-WATCHES

QTY

SB 07-MISCELLANEOUS VALUABLES

QTY

VALUABLES

Y/M WATCH W/BAND(S)

ARROW HEAD(S)

SILVER CANDLE HOLDER(S)

Y/M WATCH W/STONE(S)

BASEBALL(S)

SILVER FORK(S)

Y/M WATCH NO BAND(S)

BASEBALL CARD(S)

SILVER INGOT(S)

Y/M POCKET WATCH(S)

BELT BUCKLE(S)

SILVER KNIFE / KNIVES

Y/M POCKET WATCH W/CHAIN(S)

BEZEL(S) COIN, JEWELRY

SILVER MEDALLION(S)

BINOCULARS

SILVER SERVING PIECE(S)

Y/M POCKET WATCH W/CHAIN &

POCKET KNIFE

CALCULATOR(S)

SILVER SET(S) (# OF PIECES)

MISC. WATCH PARTS, BEZELS,

CAMERA(S)

# OF PIECES IN ALL SETS

BANDS. LINKS, ETC.

CARVED PIECES

SILVER SPOON(S)

WATCH CHAIN(S)

CHANGE PURSE OR PURSE

SILVER TRAY(S)

W/M WATCH W/BAND(S)

CLOCK(S)

SOUVENIR SPOON(S)

W/M WATCH W/STONE(S)

SPORTS MEMORABILIA

COMM. MEDALLION SET(S) &

W/M WATCH NO BAND(S)

TOTAL # OF MEDALLION(S)

SWEATER GUARD(S)

W/M POCKET WATCH(S)

COMMEMORATIVE MEDALLION

THIMBLE(S)

W/M POCKET WATCH W/CHAIN(S)

COMPACT(S)

U.S. STAMP(S)

EYE GLASSES

W/M POCKET WATCH W/CHAIN &

U.S. STAMP BOOK(S) &

POCKET KNIFE

FOREIGN STAMP(S)

# OF STAMPS IN BOOK(S)

FOREIGN STAMP BOOK(S) &

# OF STAMPS IN BOOK(S)

W/M KEY CHAIN(S)

GOLD BAR(S)

W/M LIGHTER(S)

QTY

SB 12-U.S. SAVINGS BONDS

GOLD CAPPED TOOTH / TEETH

W/M MONEY CLIP(S)

U.S. SAVINGS BOND(S) $10,000.00

HARMONICA(S)

WALLET(S)

U.S. SAVINGS BOND(S) $1,000.00

HISTORICAL DOCUMENT(S)

WAR MEDAL(S)

U.S. SAVINGS BOND(S) $500.00

KNIFE / KNIVES

WHISTLE(S)

U.S. SAVINGS BOND(S) $100.00

Y/M KEY CHAIN(S)

MANICURE SET(S) &

U.S. SAVINGS BOND(S) $75.00

TOTAL # OF PIECES IN SET(S)

Y/M LIGHTER(S)

U.S. SAVINGS BOND(S) $50.00

MILITARY PIN(S)

Y/M MONEY CLIP(S)

U.S. SAVINGS BOND(S) $25.00

MISC. BOOK(S) ALL KINDS

MISC. BOTTLES, PERFUME, PILL,

MISC. BUTTON(S)

MISC. DAMAGED COIN(S)

SB 05-BONDS

QTY

(NOT SAVINGS BONDS)

MISC. PIN(S)

OTHER BONDS (i.e State of Israel)

MISC. SHELL(S)

SB 06-PERSONAL

BEARER BONDS

MISC. TOKEN(S)

DOCUMENTS

MISCELLANEOUS BOXES (PILL,

WOOD, TIN, GLASS, JEWELRY)

MISC. ROCK (S)/STONE(S)

MISC. SILVER PIECE(S)

MUSIC BOX(S)

NAPKIN RING(S)

OLD MAGAZINE, COLLECTABLE

OLD NEWSPAPER, COLLECTABLE

QTY

SB 11-CHECKS

PEN/PENCIL(S)

CERTIFICATE(S) OF DEPOSIT

PEN-PENCIL SET / REFILLS &

TRAVELER’S CHECK(S)

NUMBER OF PIECES IN SET(S)

THIRD PARTY CHECK(S)

PICTURE(S), PAINTING(S)

OTHER CHECK(S)

POCKET KNIFE / KNIVES

PRAYER BEADS (ROSARY)

SILVER BOWL(S)

MISC. SOUVENIR’S

KEY(S)

LETTER OPENER(S)

Form Dfs-Up-155 - Safe Deposit Box Inventory Form Of Property Presumed Unclaimed Page 3

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