FARM PERSONAL PROPERTY INVENTORY …

1 farm PERSONAL PROPERTY INVENTORY SCHEDULED farm PERSONAL PROPERTY UNSCHEDULED farm PERSONAL PROPERTY TOTAL SCHEDULED VALUE TOTAL UNSCHEDULED VALUE $_____ $_____ Comments: _____ Policy provisions require individual scheduling of above items when not being used in Unscheduled farm PERSONAL PROPERTY . The following items may be optionally scheduled. Item (Describe) Value TRACTORS (505) No. 1 _____$_____ No. 2 _____$_____ No. 3 _____$_____ No. 4 _____$_____ Garden Tractor _____$_____ Skid Loader _____$_____ _____$_____ Combine No. 1 (505) ____$_____ Combine No. 2 (505) ____$_____ Combine Heads _____$_____ Swather _____$_____ Picker/Sheller (505) _____$_____ Other Self-propelled (505) $_____ _____$_____ _____$_____ Port.

2 Elevator _____$_____ Port. Auger No. 1 (505) __$_____ _____$_____ Port Auger No. 2 (505) ___$_____ _____$_____ Bale Racks & Trailers ____$_____ Beet Defoliators _____$_____ Beet Lifters _____$_____ Beet Thinners _____$_____ Chisel Plow_____$_____ Corn Planter _____$_____ Crop Sprayer _____$_____ Drill Seeder _____$_____ Disc_____$_____ Drag _____$_____ Fert. Spreader _____$_____ Field Cultivator _____$_____ Grain Wagons_____$_____ Grinder/Mixer/Mill _____$_____ Hay Baler _____$_____ Hay Crimper _____$_____ Hay Stacker/Loader _____$_____ Hay Stack Mover _____$_____ Livestock Trailer (Unlicensed)$_____ Mach. Trailer (Unlicensed)__$_____ Manure Spreader _____$_____ LIVESTOCK Number Value Total CATTLE (514) Dairy Cows _____ @ _____ $ _____ Heifers _____ @ _____ $ _____ Calves _____ @ _____ $ _____ Feeder Cattle _____ @ _____ $ _____ Stock Cattle _____ @ _____ $ _____ Bulls _____ @ _____ $ _____ Registered Cattle _____ @ _____ $ _____ SHEEP (514) Ewes _____ @ _____ $ _____ Rams _____ @ _____ $ _____ Lambs _____ @ _____ $ _____ HOGS (514)

3 Sows _____ @ _____ $ _____ Boars _____ @ _____ $ _____ Feeder Pigs _____ @ _____ $ _____ HORSES (514) _____ @ _____ $ _____ TOTAL LIVESTOCK .. $ _____ POULTRY Hens (514) _____ @ _____ $ _____ Fryers _____ @ _____ $ _____ TOTAL POULTRY .. $ _____ HAY, STRAW, & FODDER Hay (522) _____ @ _____ $ _____ Straw _____ @ _____ $ _____ Fodder/Silage _____ @ _____ $ _____ TOTAL HAY, STRAW, & FODDER: $ _____ GRAIN, FEED, & SUPPLIES Corn (521) _____ @ _____ $ _____ Soybeans _____ @ _____ $ _____ Wheat _____ @ _____ $ _____ Oats _____ @ _____ $ _____ Sunflowers _____ @ _____ $ _____ farm Chemicals _____ @ _____ $ _____ Veterinary Supplies _____ @ _____ $ _____ Fuel Oil & Grease _____ @ _____ $ _____ Paints _____ @ _____ $ _____ Commercial Feed _____ @ _____ $ _____ Ground Feed _____ @ _____ $ _____ _____ _____ @ _____ $ _____ TOTAL GRAIN, FEED, & SUPPLIES $ _____ Item (Describe)

4 Value Mower _____$ _____ Plows_____$ _____ Potato Digger _____$ _____ Rakes _____$ _____ Rotary Tiller/Hoe _____$ _____ Row Cultivator_____$ _____ Silage Wagon _____$ _____ Silage Cutter/Blower __$ _____ Stalk Cutter _____$ _____ Snow Blower _____$ _____ Spraying Tank _____$ _____ Tractor Loader _____$ _____ Vaculator _____$ _____ Other farm Mach.(505)$ _____ _____$ _____ _____$ _____ _____$ _____ TOOLS & MISC EQUIPMENT (506) Electric Motors _____$ _____ Fuel Tanks _____$ _____ Port. Generator _____$ _____ Spare Parts _____$ _____ Power Tools _____$ _____ Hand Tools _____$ _____ Welder_____$ _____ Compressor_____$ _____ Bldg/Fencing Material _$ _____ _____$ _____ _____$ _____ TOTAL farm MACHINERY & EQUIP. $ _____ 1 2 3 4 5 INSTALLED EQUIPMENT (591) (Must be scheduled to be insured) Bulk Tank/Cooler $_____ Crop or Grain Dryer $_____ Milk House Equip.

5 $_____ Milking Machine (Port)$_____ Hog House Equip. $_____ Poultry Equipment $_____ Silo Unloader $_____ TOTAL INSTALLED EQUIPMENT $_____ 6 8 7 -10- farm MACHINERY & EQUIPMENT farm PERSONAL PROPERTY INVENTORY SCHEDULED farm PERSONAL PROPERTY UNSCHEDULED farm PERSONAL PROPERTY Comments: Item (Describe) Value _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ _____ $ _____ LIVESTOCK Number Value Total _____ _____ @ _____ $ _____ _____ _____ @ _____ $

6 _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ TOTAL LIVESTOCK .. $ _____ POULTRY _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ TOTAL POULTRY .. $ _____ HAY, STRAW, & FODDER _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $_____ _____ _____ @ _____ $ _____ _____ @ _____ $ _____ TOTAL HAY, STRAW, & FODDER: $ _____ GRAIN, FEED, & SUPPLIES _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ _____ _____ @ _____ $ _____ TOTAL GRAIN, FEED, & SUPPLIES $ _____ farm MACHINERY & EQUIPMENT Item (Describe) Value _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ Item (Describe)

7 Value _____$ _____ _____ $ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____ $ _____ _____$ _____ _____$ _____ _____$ _____ TOOLS & MISC EQUIPMENT (506) _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ _____$ _____ TOTAL farm MACHINERY & EQUIP. $ _____ 1 2 3 4 5 INSTALLED EQUIPMENT (591) (Must be scheduled to be insured) _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ TOTAL INSTALLED EQUIPMENT $_____ 6 -10a- farm MACHINERY & EQUIPMENT con t Concrete Floor? Insulated & Covering? Pit Under Building? CLASS G - farm OUTBUILDING SCHEDULE Loc. # Class Building Use Type of: Year Built Dimensions/Bushel Capacity Total Square Feet Cost Per Sq.

8 Ft. Subtotal Fixed Equipment Replace- ment Cost Amount of Insurance Requested Roofing Exterior Wood/Steel/ Pole/Block Age L W H Heated? Wired? x = + = CLASS A - RESIDENTIAL REPLACEMENT GUIDE Step 1 - General Year Built: _____ Roof Age: _____ Condition: _____ Number of Stories: 1 1 1/2 2 2 1/2 3 Bi-level Tri-level Exterior Wall Category: I II III Substructure: Slab Crawl Space Basement Occupancy: 1-Family 2-Family 3-Family 4-Family Residence Ground Floor Area Square Ft.

9 _____ Base Cost $_____ Substructure and Occupancy Adjustment $_____ Total Adjusted Base Residence Cost $_____ Step 2 - Additional Features Attached Garage: 1-car 2-car 3-car Sq. $ _____ Built-in Carport Carport w/Storage Basement Frame Masonry Unfinished Lower Level & Unfinished Half Story (Bi-Level, Tri-Level, or Half Stories only) Sq. Ft. _____ (Deduct.) $ _____ Room Additions Above Garage: _____ $ _____ 3-Wall Additions: Frame Masonry Veneer w/Basement w/o Basement 1-Story 1 1/2-Story 2-Story _____ $ _____ Breezeways: Open Enclosed Area: _____ $ _____ Porches: 1-Story 1-Story with Deck 2-Story w/Basement Open Enclosed Area: _____ $ _____ Screened Alum. Encl: On Posts Slab 4 Ft Fnd Wall Sq. $ _____ Balconies/Decks: Area _____ $ _____ Roof Adjustments (Other than asphalt shingles): Type _____ $ _____ Finished Attics: Finished Area_____ $ _____ Finished Basement: Finished Area _____ $ _____ Walk-Out Basement _____ $ _____ Extra Baths: Full Half Add l Fixtures _____ $ _____ Air-conditioning: Heating Ducts Separate Ducts _____ $ _____ Fireplaces: # of Hearths ___ # of Chimneys___ Pre-Fab Metal ___ $ _____ Built-ins (Hot Tub, Sauna, etc.)

10 _____ $ _____ Total Additional Features _____ $ _____ Step 3 - Class of Construction Basic B C D Pre - 1980 BB CC DD Pre - 1940 X Y Z Class-Location Multiplier: _____ $ Adj. Base Residence Cost Total Add l Features Cost Total Base Cost Class-Location Multiplier Total Replacement Cost % Depreciation (50% max) $ $ $ $ $ 11