Appraisal Form We have carefully and thoroughly examined the article(s) listed below belonging to: Name ______________________________________________________________ Address ____________________________________________________________ This estimation is based on the current retail value and is not intended to include any applicable state or federal tax. In the event of any damage to the item(s) described below, the Appraiser is not responsible for the cost of the replacement of said item(s). Item Description Appraised Value The Appraiser assumes no liability for any action taken based on this appraisal. __________________________________________ Appraiser Signature _____________________________ Date