20 THE CONNECTICUT AGRICULTURAL 



1 



THE CONNECTICUT 



AGRICULTURAL EXPERIMENT STATION 



New Haven, Conn. 



Form for Description of Sample. 



Station No Rec'd at Station, 18 



Each sample of Fertilizers sent for gratuitous analysis must be 

 accompanied bj^ one of these Forms, with the blanks heloic filled 

 out fully and legibly. 



The filled out Form, if wrapped up with the sample, will serve 

 as a label. 



Send with each sample a specimen of any printed circular, pam- 

 phlet, analysis, or statement that accompanies the fertilizer or is 

 used in its sale. 



Brand of Fertilizer, 



Name and address of Manufacturer, 



Name and address of Dealer from whose stock this sample is 



taken, 



Date of taking this sample, 



Selling price per ton or hundred, bag or barrel, 



Selling weight claimed for each package weighed, 



Actual weight of packages opened, 



Here write a copy of any analysis or guaranteed composition 

 that is fixed to the packages. 



Signature and P. O. address of person taking and sending the 

 sample. 



