For use in connection with the Standard form of Straight Billof Lading approved by the Interstate Commerce Commissionby Order No. 7S7 of June 27, 1303 
— — — — — — — — — R3.ilr03.ci Company Shippers No. 
THIS MEMORANDUM is an acknowledgment that a bill of lading has been issued and is not the Original Bill of Lamina 
nor a copy or du plicate, cov ering the property named herein, and is intended solely for filing or record. * a f < cnts No 
RECEIVED, subject tj tho clzosiric^sns ar.d taritrs in eiiecl on the date of the receipt by the carrier of the property described in the Original Bill of Ladina, 
At Salt Lake City, Utah, 
191 
FROM 
THE MINE & SMELTER SUPPLY CO. 
said Company 
: r 01 ail or any 
dhall be subject 
The Rate of Freight from Salt Lake City, Utah, to 
If — times 1st 
If 1st Class 
If 2d Class 
If 3d Class 
If 4th Class 
If 5 til Class 
If Class A 
If Class B 
— 
If Class C 
* VV 
If Class D 
If Class E 1 
If Special 
per 
(Mail Address— Not for purposes of delivery.) 
Consigned to 
Destination 
State of 
County of. 
Route 
Car Initial 
Car No. 
No. 
Packages 
DESCRIPTION OF ARTICLES AND SPECIAL MARES 
WEIGHT 
(Sub. to Correction) 
CLASS 
or RATE 
CHECK 
COLUMN 
If charges are to be pre- 
paid, write or stamp here, 
To be Prepaid.” 
c < 
Received $_ 
to apply in prepayment 
of the charges on the 
property described 
hereon. 
Agent or Cashier. 
Per. 
(The signature here acknow- 
ledges only the amount 
prepaid.) 
Charges Advanced : 
$- 
This is to certify that the articles in this shipment are properly described, packed and marked, and that all necessary labels have been 
attached to packages, as required by General Notice r 
' A24620 
THE MINE & SMELTER SUPPLY CO., Shippers 
Per 
-Agent 
Per 
24452 M * Sft ** »r umtu aut— wa^hio Rt»«*«TE# oo., 
