Railway express agency 
INCORPORATED 
(Printed in U.S.A.) 
ORIGINAL (Form 5076) 
UNIFORM EXPRESS RECEIPT 
NON-NEGOTIABLE 
/ 
Boston, Mass. (754-M) 
Received jrom ___ 
Address 
Article _ 
21-106 PREPAID 
IQ 
Date 
A l 
_ 
A 
U 
Subject to the Classifications and Tariffs in Effect on Date of Issue 
.Weights 
Consigned to_ 
At 
. 
Express Charges 
jr 3 
Value Charges 
C. 0. D. 
C.O.D. 
Service 
. Charge 
Number 
Value herein declared 
by Shipper to be- 
Street 
City 
State 
Which the Company agrees to carry upon the tgrms and conditions printed on the back 
hereof, to which the shipper agrees, and as evidence hereof, accepts this receipt. 
-Dollars 
For the Company 
Date- 
From Boston, Mass. (754-M) 
(5076) 
V ^ 'F t ' 3 5 
No. Pieces; 
/ 
/ 
V 
/eight 
Express Chgs. 
<3 
C. 0. D. 
C.O.D. 
Service 
Charge 
Declared Value 
Value Charges 
NOTE 
/ 
The Company will not pay 
over $50, in case of loss, or 
50 cents per pound, actual 
weight, for any shipment in 
excess of 100 pounds, un¬ 
less a greater value is de¬ 
clared and charges for such 
greater value paid. 
