ORDER BLANK 
ELM HIEE FARM 
WE DO OUR PART 
R. C. BELLARD 
Wayland 
Ohio, U. S. A. 
PLEASE PRINT NAME CAREFULLY 
Ship to, 
Name 
Street & No.. 
Post Office. 
Express Office 
How ship. 
If out of size ordered may 
we substitute next nearest 
Do not Write here 
Date 
State 
Ordetr 'No 
Shipped ). 
Rec’d . 
Express 
When 
Parcel Post 
If out of variety ordered may 
we substitute similar variety .Amt. Enc’ld 
No Order Filled For Less Than $1.00 
Quantity 
Variety 
Size 
Rate 
Amount 
II 1 
(Continue Order on Separate Sheet) 
