TEAR OFF AT PERFORATION. 
Direct City Line Telephone 
Service ANgelus 3183 
Name (Please Print)- 
MONTEBELLO 
CALIFORNIA 
-Date- 
193 
Street Address or RFD No._ 
City_ 
-Ship via_ 
Mail - Express - Truck 
-State- 
Check or 
.Money Order 
Do you want us to send an equally good variety if any of the kinds ordered are sold out. Yes O No Q 
If shipment to different address than above is desired, fill this out. 
Name (Please Print)- 
Street Address or RFD No.- 
City_ 
State 
V 
Quantity 
DESCRIPTION 
Each 
Ami 
aunt 
$ 
c 
— 
— 
Add state sales tax on shipments in California. 
(OVER) AMOUNT FORWARD 
