Number 
Cash .. 
Stamps 
Check 
Draft ....... 
Refund . 
P. M. Order 
E. M. Order. 
Total . 
Do Not Use This Space 
O. K.'d by . 
Shipped via . 
Date rec'd . 
Date sent___ 
Filled by.... 
Checked by . 
Packed by .... 
Number packages.. 
Postage .. 
V 
QUANTITY 
NAME VARIETY 
PR 
ICE 
V 
£ 
£ 
S 
ry 
S 
J 
-D 
) 
O 
O- 
o 
C/D 
hH 
ar 
Eh- 
■ffl 
£h 
£ 
>—1 
IN 
W- 
-W 
h 
Eh 
h-1 
£ 
E-l 
Eh 
O 
O 
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n 
O 
W 
CO-) 
w 
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c 
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CL, 
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Amount carried forward other side: 
Order Blank 
For High Grade Tested Seeds 
f R, J E , your address plainly and in full in 
the blanks below, and use another sheet for other matters you 
o adtA°t J vrite about - This enables us to FILL ORDERS 
RAPIDLY and correctly, and your inquiries will not be so 
apt to be overlooked. For full instructions about ordering etc 
see directions page 104 of catalog. 
D. V. BURRELL SEED GROWERS CO., Rocky Ford. Colo. 
forwS^to- 1116111 aCCOrdanC ° tenns of y° ur Descriptive Catalog, please 
Check how goods 
are to be sent: 
Date. iq 
Parcel 
Post 
□ 
Name. 
Postoffice... 
(First Name) 
(Middle Initial) (Last Name) 
□ 
Rural 
Route. 
Box 
.No. 
Freight 
□ 
Please give both your Route Number and Box Number if on a Rural Route 
Street 
EXTRA SEEDS FOR THE NAMES OF THOSE WHO GROW GARDENS. SEE OTHER SIDE. 
