HORNRERGER’S ttome and garden service 
21 
Order Blank 
F. C. HORNBERGER 
Home and Garden Service 
R. 1 CLARK ST. - - HAMBURC, N. Y. 
NAME. 
Our Order No. 
DATE. 
ADDRESS. 
Express Office .If different from P. O. 
How Ship. When.. 
Wt. . Substitute.... Yes. No. 
Write Letter on Separate Sheet of Paper. 
Amount $. 
How Sent. 
Charge.. 
Balance Due $. 
C. O. D. $.. 
Refund $.. 
Packed By. 
Quantity Size_Name Price Amount 
» 
1 
i 
1 
1 
1 II 
1 II 
1 
1 
! 
1 II 
1 II 
! 
1 
1 
1 
1 
! 
1 
1 
1 
I 
! 
i 
i 
1 ! 
I 1 
! 1 
1 
1 
! 
1 
(OVER) 
TERMS: Cash with Order; or 20% Cash, Balance C. O. D. 
