ORDER FORM 
BACK SEED COMPANY 
5010 WASHINGTON AVENUE 
Racine, Wisconsin 
(Mr., Mrs. or Miss ; write name plainly) 
Street _______ R. D __ Box 
Post Office ___________P. O. Box _ 
Express or 
State _ Freight Office ..... 
Forward goods by Parcel Post .... Express .. Freight . 
Check how goods are to be sent. 
Date 
WE GIVE NO WARRANTY, EXPRESS OR IMPLIED, AS TO DESCRIPTION, QUALITY, PRODUCTIVENESS OR ANY OTHER MATTER OF ANY SEEDS, 
BULBS, PLANTS OR TREES WE SEND OUT, AND WILL NOT BE IN ANY WAY RESPONSIBLE FOR THE CROP. _ 
Lb. 
Os. 
Pkt. 
NAME OF ARTICLE WANTED 
Price 
. 
. 
— 
— 
f—.■ 1 -■ 
Total 
Amount Enclosed 
Money Order - 
Cash - 
Stamps - 
Total - 
NOTICE — Remittance by 
Postal Money Order Is a 
guarantee against loss. We 
prefer them for oar matnal 
protection. Use them if eon- 
Do Not Write in 
This Space 
TEAR OFF HERE 
