ORDER BLANK 
CARL PURDY, Ukiah, Calif. 
Please forward the following ORDEE for amount enclosed. 
Name .. 
(Say whether Mr., Mrs. or Miss; write name plainly) 
Street. 
Post Office 
County. 
Date. 
R. D.Box 
... P. O. Box. 
.. State. 
Amount Enclosed 
Money Order. 
Cash . 
Stamps . 
Check . 
QUANTITY 
NAME OF ARTICLE WANTED 
PRICE 
* 
TOTAL 
l-1939-gM. 
CALIFORNIA CUSTOMERS MUST ADD SALES TAX 3% 
Reverse side may be used for more space. Extra blanks on application. 
