ORDER FORM 
BACK SEED 
5010 Washington Ave. 
COMPAIVY 
Racine, Wisconsin 
Name 
Street. 
(Mr., Mrs. or Miss; write name plainly) 
R.D 
Amount Enclosed 
t- 
Do Not Write in 
This Space 
Box 
Money Order ... 
Ca^h .... 
Fost Office . P. O.Box 
Express or 
State . Freight Office .. 
Ftrwomrd goods by Parcel Post . Express . 
Check how goodB are to be sent. 
Date 
Freight. 
St am ps . 
T otal .... 
NOTICE — Remittance by 
Postal Money Order is a 
sruarantee against loss. We 
prefer them for oor mntaal 
protection. Use them if con* 
▼enient. 
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. 
Oa. 
Pkt. 
NAME OF ARTICLE WANTED 
Price 
— 
— 
Total 
TEAR OFF HERE 
