
SHIP VIA: O . 
ALBERTS & MERKEL N° 16961 
[] EXPRESS COLLECT : 
# 
BROS., INC. [] EXPRESS PREPAID 
la) [] AIR EXPRESS COLLECT é 
nchid WUunserted >on 
[] AIR EXPRESS PREPAID (ORDER NO. 
ROUTE 6, P. O. Box 77 [] AIR MAIL PREPAID 
SOUTH JACKSONVILLE 7, FLA. [] PARCEL POST PREPAID DATE ORDER RECEIVED 
[] AIR MAIL PARCEL POST 
() R ) kK R \ Hl i I T PREPAID DATE ANSWERED 
Se 
DATE —“‘SCSCSCSS*tsédL:C ORDER CONFIRMED 
SHIP 5 
To APPROX. DATE SHIPMENT 
(PRINT AND PREFIX MR., MRS., OR MISS) R.F.D. NO 
STREET. P, O. BOX ORDER COMPLETE 
Post ———_ 
OFFICE ZONE BACK ORDER 
STATE PAYMENT RECEIVED 
EXPRESS 
ADDRESS PLEASE DO NOT WRITE 
GIVE ONLY IF DIFFERENT FROM P. O. NEE ACE ABOVE | 
CATALOG POT | UNIT TOTAL 
QUAN. | NUMBER DESCRIPTION | wer. ieee PRICE | DOLLARS CENTS 




| 
| 
| | 
| | 
fre 
| | 
| | 

















| 


| 
| 
| 
| 
| 
| 
| 
| 
| 
te 
TOTAL 
SHIPPING AMT. FOR 
WEIGHT | __ PLANTS 
[] SEND ADDITIONAL ORDER BLANKS TOTAL BR'T. | 
FROM 
OTHER SIDE 


PACKING | 
|] CHECK OR MONEY ORDER ENCLOSED | 
CHARGES : 
(DO NOT SEND MONEY UNTIL ORDER IS CONFIRMED) | SHIPPING 
CHARGES | 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 
| 

| AMOUNT 
DUE 

0 Fa pe eri 
TERMS: CASH UPON CONFIRMATION | REFUND | RERUND. |e?) 1c 
| TOTAL | | 
