ORDER BLANK 
Humphrey-Coker Seed Co. 
Hartsville, S. C. 
Date 
Deliver. | “the Following SeedsTo: 
Ship 
Name 
Post Office 
Shipping Point 
Date Ship__ PIPE 
Draft. Through...» 4 4} es ee ee ee 
(BANK) 
CERTIFIED & SELECTED SEEDS 
QUANTITY VARIETY PRICE VALUE 
TOTAL AMOUNT OF ORDER 
AMOUNT PAID 
BALANCE DUE 
A99S 
