ORDER BLANK OurNos. eee 
SIMPSON SEED CO. 
1525 Champa St. feel te Denver 2, Colo. 
Order Early — Items Will Be Shipped Fast as Ready AMOUNT ENCLOSED 
SHI RIO'e INCING atom enuer ata keke Nt Me eee oy Dateline tbr says Biesecce’ putes 
(Please Print) Date Rec. 
Street or | 
Rear ENO seners Bi Sen et We de ess Oa a ete OR Ree at ert GL LONG see 
Town or | Date billeds¢:) oes ek fee 
City nc: CNPC eae © aaah Poirot SRC Meat ae re ot Meer eee Be oe) Stateseyp ses aera 
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May We Substitute? Yes[ | No[_ | y 
Forward by Parcel Post [| Express [| Freight [| Best Way []| Checked by... 
mh QUANTITY NAME OF ARTICLES WANTED | PRICE AMOUNT 
COLO. STATE SALES TAX 
DENVER SALES TAX 
TOTAL 
NOTE — Items out of Stock will be sent soon as ready or if unable to supply, we will refund amount due you 
