P. O. Box 908 332 Jason Avenue lowa Falls, lowa 
Namie Weeki eno ees tree So iene lp eet een yeh ea Date__ eel SP eons. 
RIED: Sor Street. ue eR ae ee 
Post Ortiee: ee ie ea aie ee a State eee 
IN CASE WE ARE SOLD OUT OF ANY ITEM, SHALL WE 
O Refund [1] Substitute Nearest Size 1) Substitute Nearest Variety 
Varieties you would like as extras: 
(Mention several from which we may select)-_.........-------_-_--________-_. 
Quantity | Size Variety Price 
iB 
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a 
: 
Ma 
TOTAL AMOUNT 
(Order may be continued on other side) 
