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Paes siss. LBW TS ES PS oe = ae ae ts i eR Fe ee ee ee ee ee eee Le Street:2. 2 eee 
(Print Name Plainly) 
HeGi ds faba (oi = et 2: Oe Oe ee ee Se ee ee State sins ee eee ee eee eee County... ee 
ERD SI Qe Beene ee Se 2 s Ox aING see ee ewe ee. 5 eS Express’ Office. =. 2 eee 
ASA SEPS SUT Teed OG el hE Sa pe at gle ool SA ce ae 
(Please Give Approximate Date Desired) (Express—Parcel Post) 
We recommend express on all heavy shipments 
QUANTITY VARIETY OR SPECIE AGE SIZE PER C PER M 
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rn | SS | || 
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= How’ To Ship 2). 5 0 ne a 
EXTENSION 
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_ Total Value 
Cash Discount on Total Value Only 
Total 
Signed 
