MELROSE IRIS GARDENS | conver no. 
ROUTE 6, BOX 424 
MODESTO, CALIFORNIA DATE RECEIVED Re notes, ote te 
DATE*SH|PPED a 
AMOUNT. ENCLOSED $20 3-22. 
PLEASE TYPE OR PRINT ADDRESS VERY PLAINLY. REMITTANCE WITH ORDER, NO C.O.D. 
IN CASE OF SHORTAGE NAME 3 SUBSTITUTES OF SAME VALUE. DO NOT SUBSTITUTE (_ ) 
QUANTITY NAME OF VARIETY 
On Mail Orders of $5.00 and under, add $.50 
ne  ———————————— 
California Residents add 3% Sales Tax 
TOTAL 
Don't forget to choose your FREE PREMIUMS (See page 1) 
Continue order on other side of sheet. 
