WHEN ORDERING ON 
MONTHLY 
PAYMENTS 
Write Order on the Other Side of this Sheet 
Then Sign and Fill In the Proper Form Below 
FOR THOSE WHO DO NOT NOW HAVE AN ACCOUNT WITH US 
Montgomery Ward & Co.: lam enclosing $.......... as a down 
payment on the Monthly Payment price of the goods listed on 
opposite side. 
Thirty days after 1 receive the goods I will pay $...:...... at the 
place to which I send this order, and a similar amount each 
thirty days thereafter until the total Monthly Payment price is 
paid. Until the goods are fully paid for, title and right to possession 
shall remain in you.* I will not sell, remove, or encumber them 
Your Signature 
WRITE—do not print 
street Address. 
Signature of Wife 
without your written consent and will assume responsibility for 
any loss or damage to them. Should I fail to make any payment 
when due, you may retake the goods at any time after such 
default* or you may hold the undersigned jointly and severally 
for the full unpaid balance, which shall then become due and 
payable. I submit the following statement to induce you to ex- 
tend credit on this basis. 
*Not applicable in Maryland or New York 
WRITE—do not print 
Box. 
Route 
Post Office Gountyiae = 2 Site: 
If married, all answers should apply to Husband unless otherwise indicated 
¥, (Minors will have Parent or Guardian sign and fill in application) 
"What is Are you Number of How long have you 
your age? married? dependents___—S “ved in your community? 
Do you rent 
or own home?____. 
Your rent or 
mortgage payment$ 
Employer’s 
name and address. 
Please give 
former address 
Are you stead- 
ily employed? 
(Please give company name and address) 
What kind 
of work? 
How long with 
present employer? 
(Yrs.-Mos.) 
Weekly average From what 
other income $22 =e source? 
Have you had a previous 
If so, give location of Wards 
account with Wards? 
Branch where account carried 
How long with 
Your present 
former employer? 
weekly earnings $ 
Wife's 
weekly earnings $ 
Wite's 
employer. 
When did you make final 
payment on your account? 
PLEASE GIVE NAMES AND ADDRESSES OF REFERENCES BELOW 
Relative Address. 
Friend 
Bank a Address 
Store Address 
Relationship. 
Address _————— nn $$. $$ 
Buciier eee 
IF YOU ARE A FARMER, ALSO ANSWER THESE QUESTIONS 
Yearly income 
from main crop? 
What is your 
main crop? 
Do you rent 
on shares or for cash? 
What is AVERAGE weekly cash 
income from eggs, milk, produce, etc.? 
Do you own 
your farm?. 
In what town do 
you trade most? 
FOR THOSE WHO ALREADY HAVE AN ACCOUNT WITH US 
Montgomery Ward & Co.: Please ship goods listed on opposite side 
and add to the account bearing the account number shown below. 
lagree that this purchase may be combined with all Monthly Pay- 
Your Signature Here (WRITE—Do Not Print) 
ment contracts bearing this account number upon which there 
is an unpaid balance. The provisions in the original contract 
and the monthly terms in your catalog apply to this purchase. 
Street Address or 
Route and Box No. 
Give location of Wards Branch 
where your account is now carried 
Post Office. 
State. 
Your,Account Number. ae ee ee 
