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ORD&
Oii
OTHER SIDI
USE THE SPACES BELOW FOR. OR.DER.ING ADDl110NAL
.
ITEMS
~":~ ~::.::r lfFumlshed..J;:~~~~~tl:SAe'!l:1temOrdered
cofc:>~
NOT
FORG~ZE eo~:rd, ~:c:::iz:
l!;
Shipping Weight
-~---------1----i---------------------------l~P=aff-e=m~,~fin="i=sh~·=Etc.=l·--W;.;.;.;M=th~,=Etc.:..._
1
_P~a-~
••
a~c.-
1
____
Th_1_1_c~olu~mn'""'"--I~~~
:c
:::;
--------1----1--------------------l·-Color,
etc.---Slz-
----1-----1----1~1----1'----
ID
~
-----------1---1-------------------1--Color, etc.---Slz-1----1-----1---
!!! ----
--------1---1-------------------1--Color, etc.---Siz- ----1-----11-
ID
:c
-I
en------
>
z
0
.. =-------1----1-------------------l--Color, etc.---Siz-----1-----1---
::?J ------
ID
c::
--------11---1-------------------1-Color,
etc.---Slz-----1-----1----1~
------
i:
:a
--------11---1-------------------1--Color, etc.---Siz-----1-----1---
~
--- ---
r-
~
--------1----1-------------------1-Color, etc.---Slz- ----1-----1--- -
---
n
---------1---1------------------~1--Color,
etc.---Slz-----1-----1---
~
------
-
~
c::
--------1---1-------------------1-Color, etc.---Siz-----1-----1---
0 ------
Z
-I
--------11---1----~----------------Color,
etc.---Slz-----1-----1---
=!------
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r-
--------1---1-------------------1--<:olor, etc.---Siz-----1-----1---
~~
---
G;
:c
________.___...,__________________.....____....i.__________
~---~1-~..;;;1~~
1l
FIGURE TOTALS HERE AND ADD IN TOTAL. SPACES
ON
OTHER SIDE_.
WHEN ORDERING ON l;ASY PAYMENT TERMS THE HEAD OF HOUSEHOLD
SHOULD SIGN BELOW AND ANSWER QUESTIONS
10.00
orm- requite a
down
payment.
See
Easy
Payment aplanallon I
SEARS, ROEBUCK AND CO.: Enclosed
is
a deposit of $.a - -
_which
is to he used
in
part payment of themerchandise shipped. Begin-
ning thirty
days
after the shipment
is
received, I
will
pay$.•
~~·
..each month as required by your terms until the unpaid balance, plus
carrying charge to
be
added as shown
in
your catalog, has been entirely paid. Until full paymcr;t
is
!T'
'1.de, I agree that title
to
and right
of
possession of the merchandise shall remain
in
you, that I
will
not sell, remove, or encumber the same without your written consent, that
I assume and shall
be
responsible for all loss or damage
to
said goods, and that upon default of any payment or payments, you may, at
your
option, take
hack
the merchandise or
affirm
the sale and hold me liable for the full unpaid
balance.
l_
____,J
Signature of the
Headof Household----:----------,-,.-.,..--.,------:--..,.,.----------
(Firlf
Name)
(Middle Jnitiml)
(Last
Nome)
Street
R..-al
Box
Add""'L..----------------------Route•-----No.--------
Please
give
both
your
Reute
ond
Box
Number
if
on o
Rural
Roule
~
-------
Postoffke·----------------------Stale·---------------
Have
you
had a previous
What is
Is account
Date final
At what
Easy Payment Acct.
with
us?____.,.ccount no.? ___________pai'd in full?____payment made?______Sears store?________
Number
Do you own
Rent
8
Age?
Married?______,,,ependents: Adults?
Children?________
~our
home?_______
~oard
(Number)
(Number)
How much rent
How long at
If
less than 5 years
do you pay?
above address?
've former addr·ess--------------------------
Are you steadily
How long with
Weekly
employed?
present employer?__________-"'Occupatio,..________________
~rnings
$_______
Name of
employer__________________________
,.,ddre:sa..--------~------------------
Nameof
yourllalll<-----------------------Addr·ess~--------------------------
If
farmer, how
Name and Address
large
is your farm?____Acres.
of landlora_______________________________ _ _ ____
Please show source and
amountof ADDITIONALincome'------------------------ -----------------------
Give Below fhe Names
and
Add,....er
of Two Store.
With Which
You
Hove Had Credit
Dealings
or
Two Su"'1eu
Men
Who
Know
You
Nam"-----------------~~ddress------------------"usin1esac...---------------~
Nam,,___________________,,.,ddress---------,---------Buslness---------- ------
The
Spaces Below Are To
Be
Filled
In
When You Order Merchandise Thal 11 To
Be
Attached
to
YOIR'
Properly
Street number or other definite location of
Cost of
Amount of
property in
which
material
is
to
be
tnstalled
roperty
Mortgage S·---------
Name of person
Name and address
holding le&al
ti
of mortgage holder'----------------------