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SEARS ORDER BLA
SEAllU~,
ROleBUCK
AND CO.
K
Satisfaction guaranteed
or your money back
4640
ROO~EVELT
BOULEVARD, PHILADELPHIA 32, PEINIMSVl..Vl\.NllA
Date'--------195--
PLEASE DO NOT WRITE IN THIS SPACE
l'LEASE PRINT OR WRITE
PLAIN~
Y
All
member•
of
the
1ame
household
should
order under one
name
NAME
(FIRST NAME)
(MIDDLE INITIAL)
(LAST NAME)
Rural Route
Rural Box
No.
P.O. Box
No
Street
Add-·
Post Office
State
HOW SHALL WE SHIP? (Mark
X
in Proper Square)
Parcel
Post
0
Rail
Freiaht
O
Express' o
Motor Truck
0
SHIP TO ANOTHER ADDRESS? If you wantthis order shipped to another person
or
to a
different address, freight or express st<1tion, give directions here:
•
IF YOU HAVE MOVED since last order, ·Please give your old address here
Rural
Box
Street
Route
No.
Address
Post
Office
State
CATALOG NUMBER
HOW
Nit.MEOF ITEM
COLOR
SIZE
PRICE
TOTAL PRICE SHPG. WTS.
MANY
Pattern,
Finish, E'tr.
Measure
to
be sure
Ea.,
Yd., Pr., Etc.
Dollars Cents
Lbs.
Oz.
-
-
-
-
•
-
We are required by law to collect tax on sales for
the
following
states
and cities:
TOTAL FOR GOODS
Total Total
rt
you llve In Auburn, N.
V.,
or Erle County, N.
Y.,
add
le tax
for every
dollar's
worth
Pounds Ounces
of goods you order.
If
you live in Broome County, N.
Y.,
District of Columbia, Maryland, Niagara Falls,
AMOUNT FOR TAX
Syracuse, N. Y., Watertown, N. Y., or West Virginia, add 2c tax for every dollar's worth
of goods you order.
Total Weight
If
you live in Monroe County, N.
Y.,
New York City, Ohio ar Pennsylvania, add 3c tax
in Pounds
for
every dollar's worth of goods you order. (Pennsylvania customers omit tax on
POSTAGE
clothing, except formals or furs.)
Enter Parcel
Amount
!
owe Sears
on previous order
Post Zone
No.
IF THIS IS
A
CASH ORDER, CHECK HERE
D
and enc.lose full remittance
Including postage and tax.
TOTAL AMOUNT
See
other
side
for
•hlpjling
IF AN EASY PAYMENT ORDER, CHECK HERE
D
and fill-in and sign
Sears
Information
the
form
on other side.
AMOUNT
Checks
p
rf
you have an open account
At
which
show account number here
Sears Store?
ENCLOSED
Money Order
Please
rechec~ ord~r
to see that you have given all necessary information such as colors,
sizes
or Check
PF6085
6-12.SSPrrnled on U.S.A.
I