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SEARS, ROEBUCK AND CO.
Kansas City, Missouri 64127
\Sears
I
Date_________195_
PLEASE BE SURE TO INCLUDE
ZIP CODE
IN YOUR ADDRESS
----------SATISFACTION GUARANTEED OR YOUR MONEY BACK----------
PLEASE DO NOT WRITE IN THIS SPACE
•
PLEASE PRINT PLAINLY
All
members of
the some hou1ehold should order under
one
nome
NAME --:~~=----.,.,~-=--=-==-:----~~:-=-:----
<F1Rsr NAME)
(MIDDLE INITIAL)
(LAST NAME)
Mailing Address_________________________
Additional Address_________________________
Post Office____________State_ ___________
--=-
z rP CODE
I
Telephone Number
SHIP TO ANOTHER ADDRESS? If you want this order shipped to another per·
son or to a different address, freight or express station, give d irections here:
IF YOUR ADDRESS HAS CHANGED since last order, please give your old
address here:
Mailing Address__________________ ______ .
Post Office____________ State_ ______ ____ -:-:-::-::
21 P CODE
STATE COLOR OR PATTERN CHOICE BY NUMBER ONLY IF REQUESTED
NAME OF ITEM
CATALOG NUMBER
HOW COLOFl
COLOR
SIZE
PRICE
TOTAL PRICE SHPG. WT.
MANY NO.
NAME
Measure to be sure Ea., Yd., Pr., Etc.
Dollars
Cents
lbs.
Oz.
---
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We are required by law to collect tax on sales for the following states:
Total
I
Total
If
you live in Oklahoma, add 2ctax for every dollar's worth of goods you order.
TOTAL FOR GOODS
Pounds Ounces
If
you live in Nebraska, add 2'hc tax for every dolla(s worth of goods you order.
------
If
you live in Arkansas, Colorado, Iowa, Kansas, Missouri, New Mexico, Utah or
AMOUNT FOR TAX
Total
We~ht
Wyoming, add 3c tax, for every dollar's worth of goods you order.
in Poun s
--- ---
If
credit order,
HOW SHALL WE SHIP?
we will figure and POSTAGE
Parcel Post
0
Express
D
Freight (Rail or Truck)
O
fill this in for you
---
---
Enter Parcel
Amount I owe Sears
Post Zone No.
on previous order
--
IF THIS IS AN EASY PAYMENT or MODERNIZING
D
and fill In and sign
TOTAL CASH PRICE
See other side
CREDIT ORDER, CHECK HERE
the form on other side.
for sh1µping
--
inlormalion
IF A REVOLVING CHARGE ACCOUNT CHECK HERE
D
Do not send Identification
Sears
K
•
card or plate.
AMOUNT
Checks
MY ACCOUNT
At which
ENCLOSED
---
---
NUMBER IS
Sears Store?
----
Money Order
Recheclt to
see
thol you hove
givPt1
all information
such os size,
color,
poHern,
finishes, etc.
or Check
!Sears
I
287