311 / 631
Date_________ 19__
Please be sure to
incl ude ZIP CODE
in your address
/Sears J
SEARS, ROEBUCK AND CO.
Philadelphia, Pennsylvania 191 32
Satisfaction Guaranteed or Your Money Back
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ADJ
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155
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AIB
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SPEC.
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21N
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c:J
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DAY
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OROER
#I#
LINES/ SOURCE I TYPE
OF SALE
SALE
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- 5
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13_
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METHOD/
~IPMT.
;
CASH
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OISCT.I TAX
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SPEC., SPECIAL INFORMATION (DO NOT TRANSMIT DASHES)
EXMT.
COOE
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PLEASE DO NOT WR TE IN ABOVE SPACES
PLEASE GIVE COMPLETE
PLEASE PRINT PLAINLY ONE LETTER IN EACH BLOCK
DELIVERY INFORMATION
Be sure to give complete mailing ad-
All members of the same household should order under one name
dress at the righl, filling in the cor-
FIRST NAME
MIDDLE INITIAL
LAST NAME
Telephone No.
rect
informati on on
the
lines pro-
- I I I I I I I I I I I I I I I I I I I I I I I I I,
vided . including telephone number.
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ON FREIGHT ORDERS. IF YOU DO
NOT HAVE A STREET ADDRESS, ad-
Mailing Address
ditional
information
is needed
for
'
eelivery by truck . The name and/or
Additional Address
Apt. No.
number ol the road or highway, land-
'
marks such as a church, gas station,
fire house or bridge are important City
State
ZIP
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I I I
guides.
CODE
PLEASE DO NOT WRITE IN SPACE BELOW
IF YOU WISH THIS ORDER SHIPPED TO AN ADDRESS OTHER THAN YOUR OWN, please give
complete address on the lines below:
@]
NAME
'
Apt.
Mailing Address
No.
'
•
City
State
ZIP CODE
IF YOUR ADDRESS HAS CHANGED since last order, please give you r old mailing address here:
[El
Mailing Address
City
State
STATE COLOR OR PATTERN CHOICE BY NUMBER IF REQUESTED
PAGE
CATALOG NUMBER
NO.
HOW
COLOR NO.
MANY
Pattern Style
SIZE
NAME OF ITEM
PRICE
TOTAL PRICE i--.,,--,D_o_N,o_t_W..,ri_te..,.-Be--:lo.,..w_ --;
Ea., Yd., Pr., Etc.
Dollars
Cents
Code
Instructions
1
2
3
4
5
6
7
8
9
HOW SHALL WE SHIP?
(mark
X
in proper square)
PARCEL POST (Mailable
Items Only)
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D
PACKAGE DELIVERY SERVICE
In Metropolitan areas, merch andise
can be delivered by fast package de–
livery service at higher cost
O
FREIGHT (Truck or Rail
Where Available)
Add this to my
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ADD TAX for orders delivered to:
CONNECTICUT . ... ..... . .. . ... .. . ....... . . ... .. 7%
(No tax on seeds or clothing for children under
10
years}
DISTRICT OF COLUMBIA . ... . .. .. .. . .... . ... . .. 5%
MARYLAND ... . ....... . .... . . . . . ............ . .. 5%
NEW JERSEY (Omit tax on exempt clothing) .. 5%
NEW YORK STATE* ..... . . . ...... . ........ . .. . .4%
*If your city or county in New York has a
tax, include the additional tax required.
OHIO
~Also
add local tax if required by county) .4%
PENN YLVANIA ... .. .... . ..... . . .. . ... .. ....... 6%
(Omit tax on food, clothing, except swim wear, formal wear,
furs and clothing designed primarily for sports activities}
VIRGINIA . ... ....... . . ...... .... ... . . . . . . .. .... .4%
WEST VIRGINIA . . ..... . . ... .. . . . . . . ... . . . .... . .3%
Tax rates based on information available at printing
and subject to cha nge.
0
SEARS REVOLVING CHARGE ACCOUNT,
0
SEARS EASY PAYMENT PLAN or
0
MODERNIZING CREDIT PLAN RETAIL INSTALLMENT CONTRACT ANO
SECURITY AGREEMENT, which is incorporated herein by reference.
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At what
Sears Store?
(M
y
ACCO
u
NT NuMBER)
(DO N0 T s"'EN°'o'"""'1
o'"EN""'T°'lf°'IC'"°'A7T"'1o°"N""c""••"'o'"'o"'R'"'P"°'L""'"A'-TE'°'
) --
Signature_ _ ________
<"'W~R~IT~E--=coo"""No~T"""'PR~IN~T~)--------------
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TOTAL FOR GOODS
~AMOUNT
FOR TAX
POSTAGE
If
credit order, we will
figure and
fill
this in for you
Amount
I
owe Sears
on previous order
TOTAL CASH PRICE
Sears
Checks
AMOUNT
r-----r---r-----
ENCLOSED
Money Order
or Check
NOTE: Please mail all inquiries not directly related to this order under separate
cover. This will speed the proc ,5sing of both your order and inquiry.
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ZIP OODE
SHPG. WT.
Lbs.
Oz.
Total
Total
Pounds Ounces
Total Weight
in Pounds
Enter Parcel
Post Zone No.
p
PF6085
7.77
Printed in U.S.A.