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_ >i <br /> X24 E3J~A~iT ~Ai~E <br /> ,43. <br /> a - .CUSTOMER'S ORDER NO. DEPT. DAT <br /> 2 <br /> ~ .NAME: ~ <br /> ~ G ; <br /> ADDRE ~ . <br /> SS. <br /> . ,CITY; STATE, ZIP <br /> ti <br /> - . .~,,W......, , _ <br /> ~ . SOLD BY: _A: ~ ~ <br /> <br /> ~ CASH C.O.D. CHARGE ON ACCT. MDSE RTD. PAID OUT , <br /> ~ ~ . <br /> f (~U ~~1TITY - <br /> _ I).LSCftIPTION 'PRICE- 1MOUNT <br /> ` _ ~f 1 <br /> T: rt <br /> r~ <br /> x - <br /> ' at 5 ' <br /> 6' P-Q' ~ f. <br /> . ~ 4~. <br /> l: ii5 <br /> 9~ ~ ~ <br /> . 7 0. <br /> YT <br /> 12 <br /> ,~w. ~r <br /> " 7~ <br /> ~ <br /> 7>: <br /> RECEIVED BY , ,-~-~a.. _ y <br /> 'j <br /> : . <br /> _ d j <br /> KEEP THIS COPY FOR YOUR RECORDS <br /> c RE~I ~ <br /> 02001 FORMo 5L320 <br /> i - <br /> <br />