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/• <br /> rt.„: ,- <br /> 6 1 6 -.), 0 <br /> CUSTOMER'S ORDER NO. DEPARTMENT !DATE / 7. <br /> a /a <br /> NAME <br /> ADDRESS <br /> CITY, STATE, ZIP <br /> SOLD BY - .."- - CASH C.O.D. CHARGE ON ACCT. MDSE RETD PAID OUT <br /> QUANTITY ' - DESCRIPTION - ----, - PRICE AMOUNT <br /> ' 1 (" .■ i <br /> 2 , ....- <br /> - r , .17 <br /> ' 4 ' <br /> 5 , <br /> - 6- . .... . <br /> . , . <br /> : . <br /> 7 . <br /> • <br /> 8 <br /> ' • <br /> . . <br /> ........- : <br /> ! . .. <br /> 12 <br /> (--___ '-'°- -c;-- <br /> 13 <br /> , 14 <br /> 15 i <br /> 16 , <br /> 17 . <br /> 18 , <br /> 19 • <br /> i , - 20 - • . - <br /> ' I RECEIVED BY - - - <br /> KEEP THIS SLIP FOR REFERENCE <br /> 5805 <br /> 5331254 <br /> 04/13 <br /> JANE K CRAMER <br /> .' . 02743152 ,-;., ' MAN. CLASS DESCRIPTION PRICE • AMOUNT <br /> , ... <br /> I )" <br /> b 4 5 4 0 71 L 5 0 1 2 5 I,S . ,-.31.7#:,y,','. 1 ..:t <br /> DATE AUTHORIZATION <br /> SUB et <br /> • , ,, :' Sl.: RV E "IND VE v , .-5- j w <br /> i A L V AOCRE. OR TOTAL <br /> 0 <br /> 7 0 C 1 I ' REFERENCE NO. REGJDEPT. <br /> CO <br /> FOLIO/CHECK NO. SERVER CLERK S M <br /> OS 0 <br /> f?Li HASE - SIGN H - <br /> ER , ; , , SALES SLIP TOTAL i 7 <br /> . <br /> . . J/N <br /> Cardholde acknowledges receipt of goods and/or services in the , IMPORTANT: RETAIN THIS COPY FOR YOUR RECORDS <br /> amount • the Total shown hereon and agrees to perform the <br /> obligati • s set forth In the Cardholder's agreement with the Issuer. <br /> .... ,,,.. <br /> ...' ,. ..' <br /> — - _ <br /> . __ . <br />