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This Shipping Order mus#be legibly filled in, in Mk,in Indelible Pencil,or in
<br /> Carbon,and retained by the Agent.
<br /> 4qShipper's No.
<br /> Carrier Carrier's No.
<br /> RECEIVE,subject to th cimsfficetions and tariffs in effect on the date of the issue of this Shipping Order,
<br /> at 19 + from
<br /> 1egp7oo' M. ; ',rtsu.d r•n.11 wo gaovdaodp�op.—rry PI M.1yd a p mrd «en �nall .s.qw ro ex M•b�•dro,irr,roo�d<ona•ru+i.nw,dom.a p.sod.m.re.dnu„•naeeSnu-en gnr mBi.dr WlloodQr;q vi«aIow dn�1 Ubn.ml•e,rm a nordn. narn,CraIa.u,eeAJaa �rhn :..:1
<br /> — ud.•n ei ' �[ d emn ap.aN!ruv10 .d 'o
<br /> ben r eI da�^ne.en,d•1�r.n...,a�•v,eo re.rep oar.e��wa•.1er«°e«a
<br /> v•n n•ater.rnw
<br /> a wet tenon or r.,Al.1 rn
<br /> ee Sl.pp.r h«N. n',he.Mw n.,.Iwnili.r wiN.dl M•r«m.end aeMirien.d M•,eid bdl d 4di..,ind.dil M...r Me Mal M«.d.1.I.,M in M•.I...Iteh.n.,tenet.b:,b. erw,M•,ren roe.Mn d Mie.hif--t eM er.raid I...W.s,.MMm.r.-A,.91.d re b.M.,hype a•rd
<br /> Consigned to r ri A =✓'- '
<br /> (Mal or street address of consignee—For purposes of notification
<br /> Destinatio -State '1T County
<br /> Delivery Address*
<br /> (*To be filled in only when shipper desires and governing tariffs provide for delivery thereat.)
<br /> Route
<br /> Delivering Carrier Car or Vehicle Initials No.
<br /> AZ g ass CheckSubl...ro Seawn 7 a Cond,1 o,of pppltobl•
<br /> Packages MAT Kind of Package, Description of Articles, Special Marks,and Exceptions (so.Wb e.Cor.) or Rate Column b,ll of lad,nq.,1 rh.,,h�pm.nr„reg n.a.lr..,.d reg
<br /> rh.<onugn. ,.uhour,.call,,.on IA.Sonspno,M.
<br /> `n _ n,rgno,,hall,iqn Ihs IWIo«rnq slel•m.nl
<br /> i t_ J -i 7 1 ' 1 �^(- �J i FSI C I _ p Th.<a ,hall n k.e•I,..,r a Ms,h.p
<br /> .,.no..porm.m a 1 ghr and all orh•,1-1.1
<br /> •� (J l l / cnorgn
<br /> ISignalu•of Consigno,.i
<br /> JI
<br /> x <horq.,m o b.d,oe
<br /> .rry or ,la u
<br /> -Ip e.p,epo,d
<br /> / lr
<br /> al s herFlcm is l ted Rd$ apply.
<br /> o,.pown.nl of rhe Sh.,ga an rh......r.,d.
<br /> <rrbed h•r•en
<br /> This isto certlfy that f e above named materials are property classified,described,packaged,marked and labeled and are in proper condition
<br /> for transportation according to the applicable regulations of the Department of Transportation.
<br /> *If the shipment moves between two ports by a carrier by water,the law requires that the bill of lading shall stale
<br /> whether it is"carrier's or shipper's weight." Agent o,Cashier
<br /> NOTE—Where the rate is dependent on value, shippers ore required to stole specifically in writing the agreed or
<br /> declared value of the property.
<br /> The agreed or declared value of the property is hereby specifically slated by the shipper to be not exceeding pe,
<br /> per
<br /> ITh,„gnowr,Aar.mkno,.l.dg.,only the omounl
<br /> p,app,d,
<br /> i"The fibre boxes used for this shipment conform to the specifications set forth in the box maker's certificate thereon, Ch-Q.,Ad. -al
<br /> and all other requirements of Uniform Freight Classification."
<br /> tshipper's imprint in lieu of stomp; not a part of bill of lading approved by the Interstate Commerce Commission.
<br /> Shipper, Per Agent mud detach and retain this Shipping Order
<br /> And must sign the Originyl !l p Lading.
<br /> Permanent post-office address of shipper, I n s (��� _ — _
<br /> 65696 REOIFORM
<br /> Poly Pak(50 sets)6P696
<br />
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