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~~~~'~ - ~I-~ITE <br />(~ ,y ~~ `' ' ND 93790 <br />55 WEST SHERMAN ST. 2860 SANTIAM HWY S.E. <br />~ ~`~ LEBANON, OREGON 97355 ALBANY, OREGON 97321 +~ <br />soid ~-1 ., 59-2429 / ~~ 7-9340 nnre / i 7 <br />~ ~ v . ( ~ ~~ ~ ~ iis ~ _ <br />, To ~~ ~`.~ ~ ~ r SMp To: Same as Soltl To Unless S~own Here <br />Add. !f ~ ~~ ~ ~ <br />! ~ City <br />~, ~ ~ Y ash heck har e ~~ ~~ ~ ' <br />G Mdse. Ret. Bank artl redlt R.O.A. Paid Out <br />~ QUANTITY f <br />~} ~~ag~ <br />DESCRIPTION : <br />~ EACH <br />_ ~ ~ 3 0 ~, ~ <br />~ c~~~` t-f !~ L~'C, o~ ~ ~ ~ <br />,~~ .. 7~ 20 <br />~~ ;tl-c ~, <br />,~ ~ F <br />- (~ S 41Z ~ i~ o~.r ~f 3a <br />i <br />~ <br />r <br />~ <br />SUB TOTAL <br />Signature <br />~~ <br />~~0 <br />i ivu. n~ <br />I <br />AMOUNT ~ S <br />~~- <br />s <br /> ~ ~ ~~~ f~' <br /> PAY THIS <br />AMOUN ~I I <br /> T <br />. <br />~ - ~. Y r... . ' <br />: 7'y ~ •.'. ~.:. .. ~ ~ ' ~ ... <br /> <br />. • . I <br />r `BI RITE h~ ~ z ~~" f `'' F ~;~ ~;~ ,.,. ~ ~ a ,la ~ <br />'~ <br />~~ a <br />Y 1 <br />TO THE ~ <br />-- <br />\ - ____ <br />~ <br />- <br />' ( <br />: <br />ORDER ~`L86O ;SANTIAM ~IWY ISE~ ~ <br />y. <br />t .._ <br />°~`~ ~ ~ <br />. ~'~- ~S ~ :_~ <br />~ . <br />~ <br />, _ oF ~LBANY: '' OR 97321 <br />s t <br />: , ~1 <br />~." ~ ;: <br />' ~_....-r'.,~ }~ ::~ <br />NOT NEGOTIABLE <br />: <br />~ <br /> <br />~ ~~ ~; ,. <br />~~ar~ SIGNEt)-~s.v~ _ ~. , ~,, <br />~~` .-~---- .!•. / <br />. <br /> <br />- <br />" <br />_ r,^.> <br />`i ~ i. - . <br />~ <br />. . . . . . . <br />. <br />. <br />. <br />7~.:~: . . . <br />i <br />.. . ~ i .. .i., _t ~ . <br />~ . . . " ; . . . ~ ~ <br />. . . . . . ~ <br />.. <br />~ ~-.~~a..~-._._ - ~_ . ~' `.- ' _ _ . ' --~., ,~.,~ .-.~..~... .~ ,~ ~~ .~ ~- ~_ -_^_ _ <br />~ ~ a~ ~- 7' ~~ ~ ~ <br />~- ~~~~ _ 5 ~3~- <br />v~ ~~ <br />~v ~ ~ ~`j,~C <br />~ ~ L°~ <br />-7 ~-~~~. <br />