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PLEASE PRINT
TRADE NAME OF ESTABLISHMENT____________
Check One:   ___Partnership   ___Corporation  ___Single Ownership
ADDRESS_________ TELEPHONE NO.____________
OWNER'S NAME______________ MGR'S NAME__________

FOOD
___Dry groceries
___Fresh fruits and vegetables
___Meats
___Kosher Meats
___Poultry
___Fish, fresh and frozen
___Milk, butter, cheese and eggs
___Bakery products
___Soft drinks (bottled)
___Beer (bottled)
___Distilled wines & liquors (pkgd.)
___Ice cream (bulk or packaged)
___Candy, nuts and food sundries

TEXTILES AND APPAREL
___Shoes
___Furs
___Hosiery
___Women's underwear (lingerie, corsets, brassieres)
___Women's and Children's outerwear (coats, suits, skirts, dresses, hats, blouses, jackets, snow suits, leggings, slacks.)
___Men's haberdashery (ties, shirts, hats, etc.)
___Workmen's clothing
___Military uniforms
___Apparel accessories
___Yarn
___Linen
___Piece goods
___Domestics

CONSUMER DURABLE GOODS (NEW AND USED)
___Furniture
___Bedding and bed springs
___Linoleum and other floor coverings
___Rugs and carpets
___Baby carriages
___China & pottery
___Trunks and luggage
___Bicycles
___Hand Tools
___Electrical appliances
___Ice boxes
___Musical instruments
___Umbrellas
___Jewelry
___Optometrists
___Furniture
___Hardware
___Pumps

RESTAURANTS
___Lunch rooms
___Tea shops
___Boarding houses
___Cafeterias
___Grills
___Cafes
___Hotel dining rooms
___Taverns
___Taprooms
___Bar-rooms
___Soft drink fountains
___Sandwich stands
___All other eating establishments

SERVICES
___Auto repairs (including washing, towing, lubrication)
___Automobile storage (garages)
___Automobile parking lots
___Auto rental agencies
___House and office building cleaning establishments (window cleaners, chimney cleaners, sanding, scraping, waxing, including the rental to perform these services.)
___Office equipment maintenance (rental of and repair)
___Clothing services, tailor (cleaning, dyeing, alterations)
___Hand laundries
___Power laundries
___Electrical appliances (repair and rental of)
___Furs (repair and storage of)
___Furniture maintenance (general repair and cleaning of)
___Radio and phonograph maintenance (rental and repair of)
___Shoes (repair, alterations, dyeing, waterproofing)
___Storage of household goods (packing, crating, storage, but not transportation.)
___Cabinet makers
___Carpenters
___Building contractors for houses
___Interior decorators
___Painters
___Wall paperhangers
___Plumbers
___Upholsterers

FUEL
___Fuel oil retailers
___Kerosene peddlers
___Coal retailers
___Gasoline filling stations
___Firewood retailers
___Ice Dealers

OTHER
___Drugs and sundries
___Fertilizer distributors
___Oil burners
___Lumber
___Tires and tubes
___Passenger automobile dealers (including used car dealers)
___Farm equipment dealers
___Ice
___Housing building supply yards
___Gift shops
___Antiques
___Stationers
___Commercial vehicle dealers (including used trucks)
___Automotive parts
___Automobile accessories

Transcription Notes:
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