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[[preprinted form]] BEMO SHIPPING CO. CUSTOM HOUSE BROKERS - INTERNATIONAL FREIGHT FORWARDERS CARGO BLDG. 80, J.F.K. INTERNATIONAL AIRPORT JAMAICA, NEW YORK 11430 TEL. (212) 656-6090-1 TO ^[[Jacques Seligmann & Co. 5 E. 57th St: NYC]] DATE ^[[6/19/68]] 19__ NO. BEMO REFERENCE ^[[K 5045]] COD [[blank]] MARKS AND NUMBERS ^[[Adr JSI/134]] DISPOSITION | LOCAL TRUCKER | PARCEL POST | OTHER | ^[[Via]] | | ^[[J&J]] NO. PIECES ^[[ (1) ]] WEIGHT ^[[ 28# ]] B/L NUMBER ^[[AWS: 026-I-545-822]] AIRLINE - DATE ^[[Pan 6/19/68]] DESCRIPTION ^[[Drawings]] ENTRY NUMBER [[blank]] SPECIAL INSTRUCTIONS [[blank]] EXCESS VALUE DECLARED [[blank]] RECEIVED IN GOOD CONDITION BY ^[[signature]] (CONSIGNEE'S SIGNATURE) DATE ^[[6/21/68]] AGREEMENT: Liability is limited to $50.00 per shipment unless a higher value is declared and applicable charges paid thereon. PICK UP ORDER (B) [[/preprinted]]
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