57
20
4487
-
https://omeka.lib.jmu.edu/erp/files/original/Rockingham_County_Prohibition_Records_Criminal_Cases/RcPr-box10-036.pdf
2098b202ba9c63b8a4d3368ee6bc7aed
PDF Text
Text
WARR ANT OF ARRES T
STA'rE OF VIRGINIA , CITY OF HARRISON BURG, TO-WIT:
To Frank L. Dovel, Chief of Police, or any Policeman of said City :
Whereas
~~. .. %~--1n-~ ......... has this day made complain~ and infor-
mation on oath before me, W . W . WHARTON , City Justi ce of Peace of said City, that ......... ... .
.~
•~
·· .. on the ~87'6 .day of / ~ . ·· ·· ··· ·· · ...... , ~9:,5 .
·~ · /,UV.r ~,
in said city did
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1/._~ ····/ P ~ ...
lh~~ .(#1~
/ h.4a,l. .. . . /Wt ....
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . in violation of an ordinance of the said city:
These are th erefore in the name of the Commonwealth of Virginia to command you forthwith to
app,-e,,en.d and bdn.g
b~
o:M#Z~/°"y
of the ~aid .••• .· ••••••••••• ••••.• ·.
to answer the said complaint and to be further dealt with according to law.
Gi.en under my hand and seal this
.<-!J/4'-, day of ~ ~· . .. .,if:7 .. J ., 10"-5...
•········~ M . r . " n - f _ .. (Seal)
City Justice of Peace.
�£)
VIRGINIA, CITY OF HARRISONBURG, TO-WIT:
This day -~
m e, Vf/. W. WHARTO~, u
411.if_...7 . . ~.~
- . . .. . •
s~ ice of P .
fJ!U/L
..
cam e before
City of Harrisonb u rg, V a. , and severall y and r espe ctfu ll y acknow l-
$d 6.~.~-~to
e dged th e ms e l v e s to b e ind eb t e d to the Commonweal th of Virginia in th e sum of
b e l e vied of t h eir
r es p ective goods and chattels, lands and t e n e m e nts, as to whi c h ob l igation the y waive their Hom e stead a n d a ll oth er
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:/1-115 7
CITY OF HARRISONBURG
v.
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Misdr.
(appeal)
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Criminal Cases
Description
An account of the resource
The first series of the Prohibition Records collection consists of all criminal case records associated with cases brought to the <strong>Rockingham County Circuit Court</strong> from 1916-1964. Not every individual was indicted for a criminal offense and many were simply judged as misdemeanors. The cases have been separated and arranged by the last name of the defendant. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1933
Identifier
An unambiguous reference to the resource within a given context
Pro001
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a><br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/6">Prohibition Records: Affidavits for Ardent Spirits </a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
City of Harrisonburg v. Henry Shifflett
Description
An account of the resource
Misdemeanor
Subject
The topic of the resource
Misdemeanor
Appeal
Posession of Ardent Spirits
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre, 2019; Updated by Megan Pullen, September 2025.
Date
A point or period of time associated with an event in the lifecycle of the resource
1933
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/" target="_blank" rel="noreferrer noopener">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box10-036
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Shifflett
-
https://omeka.lib.jmu.edu/erp/files/original/a1940922bb928641a5ce6d6e9166ee91.pdf
d84d1fb6fe6543bdeafc10684543acdd
PDF Text
Text
DEL I VERY FORM 60
ADAMS
EXPRESS COMP ANY
SPECIAL LIQUOR RECORD
Received~ ,!_.!_~~ ~~~~~~-4 --J,.£.(L,~ :....:•oate
I 2, /
I
~
1
-=-.::........:c.=...-."-L..-c...c..'c'l-..---,--------:;:------,----'"'mou nt
~~~-----• ate_~.,_ --+---=-- '_
191 -6_ Affidavit No. - /-- -
I
_ _ 191-b
Ad vances to
Collect
~JVt:.
From _ _ _ __ _ _ __ _ _
PREPAID
'·
RECORD OF NOTICES
To Consigne e
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
(OVEI<)
Add
Undercharg e
�--- ------ ---- ~--- ---- ---- ---- ---- -=-- ---- -------AFFIDA VIT FOR ARDENT SPIRITS FOR PERSON AL USE
I, --+-=---'------"-__._,._,,,'-=.<........,c.=ffC- - - - - - - - , being duly sworn, depose
and say that I am
the consigne e of o. cer t ain shipme of ardent spirits, as specified on other
side of this form, this day
delivered to me by the Adams Express Company , from <?.,
J
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty days previous
hereto, received any ardent.sp irits of any kind whatsoev er, from any per
son or from any place whatsoever, in excess of the quantity allowed by the provision s of the Act of the
General Assembl y of Virginia ,
approved March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are for
my own use, at my own home, and that the said ardent spirits will not
be used in violation of law.
Y UJ
Sworn to and subscrib ed before me,
this~
day of__::,,,,,,,,=-:.-=-.:_ , 191JQ
A g en t f or Adams Expre ss Company .
Consignee~
�ADAMS EXPRESS COMPANY
DBLIVERY F O RM 60
T o _ --1.!::~~-\c-- -irl.:.:5>----'---"'=-=--~~--<t,A ,------Shi pper -------c,t------'"--:-"----,.,:--=-..c:r'.iY,U-4o--'-,,---"-----="--:-RE C O R D OF NOTI C ES
T o Consig nee
To Shipper
AFFIDAV I T FOR ARDENT SPIRITS FO R PERSONAL USE.
( OVER )
�AFFID AVIT FOR ARDE NT SPIR ITS FOR
PERS ONAL USE
I, _ ___,__._ _...,___,.-- --,p,,~.,........_-+-__.,___._---'---+--',,,_-,
being duly sworn , depos e and say that I am
t he consig nee of a certai n sli ment of arden t spirits
, as specif ied op fc)ther side of this form, this day
delive red to me by the Adam s Expre ss Comp any,
from_ _,-...~ _,___~ '-+'CJ.-...............-'-'--,,-,;, that I am not
a
stude nt or minor, and, if a femal e, I am the head
of a f amily ; that the rdent spirit s so receiv ed by
me
were broug ht info the State on my writte n order,
an,d that I have not, within the thirty days previo
us
hereto , receiv ed any arden t spirit s of any kind whats
oever , from any person or from any place whats
oever, in excess of the quant ity allowe d by t he provis
ions of the Act of the Gener al Assem bly of Virgin
ia,
appro ved March 10, 1916, or contra ry t o law, and
that the ar dent spirit s so received by me are
for
oy own use, at my own home, and that t he said
arden t spirits will not ~
olatio n of law.
-
Consi1rDee.
�ADAMS EXPRESS COMPANY
DIEL IVERY F ORM 6 0
A d vances to
Collect
RECORD OF NOTI CE S
:T o Con sign ee _ _ __ _______ _ _ _ _ __
To Ship per
AFFIDAVIT FOR ARDENT SPI R ITS FOR PERSONAL USE .
( OVER )
A dd
Under charge
�AFFIDA VIT FOR ARDENT SPIRITS FOR PERSON AL USE
STA.TE OF
VI~ ,11'!1A,
-~
~ e{....
COUNTY OF._J'..S
~
_f__£~ ~ ~,rri
I am
( (. l: ti , being duly sworn, depose and say that
""'1° •
I,
form, this day,
this
t>f
e
other'sid
on
specified
as
spirits,
ardent
of
t
shipmen
certain
n
of
the consigne e
I
; that I am not a
1
delivered t me by the Adams Express Company , fro
received by me
so
spirits
ardent
the
that
family;
student or minor, and, if a f emale, I am the head of a
days previous
thirty
the
within
not,
have
I
that
d
an,
order,
written
my
on
State
the
were brought into
place whatsoany
from
or
person
any
from
ver,
hereto, received any ardent spirits of any kind whatsoe
y of Virginia ,
Assembl
General
the
of
Act
the
of
s
provision
he
t
by
allowed
quantity
ever, in excess of the
me are for
by
received
so
spirits
ardent
the
that
approved March 10, 1916, or contrary to Jaw, and
violation of law.
in
used
be
not
will
spirits
rdent
sai
the
that
and
home,
own
my
oy own use, at
• I.
Sw=
:7ore
to m
=d
day of
thi
(P
me,
, 191
.
�- - -- --- -
---
- - - -- -- ------------------ --------~-----ADAMS
Dl!LIVERY F O R M 60
EXPRESS
COMP ANY
To -----,;:i----~-n-4--'-'-----;;~ =v"'--'--,,___,L'-"-¼--;-=-----"~
Shi pper ~ ~ ~..,2;~~~tbt,~':____J'_~c:..__
RECO RD O F NOTICES
To Consig nee ·
T o Sh i ppe r .
A FFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVE R )
----~- ·
�'
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I. -----'-~ - -~......._-"-_____,.....,..._..__~---''---,
t he consignee of
o.
being duly sworn, depose and say that I am
certain shipment of ardent spirits, as specified on other side of t his form, this day
delivered to me by the Adams Express Company, fro
-'
; that I am not a
student or minor, and, if a female, I am the head of a family; that th ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever; from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
• y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
~
•/
•
. { q
I
·'
{!)1-- ,
Consignee.
this_ __ day of.=~=__._-, 191__
{:
A g ent for Adams Express Comoany.
�DE L t VER Y
FORM
ADAMS
60
EXPRESS
COMPANY
Affidavit
To ..J.L.L4-~-l -~~".:-!o"~~"-~""Shipper
-
--l---'--""''-f----j~.r=..,,4--
Ad vances to
Collect
P REPAID
No.L
Add
Unde rcharge
-11~'--------
RECORD OF NOTICES
To Consignee _ _ _ ________ _____
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVEll)
�AFFIDAVIT FOR ARDENT SPiRITS FOR PERSONAL USE
= ~- ,
STATE O F : a _ I A
~ ~~
COUNTY OF-,o,,---"-~'~.....,.~ - -
1,
being duly sworn, depose and say that I am
the consignee of n certain shipment of ardent spirits, as 8JfJc1fj~he r/J~his form, this day
delivered to me by the Adams Express Company, from C.:::.. ~ h a t I am not a
student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any persor or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
.my own use, at my own home, and that the said ardent spirits w·µ not be used in vi ation of law.
.
V
f"
A g ent for Adams Express Company.
�ADAMS. EXPRESS' . COMPANY
DELI VERY FORM 60
,,
SPECIAL LIQUOR RECORD
_______ 191 - Affidavit No, _____
~_,,.
I
191 Advances to
Collect
I
F rom
- ~.
,t.
EXPRESS CHARGE.
PREPAID
COLLECT
I
.1 ,)
!
j
Add
Undercharge
I
RECORD Of" NOTICES
To Consignee_ _ _______________
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVEK)
�AFFIDAVIT FOR ARDENT • SPIRITS FOR PERSONAL USE
STA.TE OF
COUNTY OF---,~ -- ----;~-..,..,-
1. - -~ .,.----.----~----- ---'-----, being duly sworn, depose and say that I am
the consignee of o. certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, from __________ __ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any per son or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act'of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
• y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
Consignee.
Sworn to and subscn"bed before me,
I
•
this _ __ day of ,
I
, 191-
I
Agent for Adams Express Company.
�----- -~--- ------ --··-------DIKL I V E RY FORM 60
ADAMS EXPRESS COMPANY
I
A d vances to
Collect
To Sh i pper .· ·
,r
.L.
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE .
.
(OVEK)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
delivered to me b the Adams Express Company, from _ _ _ _ _ _ _.......--:.;=.._; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I have not, within the.thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of t he Act of tqe General Assembly of Virginia,
approved March 10, 1916, or contrary to -law, and that the ardent spirits so received by me are for
• y own use, at my own home, and that the saicl,. ardent spirits will I)_Ot be used in violation of law.
G
i..:.tA-__;,.....:;;
, . =-------=----~______:____:__:_
.
_
Consignee.
Sworn to and subscribed before me,
:.2..
this_2_day of.~ _ _ _ _,
A gent f or Adams Express Comoany.
�D • LIVERY F OR M 6 0
ADAMS
EXPRESS
COMP ANY
RECORD ,OF N OTICES
T o Consignee _ _ __ __ _~ - - - - - - - - - T o Shippe r _ _ _ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVE R )
�AFFID AVIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE
STA.TE OF VIRGI NIA,
COUNT Y OF_(- r--'\-
-
------'--
J, - ---"'-- ~'----+ ---..,....- - - - - - ~- --, being duly
sworn, depose and s ay that I am
t he consign ee of n certain shipme nt of a r dent spirits, as
specifie
d on other side of this form, this day
delivered t o me by t he Adams E xpr ess Compa ny, from
_ _ _ _ _ _ _ _ _ _ _ ; tha t I am not a
studen t or minor , and, if a female , I a m t he head of a family
; that the ardent spirits s o r eceived by me
were brough t into the Stat e on my w ritten order, and that
I have not, within the thirty days previou s
hereto, r eceived any ardent spirits of any k ind w hatsoev
er, from any per son or from any place whatso ever, in excess of t he quantit y allowed by the provisions of
the Act of the Genera l Assemb ly of Virgini a,
approv ed March 10, 1916, or contrar y t o law, and that the
ar dent spirits so re ceived by m e ar e for
• y own u se, at my own home, and t hat the s aid
ent spirits w ill not b used in viola tion of law.
~
Consigne e.
this
A g e nt for Adams Express Compa ny .
�/
ADAMS EXPRESS COMPANY
0BLIVERY FORM 60
SPE/
L LIQUOR RECORD
Received;~-'---'=--...._----==-=-"'-=-..c,....,c_,.,,,__--=-=-'.-'--Date.acc=--:J'----------1,;;;Z.----191 _
Affidavit No.~ - - -
Consignee _1=,--t--v-~ Yi!';.---,~+-.,-'...,_.'---i:':--'~ - - - - - - - - = - ~ ; 1 - •- - - - - - ~ - -,- -----..~~_c....-----':-"----1-~Amount
----+----".._.,.~
;- -'"'--'--F-.,_-L_ __ __
To _ _,...__---:-- ,:;;;i'.....,--:::--+-r.~----<-:r ~ - - Shipper
Jlfij
,f
191 v .;om--t-.:=a<~e"'-1c-"'-,,.....,~P'-'i'-c-F-
Advances to
Collect
- - - + - - \...-'~---
RECORD OF NOTICES
To Consignee
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, - - -~..---'--+-....._~~-_.___ ___,~-'---, being duly sworn, depose and say that I am
tbe consignee of o. certain sl:iipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, from
( , t
; that I am not a
student or minor, and, if a female, I am the head of a family; that th; ardent spirits so r eceived by me
w ere brought int o the State on my written order, an.d that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of t he quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits .so recew d by me are for
• y own use, at my own home, and that the said ardent spiri
~ be
I'- • violation of law.
Sworn to and subscribed before me,
this3 - _day of
...A,
,191_•
A gent for Adams E xpr ess Co,nvany.
�ADAMS EXPRESS COMPANY
0aLIVIERY FORM 60
SPECIAL LIQUOR RECORD
Reoeived,-_ _ _ _ __ _ _ __ _ _ __
_ _______ 191 -'- Affidavit No·- -
Consignee _ _ __ _ _--=~~-~--=:........c_..,,,____
_______~ - - - - - - - - -- -
Advances to
Collect
PREPAID
COLLECT
RECORD Of' NOTICES
To Consignee_ __ _ __________ __
T o Sh ip per _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE,
(OVEll )
= ---
Add
Under ch arge
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STA.TE OF VIRGINIA,
CoUNTY o~
=-~
' ~ - - - - '::.__---=+-'-- ~
I, - c+---+-'----+--+----+-.....,..........--+--+~--'----- -, being duly sworn, depose and say that I am
t:le consignee f ;_ cert ain shipment f ardent spirits, as specified on other side of this form, this day
~
delivered to me by the Adams Express Company, frorn (! • :/ ! /,
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, a,,d that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
o.y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
this_l::__day of_ _ __ _, 19J.L..._
A g ent for Adams Express Comvany.
�ADAMS
DEL I V E RY FORM 60
EXPRESS
COMPANY
SPECIAL LIQUOR RECORD
_.
I
Add
Undercharge
RECORD OF NOTICES
To Consignee ___ _ _________ _ __
To Sh ipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, - -~'--~ -_.e.---'------- --'----'------ ,' being duly sworn, depose and say that I am
the consigp.ee of a certain shipment of ardent spirits, as specified on ot,her side of this form, this day
,delivered~ me by the Adams Express Company, froJ
., , ,. ; that I am not a
student or minor, a nd, if a female, I am the head of a family; that the ardent spirits so received by m e ·
we re brought into the State on my written order, and that I have not, within the thir ty days previous
h ereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever , in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contra ry t o law, and that the ardent spirits so r eceived by me are for
my own use, a t my own borne, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
this_ __ day of._ _ _ _ _ , 191__
.,,
A g ent for Adams E x pre ss Company.
Consignee.
�oaLrvERY P'ORII 60
ADAMS
EXPRF.5S COMPANY
To_-t----..r-'"-rtA-fl''-\r.-'<C>C ·.fF..:.±-=-....c.---..;,-~
PREPAID
Ship
To Consignee _ _ ______ ___ _ _ _ _ __
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVl"J; FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�AFFIDAV.IT FOR ARDENT SPIRITS FOR PERSONAL USE
STA.TE OF
CoUNTY OF-,1,--JI-'---'' -'----'--',-- - -
I, - --,E----;,........,.--~ -'----"'-.....,.__--.--_.....,_--'--it"--.--, being duly sworn, depose and say that I am
the consign of o. certain shipment of ardent spirits, as specified on' other side of this form, this day
delivered t /, me by the Adams Express Company, from ..._~----..,.L-1'--'-...i;......,...:;'"""'-=-- -; that I am not a
student or minor, and, if a female, I am the head of a family ; that th ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to -law, and that the ardent spirits so r eceived b,1 me are for
• y own use; at my own home, and that the said ·ardent spirits will not be used in violation of law.
)
.
'
4Y? ,
(
Consignee.
Agent for Adams Express Company.
�- ----------------~-·- -------------~----------------D•LIVERY FORM 60
ADAMS EXPRESS
COMPANY
SPECIAL LIQUOR RECORD
Received, _,,__ _.._,,__:_::::._=::..:.c-:.=-=----'' _ _ ::__Date
/
-
/
)f'
2
191 _
Affidavit No. _ _ __
Advances to
Collect
To Consignee_ ____________ _ _ __
Add
Undercharge
To Shipper ___ _ __ _ _ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVEK)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRGINIA,
COUNTY
or,,_-
1
<
J
-
I, ---,,+---,,------~; -----c---,,..~ - - - ; . - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of a:rdent spirits, as specified on other ide of this form, t_his day
delivered to me by the Adams Expre s Company, from - - ---ic,--<:...........,......::;.:...:.a::....::..-; that I am not a
student or minor, and, if a femal e, I am the head of a family; that the ardent spirits so received by me
. were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by t he provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary t o -law, and that the ardent spirits so r eceived by me are for
o y own use, at my own home, and that the said ardent spirits will not be used in iolation of law.
,
I
I
Sworn to and subscribed before me,
191
A gent for Adams Express Companya
/I
rJ
�ADAMS EXPRESS COMPANY
D•LtvERY FO RM 60
• SPECIAL LIQUOR RECORD
I
~ - - - - - - -191 _
Affidavit No. _ _ _ __
Advances to
Collect .
COLLECT
RECOR D OF NOTICES
To Consignee
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE,
(OVER)
Add
Undercharg e
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I,
.
, being duly sworn, depose and say that I am
the consignee of a. certain shiprilentof ardent spirits, as specified_.qn her side of this form, this day
(j"'
v/4 .(; ;
delivered to me by the Adams Express Company, from
I~
thaj; I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, an.d that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
ny own use, at my own home, and that the sai rdimt sri its will not be used in violation of law.
'' A
Sworn to and subsc ·
this_May o -~ - ~-
Agent for Adams Express Company.
Consignee.
�DBLIVERY FORM 6 0
~DAMS EXPRESS COMPANY
Affidavit No/ _____
To Sh i ppe r _ _ _ _ _ _ _ _ _ _ _ _ _ __ _
A FFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�AF FIDAVIT FO R ARDENT SPIRITS FOR PERSONAL USE
I'•
; that I am not a
delivered to me by the Adams E xpr ess Company, from
student or minor, and, if a female, I am the head of a f amily; th at the ardent spirits so r eceived by me
were brought into t he Stat e on my written order, and tha t I have not, within the thirty days previous
hereto, received any ardent spirits of any k ind whatsoever, from any per son or from any place whatsoever, in excess of t he quantity allowed by the provisions of the Act of t he General Assembly of Virginia.
approved Mar ch 10, 1916, or contrary t o law, a nd that the a rdent spirits so r eceived by me a re for
o y own use, at my own home, and that the said ardent spirits wiH not be used in violation of law.
'
~
I
A g ent f or Adams E x pre ss Company.
Consignee.
�OSLIVERY FORM 6 0
ADAMS EXPRESS COMPANY
Advances to
Collect
PREPAID
I
R E COR D
To Consignee __________~ - - -- - - To S hi ppe r _ _ _ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( O VER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE
OF VIR,GI~L\. ~? /)_
COUNTY OF -+~~~ -- -,I ~ \- ~-
I
,
I, _:___:_ _--,.--iiiiiJl.~'L~++'-'-4'4'!'.~~L -, being duly sworn, depose and say that I am
t'.le consi~ee of n certain shipment of ardent spirits, as specified o i;i
delivered o me by t he Adams Express Company, from.~~~-,-!tf....;'-J~~~~~ ; that I am not a
student or minor, and, if a f emale, I am the bead of a family ; that the ardent spirits so received by me
w ere brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or f rom any place whatsoever, in excess of the quan~ity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary t o law, and that the ardent spirits so received by me are for
• y own use, at my own .home, and that the said ardent spirits will not be used .in violation of law.
/, tl
0
ct'
I
lrJ ) 1,,,
Coneilrnee.
�----- -- - --- --- -- -- - ------------------ ----~---------- --- ---~
ADAMS EXPRESS
D•LIVERY FORM 60
COMPANY
SPECIAL LIQUOR RECORD
...._,,.;>£--"""'.,_.._=-,;=--....-"-"-'"--""---=~::c....='--' --'--Date
To---;---- - --"'----~_,__~,.,_,c.....c-----"'----""'e...._--
/ /'"
(
Advances to
Collect
i
191
Affidavit No, _ __ __
PREPAID
I
Ship
RECORD OF NOTICES
To Consignee ______,._____________ To Shipper _______________ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE O F VI
COUNTY OF:1,4,,..-1,,'-L-- '--=-=~ :..:...::~
I, - ------1e-----:---'-'-- - -- -<-- --.,.--+-=---'c....==--- - - , being duly sworn, depose and say that I am
the consignee of u certain shipment of ardent s pirits, as specified on o't her side of t his form, this day
delivered to me by the Adams E xpress Company, from ~ -------'~ ---="""-.; that I am not a
s tudent or minor, and, if a f emale, I am the head of a family ;·that t he ardent s pirits so r eceived by m e
were brought into t he St ate on my writt en order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of t he quant ity allowed by the provisions of the Act of the General Assembly of Virginia,
approved Mar ch ·JO, 1916, or contrary t o law, and t hat t he ardent spirits so received by me ar e for
o y own use, at my own home, and that the said ardent spirits
not be used in violation of law.
S
I
will
Sworn to and subscribed before me,
thia
day of_ ~~ -
Consignee.
�- ------ -·- -~~-------~---------- --·------------- ~----~ ~- .
DIKLIVl!:RY F ORM 60
ADAMS EXPRESS COMPANY
I/
AL LIQUOR RECORD
'' --=--"-~~ ::--"-==- -=-~Date
Q
~r.6.C.}6~~~~6 / ~ ~ - -___Amount
'--"'--1-+-'---'--- --·
191: z Affidavit No. _ _ _ _
/9 /
_ 191=7 From
Weigh ,"c---'l"'---l bs.
?{_,/J )
Advances to
Collect
\....
A dd
Under cha r ge
R ~ CORD Of" NOTICES
To Consignee_ _______ ______ __ _ T o Sh i pper ______ ______ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STA.TE OF·
COUNTY
V~ Nu.,.P ?
OF.,._,.,.._,/=J-r.-_
C'A
__
~ ~ -------1
)
---'......,.,___~-~-~---c-"-"'---- - - - - - - •
I,
the consignee of
being duly sworn, depose and say that I am
ert ain shipment of ardent spirits, as SP.ecified on other side of thie form, this day
delivered to me by t he Adams E xpress Company, from _ _ _ _ _ _ _ _ _ _ _ ; that I am not a
student or minor, and, if a f emale, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, an.d that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of t he quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved Mar ch 10, 1916, or contrary t o law, and that the ardent spirits so received by me ~re for
o y own use, at my own home, and that the said ardent s iri
not be used in violation of law.
'
Sworn to and subf.ribed before me,
thisj;i__day
o
,f,AC , 19!7 .
rr
A g ent f or Adams Exp ress Company.
t
�---- -- - - - ~ - ---- -- -- -------- -------- --·
O a LtvERY F O R M
ADAMS EXPRESS COMPANY
60
Affidavit No._/_ __ _
To_~ ------=-'--~.
Advances to
Collect
RECORD OF NOTI CE S
T o Consignee
PREPAID
I
Shi p
To S hi p per
AFFIDAVIT FOR ARDENT SPI R ITS FOR PERSONAL USE .
( OVER )
�-------~---,AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, - --,:-....._.,.,____.F--=----'-......_-'---r---------, being duly sworn, depose and say that I am
foe consi
t of ardent spirits, as,specified
otre si ' of this form, this day
delivered to me by the Adams Express Company, from L~-..,.;.~df--,~~~~~::=:::...; that I am not a
student or minor, and, if a female, I am the head of a family; that e ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for
cy own use, at my own home, and that the said ardent spirits will no be used ·n violation of law.
Sworn to and subsc ibed before me,
this /
L/,. day oL~
- -/ 191
G ,JJ<,/1,;
Agent for Adams Express Company.
�-----------~---- ---------- ~---- ----,
- -- - --------------
ADAMS EXPRESS COMP~
OllLIVERY FORM 60
SPECIAL LIQUOR RECORD/
lb
L--'.._'-=---"-';..c;-=.:....:::c::=~ ===---=----'---' Date
1912
Affidavit
No.__,/_ _ _
Consignee------t-r --.-rF-------='--r---t--,.,,-·--"--<r-"---r-:---------/--- -:---=----,fr'~-------.~---_.,,,_'----JC--="'-----'------'A mou nt _ _ +1 _ _ _ _ _ Weight~ _ __ Ibs..
-~'"'+-~,__..___ _ __
Advances to
Collect
REC OR D OF N O TI CES
To Consig nee._ __ __________ ___
191,z_ Frpm---~ - - --~-,-EXPRESS CH ARGE .
PREPAID
Add
Undercharge
To S hi p pe r _ _ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I,
, ,
, being duly sworn, depose and say that I am
foe consignee of ~ certain shipment of ardent spirits, as specified on other. ide of this form, this day
tleJivered to me by the Adams Express Company, from _
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or ·contrary to law, and that the ardent spirits so received by me are for
• y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
thi/ k _day of
,
191Z
Agent for Adams Express Comoany.
Consignee.
�08LIVERY FORM 60
ADAMS EXPRESS
COMPAN Y
191. L Affidavit No. _-=:::::c......._
To___,,_,__ =--,..,-1-'--------'-=a!!!e....,~----v--- - -Shipper
---'""'""--f'L --
A d van ces to
Collect
#'
RECORD OF NOTICES
To Consigne e
To Shipp er
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
( OVER )
Add
Unde rcha r g e
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, _,z:._+ e...:_-".-~ ---=-----'-'=-...::_- - + - - - - - - , being duly sworn, depose and say that I am
r-s·de of this form, this day
·
tae consignee of o. certain shipment of ar ent spirits, as s eci
delivered to me by the Adams Express ompany, from 6,;,...(~~rLJI~~~~~~~; t hat I am not a
student or minor, and, if a femal e, I am the head of a family ; t ha the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any per son or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrar y to law, and that the ardent spirits so received by me are for
II not be used in violation of law.
o y own use, at my own home, and that the said arde t spi~
Consignee.
A gent f or Adams Expre ss Company.
�0Kl:,IVll:R Y FORM 60
ADAM S EXPRE SS COMP ANY
...
Reoeived~..--,,1__,
. _,{
__,___,~ ____,__~ ....e..."'-'-''-"'--"'-- -__,___~'Consig nee '} '.J-.: / (. :,,,(
H
,-
. r
1·
Kind of Ardel)t S pirits~- '-r---4- ----,"1'-.;=r.- t.-=i-; ---Amo u
nt- ~,~ - - - -'Way-Bill No, -.rJ---...~ ...-,.......--
To
+--
1
To Consig nee
., I
1
-r'.-.-l -~_,___ _ __
191 _
From_,_• _ ..,.....~r1::: ::;t--+-:,_ ___'--f- /
A dvances to
Collect
T o Shi pper
AFFIDA VIT FOR ARDEN T SPIRIT S FOR" PERSO
NAL USE,
( OVE R )
-
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VqiGINIA,
COUNTY
OF_,_✓_,__;._~c-"-"-"-'--'---,'---j'"---- "'":+-5,,--,L-it - ----i,f-bJC,C::~-F-=:,.,?-- - - - - , being duly sworn,
of a. certain shlpment of ardent spirits, as specified on other
depose and say that I am
side of this form, this day
• I
I
delivered to me by the Adams Express Company, from ---'..__-f-\:=-i,,.:..L-"""-+''-""'"--~; that I am not a
student or minor, and, if a female, I am the head of a family; th;t the ardent spirits so r eceived by me
were b rought into the State on my written order, and that I have not, w ithin the thirty days previous
hereto, r eceived any ardent s pirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that t he ardent spirits 'so received by me are for
r::iy own use, at my own home, and that the said ardent spirits w ill not be used in violation of law.
✓
Sworn to and subscribed before me,
this
~ --=:::-'"-- • 191_.
..,.,,
I..
Agent for Adams Express Company.
I
'
Conai8Dee.
�DEL I VERY FO RM 60
ADAMS EXPRESS
COMP ANY
Wa
To-,~-:l'-Y' --l---"----l""-C, ---:-- -7"r--
To Consignee
PREPAID
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�__________________ _
,
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE
I, --£--.,,,,e:._:::;_,-=---....::;--,'-'"-----,,""'-' -- - - - - - - , being duly sworn, depose and
say that I am
'the consi
e of n certa· shipm ntof ardent spirits, as specified o ther id
this form, this day
delivered
me by the Adams Express Company, from
"'?J.
; that I am not a
student9r minor, and, if a female, I am the head of a family; tliat e ardent spirits
so received by me
were brought into the State on my writt en order, and that I have-not, within the
thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person or from
any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
.approved March 10, 1916, or contrary to -law, anp. that the ardent spirits so received
by me are for
my own use, at my own home, and that the said ardent s pirits will not
be used in violation of law.
✓~
Consignee.
�D•LtvERY FORM 60
ADAMS EXPRESS
To_~ --~ ~ ~ -~~~.... ,...,.,-.,.-"--- ,,-----
COMP ANY
Advances to
Collect
'EXPRESS CHARGE.
PREPAID
COLLECT
I
Shi pper - ----'"'---.RECORD OF NOTICES
To Consignee _ _____ ______ _____
Add
U nde rcharge
J
To Sh i p per _ _ _ _ __ _ _ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVE R )
�AFFIDA VIT FOR ARDENT SPIRITS FOR PERSON AL USE
_ -9..,__------,+.=::.-',,.,_-#-.c._-#-....t,:-- '1£1LJc:_..J\.._ _ _ _ ,
being duly sworn, depose and say that I am
certain shipmen t of ardent spirits, as s cifi'
his form, this day
delivered to me y the Adams Express Company , from ·
;-"tha I am not a
student or minor, and, if a f emale, I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
h ereto, received any ardent spirits of any kind whatsoever, from any person
or from any place whatsoever, in excess of the quantity allowed by the provision s of the Act of the
General Assembl y of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are for
oy own use, at my own home, and that the said ardent spirits will
not be used in violation of law.
�~---------------- ------------·- ------ - - --------------ADAMS EXPRESS COMPANY
O • L tV E RY F OR M 60
T o C onsig nee._ _ __ _ __ _
T o Ship pe r
AFFIDAV I T FOR ARDENT SPI R ITS FOR PERSONAL USE .
( OVE R )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, ...-,,;..,:1-+--,--4--- =---A- :-e,..:..,~ - = - - - - - , being duly sworn, depose and say that I am
foe consi e of o. certain shii/ment of ardent spirits, as specified on other side of this form, this day
me by the Adams Express Company, from~---l-..--1 .-~~.o::~; that I am not a
student or minor, and, if a female, I am the h ead of a family; that the ardent spirits so received by me
w ere brought into the State on my written order, and that I have not, within the thirty days previou.'3
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
o y own use, at my own home, and that the said' rdent spi its iWill n t e use in violation of law.
""
�DELIVERY FO R M
60
~DAMS EXPRES S COMP ANY
Adva nces to
Collect
PREPAID
I
To Consig nee.____ ____ ,_ __ _ _ __ _
I
To Shippe r _ _ _ _ _ _ _ _ _ _ _ _ __ _ _
AFFIDAV IT FOR ARDENT , SPIRITS FOR PERSON AL
USE .
(OVER )
�AFFIDAV IT FOR ARDENT SPIRITS FOR PERSONAL USE
COUNTYOFOF_,__
--,_~
_ ........_
_..L..,_ ~
_ ,
STATE
j.J.i....t<'NIA
~
I,
~ /
, being duly sworn, depose and say that I am
Cle consignee of n certain~ ~ rdent spirits, as SP, cifie on tl\ers· e of is form, this day
delivered to me by the Adams Ei press Company, from
, tliat I am not a
student or minor, and, if a female, I am the h ead of a family ; t hat tlie ardent spirit s so r eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ar dent spir its of any kind whatsoever, from'any person or from any place whatsoever, in excess of the quantity allowed by°the provisions of the A ct of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and t hat the ardent spirits so received by me are for
o y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
I
Consianee.
�DRLIVERY FORM 60
To
ADAMS EXPRESS COMPANY
Consignee _ _ _____ _____ ____ _
To Shipper
AF'FIDAVIT FOR ARDENT SPIRITS F'OR PERSONA L USE.
( OVER )
�AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE
STA.TE OF
COUNTY OF --f~_.,_~ ~-'-.,,.___ _ _,_
delivered to me by the Adams Express Company, from
• hat-I am not a
student or minor, and, if a female, I am the head of a f amily; that the ardent spirits
so received by me
were brought into the State on my written order, an.d that I have not, within the thirty
days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person or from
any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10,, 1916, or contrary to law, and that the ardent spirits so received
by me are for
• y own use, at my own home, and that the said ardent spirits will no be used in violation
of law.
~
Consignee.
A g ent for Adams Express Companya
�ADAMS
OEL ?VE RY FORM 60
EXPRESS COMPANY
---'-"--=.....c._+ - f ~f----=--'"' mo u nt
e=---=~IJ----jf}--
m
---""'q__+"~....+----- 191~
rnm=-~..,:,.,::_--,:-----lL..1--j,,,tE--.S.-
EX PRESS
PREPAID
COLLECT
Add
Undercharge
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ __ __
AFFIDAVIT FOR ARDENT- SPIRITS FOR PERSONAL USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSON.AL USE
I, ---\::'----"'--il;L-~.L--=--=-...,;s'---'-------,!'-------, being duly sworn, depose and say that I am
the consignee of a certain shipment of argent spirits, as s ecifi d• of ~h
delivered to me by the Adams Express Company, from .
VA
; that I am not a
student or minor, and, if a female, I am the head of a family; that he ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
.approved March 10, 19H\, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits wil o be used in violation of law.
C.OnErignee.
�- ~--- - -~----- -------------~-- ----- - ----- ----- ---- ----- ---O&LIVERY FO R M 60
ADAMS EXPRESS
COMP ANY
Affidavit No.-=- - -
PREPAID
REC OR D
I
O F N OTI CES
To Con signee_ _ _ _ _______ _ _ _ __
T o Shipper _ _ _ _ _ _ __ _ _ __ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS F OR PERSONAL USE.
( OVE R )
/
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF V,#ilpINI ,
COUNTY OF r u
cf £'
t
n
• ;#
,
being duly sworn, depose and say that I am
1
I,
the consignee of n cer am shipment of ardent spirits, as specified on otpe side of this form, this day
delivered to me by t he Adams Express Company, from_;;__ _ _ _=---'-'---'-...,.-"--• that I am not a
student or minor, and, if a female, I am t he head of a family ; that the ardent spirits so received by me
were brought int o t he State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary t o .Jaw, and that the ardent spirits so r eceived by me are for
• y own use, at my own home, and t hat the said ard~ t sp· ·ts · not e used in violation of law.
l
A g ent for Adams E x pres s Comoany.
Consignee.
�D•LIVERY FORM 60
ADAMS
EXPRESS
COMPANY
To --,F-+.Har--~~r~"±t...-.i"w..,_,.,_..'+--:..;.:"--Shi
To Consignee ___________ ______ T o S hipper _ _ _ _ _ _ __ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, ---'f"--__!.--¥---I-F--~::.....,Hf;p.-r--'!----it:.::..i;::_--\::=-- - • being duly sworn, depose and say that I am
r 1de • this form, this day
t he consigpee of o. certain shipmen o'f ardent spirits, as specified o
at I am not a
tlelivered to me by t he Adams E xpress Company, from+-=--1::::::,-1,.,1-,,#---w-q,qbi"_,.
student or minor, and, if a f emale, I am t he h ead of a family ; that e ardent spirits so received by me
w ere .brought in to t he State on my written order, an.d t hat I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, fro m any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Ass~mbly of Virg inia,
approved March 10, 1916, or cont rary to Jaw, and that the ardent spirits so received by me are for
• y own use, at my own home, and that the said"arde t spirits wil ot be used in viola.'tion of law.
r
Consignee.
Sworn to and subscrioed b efore me,
A gent for Ada ms E xpress Comvanya
�-
- --- -----~----- --------- --- - - -- ADAMS EXPRESS
DBL IVERY F ORM 6 0
COMP ANY
PREPAID
R ECOR D
I
OF N OTI CES
To C onsignee
To Shipper
AFFIDAVIT FOR ARDENT SP IRI T S FGI R PERSONAL USE .
( OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF
COUNTY OP -4---\..'b;,!'l.;:-.........,:~ ~'a_L
I, _ J,!;~'....,,..~"/---l-Y~~~~~L-- - - - - - , being duly sworn, depose and say that I am
the consignee of o. certain shipment
ardent spirits, as specifie on ther siile of tbjs form, this day
delivered to me by the Adams Express Company, from '\:!!.----'--=-'=--,,-~;,.:,,,,..!:=c:,.,; that I am not a
student or minor, and, if a f emale, I a m t he head of a family ; tha t the ardent spirits so r eceived by me
were brought into the Sta te on my written or der , an.d that I ha ve not, within the thirty days previous
hereto, received any ardent spirits of any kind what soever, from any person or from any place wha tsoever, in excess of the quantity allowed by the pr ovisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, a nd tha t the ardent spirits so received by me are for
• y own u se, at my own home, and tha t the said rd nt spirits will
be used in violation of law.
Consignee•
..
�------ -----·---- -- ---- ---- ---- ---- --- ----....
DRLIVERY FORM 60
ADAMS EXPRESS COMPAN Y
RECORD OF NOTICES
To Consignee
· To Shippe r
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
(OVEII. )
�AFFIDA VIT FOR ARDE NT SPIRITS FOR PERSON AL USE
A\J~...JLJ~~~:,.___ _(___,~~ ~~~~ ~~-,
being duly sworn, depose and say that I am
t of ardent spiz:its, as s pecified~ n ~ er si · e of this form, this day
delivered to me by t he Adams Express Company , from--- '----',,- ~-"'-'"+-~ s tudent or minor, and, if a f emale, I am the head of a family; that t ardent
spirits so received by me
were brought into the Stat e on my written or der, an.d that I have not,
within the thirty days previous
hereto, received any ardent spirits of any k ind what soever, from any person
or from any place whatsoever, in excess of the quantity allowed by the provision s of the Act of t he
General Assembl y of Virg inia,
approved March 10, 1916, or contr ary to law, and that the ardent spirits
so r eceived by m e are for
n y own use, at my own home, and that t he s aid ardent spirits will not
be · used in violation of law.
'),ti
Sworn to and subscrib ed b efore me,
~;-;;;.,:::;: :er;,-~,,
1917--
eontgnee.
�ADAMS EXPRESS COMPANY
DIELIVERY FORM 60
Add
Unqercharge
RECOR D
O F' NOTI C E S
To C onsignee,_ _ ____________ _~ . To S hi pper _ _ _ _ _ _ _ _ _ _ _ _ _ __ _
AF'FIDAV I T FOR ARDENT SPI R ITS FOR PERSONAL USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, + - ---1-F=--=#-----"::..._~-=__._----"=--=-- - - - , being duly sworn, depose and say that I am
t l:J.e consi ee of ::i cert ain shipment of ar dent spirits, as s~ cified Off other side of this for~, this day
delivered to me by the Adams E xpress Company, from ( /
_
; tjiat I am not a
student or minor, and, if a female, I am t he h ead of a family; that the ardent spirits so r eceived by me
w ere brought into t he S t ate on my w ritten order, and that I have not, within the thirty days previous
h ereto, received any ardent spirits of any k ind whatsoever, from any per son or from any place whatsoever, in excess of t he quantity allowed by t he pr ovisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contr ary t o law, and that t he ardent spirits so received by me are for
n y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
Consi1r11ee.
. .·"'
_
�------ ------ ~--- ----------------------,
OIELIVERY FORM 60
ADAMS EXPRESS COMP ANY
Affidavit No•--'---
To_~ ~ -:,,;,.--=~::...,,:c,...;~--"'---------'__,~'-----\..-----Shipper ~....._,.__ _ _
RECORD OF NOTICES
To Consignee
To Shi ppe r
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
delivered to me by the Adams Express Company, from
· that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
• y own use, at my own home, and that the said ardent spirits will not be used in violation of law.
&:.L ~CUJ
Consignee.
Sworn to and subscribed before me,
this_s__day of-;'.;;:::;;;;:;:~:;-
�ADAMS EXPRESS COMPANY
DRLIVERY FORM 60
PECIAL LIQUOR RE f ORD
Received-----l~ ~~+!l~ ~~Y-l~~ ~c.....J, ~ Date
'f)f ?J
191 7
Affidavit No._____::,,,_.. .__
Way-
T o --'....,_- - .~ - ~ ..,__=• ~"t---f"'- - - - -
PREPAID
-i-
RECO RD OF' N OTICE S
To Consignee _ _____ _____ _____ _ To Shipper _ _ _ _ _ _ _ _ _ _ _ _
__ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE .
( OVER )
�AFFIDAVIT FOR ARD ENT SPiRiTS FOR PERSONAL USE
I,
t he consignee of
, being duly sworn, depose and say that I am
cert ain shipment of ardent spirits, as s
~
delivered t o me by t he Adams E xpr ess Company, from-==-----..+.....;,~..q,4,. +4"""'1,.1;-,A.::t
at I am not a
student or m inor, a nd, if a female, I a m the head of a family ; that e ardent spirits so rece ived by me
were brought into the State on my writt en order, a nd tha t I have not, within the thirty days previous
her eto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in ex cess of t he quant ity al19wed by t he provisions of the Ac~ of the General Assembly of Virginia,
approved March 10, 1916, or cont rary t o -l aw, a nd t h at the ardent spirits so received by me are for
• y own use, a t my own home, and tha t the s aid ardent spirits will no be used in violation of law.
Consignee.
'
A g e n t for A dam s Express Company.
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 01
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Bridgewater in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
Bridgewater
Virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1916
1917
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box10-037
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Bridgewater, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/017c224e92ca6c6d7a0476649b5317e1.pdf
50058498ccc54c10e4b4818e440335f1
PDF Text
Text
SOUTHERN EXPRESS COMPANY
FORM 370•VA
.
( I ncorpo rated)
SPECIAL LIQUOR
RECORD
Way-Bill No..,,._.--- ~ -i---- Oate, _ _ _ _~ ~~ -- - - 191 _
' / . .,
,.:........;._ _ _...,._ _E_X_'P_R_E_S_S_C_H_A_R_G_E_S_ _ _ _ _ _ _ _ __,
To
Advaurea to
Col lect
COLLECT
RECORD OF NOTICES
To Consign ee _______________ ___
To Shipper _ _ __ ____ ___ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVICR}
�AFFIDAVI T FOR ARDENT S~IRITS FOR
STATE OF' VIRGINI A1 = J
C OUNTY· OF
("t:
PERSONA L USE
/
<:'- /~..,,.--,~' I
1
{
~---·
1
·-'• ,
,<" being duly sworn, uepose and say th at I am
the cou~iguee of a cert ain shipment of I r<lelt' spirits~ as \ pecified on olher side of thi s
form , this day
l,;i} ~ ~ ~ C.,,.✓
delivered to me by the Southern Express Company, from
l• ,; hat I am not a
student or minor, and, if a female, I am the head of a family ; that the ardent s pirits so received
by me
were brought into the State on my written order, ana ihat I have not / ' ithin the thirty
days previous
hereto, received any ardent spirits of any kind whatsoever, from any pers n or from any place
whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for m
y own use , at
my own home, and that the said ardent spirits will not be used in violation of law.
S worn to and subsc ribed before me,
thi s -.l-:fday of~ -'=--=---
~~-_r1=,r.~
-;--~
-::"-----: ---=----
.x 1·es::s Company.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(lucorpornt ed)
RECORD
Arlvnt1f'C8 to
Collect
COLLECT
RECORD OF NOTICES
To Consignee _ _ _ _ _ __
__ __ _
To Shipper_ _ _ _____ ___ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE: .
•
(OVl<R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE Ob' VIRGINIA,
CoUN'J'Y m' - - -- - -- - - - ~
1,
=--~------ -, being duly sworn, depose and say that I am
the consignee of a certain s hipm Jnt of ardent spirits, as s pecified op oth er side of tbis form , this day
• , ;' .
1.
delivered to me by t he Southern Express Company, from _ _ ___._ _.......,..-~::..c.......;.:.._=f.- ; that I a m not a
student or minor, and, if a femal e , I am the head of a family;
rd ent spi ri so received by me
were brought into the State on my written order, and that I have{ not, ithin th thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any IJer on or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law , and that the ardent spirits so received by me are for m y own use, at
· my own hom e, and th at the said a rdent spirits will not be nsed in violation of law ,
Sworn to and subsc ribed before me,
thi ~
_ day of
~/i
/
(
"':'~ f
, 191_.
\;uu s i2uee.
�FORM 370•VA
SOUTH ERN EXPRES S COMPA NY
(lucorporate d)
SPECIA L LIQUOf \ RECOR D
Received at--~- -- - - -- - -- - ~ - -Date_ ~ - - -
~- - 19"1 Mlidavit No. _ _ __ _ _
I
Consign ee - - - - - - -- - ~ - - - - - - - -- - - - - -- - --...,.-- - -- - -- - -- -Kind of-Ard ent Spirits_ _ _ _ - ~ - ~ - - -- - - -Amoun ~ ____
____ __ Weioht~- ~ -- lbs.
Way-Bill No._ ,.____ _ __ _ __
/,
:/
J If.
I
To - - - ~=:::.o: =:.==:::_: _ _---1._ _ _ _ __
Advonres to
Coll ect
E XPRESS CHARGES
PREPAID
COL L ECT
:A~d
Oudercharge
RECORD OF NOTICES
To Con signee ____ ____ _____ _ _ _ __
To Shipper _ _ _ __ _ ____ __ _ _ _ __ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE.
(OVER)
�AF'F'I DAVIT F'OR ARDE NT SPIR ITS
F'OR
PERS ONA L USE
STATE 0~' VIRGJ NI,I,
COUN'. l'Y OP--- ~---- '-------'='---"''-"C
:---
1,
/
, being duly s worn, d epo~e a nd say that I am
th e consig uee of a certai u s hipm ent of a rdent
spirjts , as s pecifi ed on ot he r side of thi s form
, t his day
delive red to me by the South ern Expre ss Com
pany, from _ ~ ~,--- - ~ · - - - - - - - ; that
I a m not a
studen t or minor , and , if a femal e, I am the
head of a fa~ily ; th at the ard ent spi rits so 1·eceive
d by m e
were broug ht into the Stat e on my writte n order,
and that I have not, within th e thirty days
previo us
hereto , receiv ed an y ardent ~pi rits of any kind
what soever , from any person or from a ny place
whats oever, in
excess of t he quant ity allowe d by the provis ions
of the Act of t he Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or cont rary to law, and that
t he ardent spirits so receiv ed by me are for m
y own u se, at
my own home, and t hat t he said ardent spirits
will not be nsed in violati on of law.
~worn t o and subscr ibed be fore me ,
thi s ___ d ay of___ ___ , 191
;\~t:, 11t for Southe rn F,x11r e~s Compan
y.
/
(.;uu sj e u~e.
�r
SOUTHERN EXPRESS COMPANY
FORM 370•VA
( lucorpor atcd)
LIQUOR, RECORD
--~
) ~,_ _ 191_l
I
Affidavit No.
___.__.,.,,cc.J~--==---,-...--------.--Am oun~ - - ~/_ _ """'-_ _ __
,,
Advauces to
Co llect
COLLECT
Add
Undercha rge
RECORD OF NOTICES
To Consign ee _ _ _ _ _ _ _ _ _ _ _ __
_
To Shipper_ _ _ _____ __ __ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FDR P f; RSONAL USE.
(OVER)
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NA L USE
S TATE 0~' V rn GJNIA ,
C OU NTY
m·----,--- ~ -1.- ~ -h~(,.-,1-'------.-,'-,-·'-~,___
4
,
I,
1v
being duly s worn, uepose and say that I am
the consi gnee of a certain s hi p ment of arde ut spi r its,
as s pecifi ed on other side of thi s form , t his day
delivere d to me by t he Southe rn Expres s Compan y, from
th at I a m not a
titudent or minor, and , if a fem a le, I am th e head of a
famil y; th at the rd ent s pi rits so r eceived by me
were brough t into the State on m y written order, and
t hat I have not , within th e thirty days previou s
heret o, receive d any ard ent spirits of any kind what soever,
from any person or from an y pl ace what soever, in
excess of the qua nt ity allowed by the p rov isions of the
Act of t he Genera l Assemb ly of Virgini a, approv ed
March 10, 1916, or cont rary to law, and t hat t he ardent
spiri t s so receive d by me are fo r m y own use; at
my own hom e , and that th e sa id ardent spirits will not
be n sed in v iol ati on of la w.
L
~ worn to and subscri bed be for e me,
I
thi s-d:,_ d ay o ~ -- - ~- , 191_ ,
.-\i.:-e 11t for
S outhern ExJ}rei=-8 Co n11,rm y.
, '-
;
�------------------------ - - - - ----- ------- ------ ---~-- -----FORM 370•VA
Way-Bill No. _ ~ ~ - - ~- -To
Advnures t o
Collec t
EXPRESS CHARGES
COLLECT
Add
Oude rc ha rge
RECORD OF NOTICES
To Consign ee _ __ _ _______ ________ To Shipper _ _ _ __ _ _ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVE R)
�AFFIDA V IT FOR ARDEN T SPIRIT S FOR
PERSO NA L USE
l,
, being duly s woru, <lepose a nd say that I am
th e cons ign ee of a cert ain s hi p ment o( nnlent spirits, as s
ecifi ed on othe r side of th is form , this day
I
I
t
delivere d to me by the Souther n Express Compan y, from
V - - -~ - - - i that I am not a
student or minor, and, if a femal e, I am the head of a family;
that the ard ent spirits so 1·eceived by me
were brought into the State on my written order, and that I
have not, within th e th irty days previous
heret o, received any ardent spirits of any kind whatsoe ve r, fro
m any person or from an y pl ace whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
t he Genera l Assemb ly of Virginia , approve d
:March 10, 1916, or contrary t o la w, and t hat t he ardent spirits
so r eceived by me a re fo r m y own u se, at
my own home , and th at the sa id ardent s pirit s will not be nsed
in violation of law.
·
Swo rn to and subsc ribed befo re me ,
C), it
1
I
----<..: v u si gu~e.
�F ORM 370•VA,
SOUT HERN EXPR ESS COMP ANY
(I u
co rporate d )
Sh ipper _ _ _ _ _ _ _ __ _ _ __ __ _ _
_
RECOR D OF NOTIC ES
To Consignee ___ ___ ___ ____ _ _ _
__
To Shipper _ _ _ _ _ _ ____ _ _ _ __ __
_
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAi USE .
(OVJCR)
�AFFID AVIT FOR ARDJ; NT SPIRI TS FOR
PERSO NAL USE
STATE OF VI
COUNTY OF
NA,
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, being duly sworn, depose and say that I am
the con~ign ee of a certain s h ~ t of ardei'i sp.i rits,
as specifie d on other side of this form, this day
~1 'r; r.r.
,I - -.
deliver ed to me by the Southe rn Expres s Compan y, from
✓ t "~ •·
~ that I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent srits so receive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisio ns of the Act
of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and that ~he ardent
spirits so receive d by me are for my own use, at
my own home, and that the said ardent spirit., will not be
used in violatio n of law.
J
/ ~·
-;li' /11
Consi(lne e.
Aatent for Southern Express Company .
�SOUTHER N EXPRESS COMPANY
FORM 370-VA
(In corporated)
SPECIAL LIQUO~
::\
Kind of Ard ent Spirits _ _
Way-Bill No.
"-J
_ Date_
To - -~ - ~
'
RECORD
"
_ _ _ Am ount,___..,__
,
- - - ~ - 131 _
Arlvaures t o
Co ller t
---'--- Weig ht.
EXl'RESB CHARG ES
PRE PAIi)
RECORD Of" NOTICES
_ To Shipper_
Af"f"tDAVIT FOR ARDENT SPIRITS FOR PERSONAL
(OHR )
A~d
Upcte r <'hn.ri::e
Shipper __ _
To Consign ee
_lbs.
From, _ __.,__ _ _ _ _ _ ___,___..,
use .
�A°~F'IDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I
STA.TE OF VIRGIJUA,
COUNTY OF_....,...._ _ _ _ __::_::___
c_ .,
l,
/
, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as spe ified on other side of this form, this day
delivered to me by the Southern Express Company, from _ __ ~ - - -- - - - - - - ; that I am not a
smdent or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and ihat the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will noi be used in violation of Jaw.
/"
(~
.)
Sworn to and subscribed before me,
this ___ day of-.,-_ _ _ _ , 191_,
J\eent for Southern Express Company.
Consienee.
��'
...
--
�FORM 370-VA ,
SOUT HERN EXPR ESS COMP ANY
(Iu
co rporo.te d)
SPEC IAL LIQUO ,~~ RECO RD
Received at
Date
Consignee _ ...i....:r.:c...:1c..:::_-'----'----'-"---'--· ---'- - -/-,,-/ ;
i:,
U
~l~i~l~•=""=;-.~,-~·~·~~ - - - - -l'.
Kind of Ardent Spints,___
Way-Bill No._~ ' -.:..,...
>-"---:- -''-'-- --Date
, , / ;,· ;
J
191
/
- AmountL_ _,___=->..._
,, '
i
Advnn ce a to
1
I
l
~-----W
191 ,
eich ~-✓•_
_
;; _,.
/.
EXPRES S CHARG E S
Coll ect
lbs.
.Add
Unde r charge
RECOR D Of' NOTIC ES
To Consignee ___ ____ _ _ ___ ___ __
_
To Shipper ___ ___ ___ ____ _ _ __ _
Af'f'IDA VIT f'OR ARDEN T SPIRIT S f'OR
PERSO NAi USE.
(OVIIR)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
/'
STATE OF VIRG~~\k,
COUNTY OF
I
the co~igne e
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.
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-
PERSO NAL USE
~
•t
·f, .i,_'). --1
V 1certain shipment or' ardent spirits, as
, being duly sworn, depose and say that I am
specified -on other sip.e of this form, this day
1
I
.,
..
l
1 1
delivered to me· by the Southern Express Company , from
~
'
'#
•
f
;
that I am not a
student or minor, and, if a female, I am the head of a fam ily; that the
ardent s#its s9 received by me
were brought into the State on my written order, and that I have not,
within the t~y days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from anyllace whatsoev er, in
excess of the quantity allowed by th e provision .! of the Act of the General
Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received
by me are for my own use, at
my own home, and that the said ardent spirits will not be used in vio lation
of law.
Sworn to and subscribe d before me,
A1tent for Soutbe<fi' Express Company.
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
( lnc orpo r
otc d)
J
Advnu re a t o
Co llec t
COLL ECT
RECOR D OF NOTIC ES
To Consionee ___ ____
· - - - - ___ __ To Shipper_ _ _ ___ __
___ _ _ _ _ __
--- --- --- --- --- --
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL
(OVER }
us e.
�FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STA TE OP
C OUNTY OF'- -::a:a:::- -L-=i"""'- ,~ Cf-'-~
l,
-~--..cY --_.,,_.::::-J,-..,,'----f>,._.-"i·_,,_...c;;=11..,11....,.,_:w.._ _ _ _ ,
being duly swom, uepose and say th at
I am
1ipment of aru e ut spirits, a:; ,Peci6ed on oth er side o tu is
fo1·m , this day
delivere d to me by the Souther n Express Compan y , from {,,,1,A,J
.{ --~~ ~-,,~ ; at I am not a
student or minor, and, if a female, I am the head of a family
; that the ard ent spirits so r eceived by m e
were brought into the State on my written order, and that I
have not, within th e thi rty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quant ity allowed by the provi sions of the Act of
the Gener al Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that t he ardent spiri
ts so r eceived by me a1·e fo r my own use, at
my own hom e, and th at the said ard ent spirits wi not be sed
i 1 vi olation of law .
the consigu ee of a certai v
�---- -- ~- ---- ---- ---~---------------- ---- ---- -..
FORM 370•VA
SOUTH ERN ·EXPRE SS COMPA NY
( Incorpo rate d)
LIQUOR RECOR D
Affidavit No.
Way-Bill N
To
Fro ._________ __ _
l
EXPRE SS C H ARGES
A d vn 11 re e t o
.;
C ol lec t
PRE PA ID
COLL ECT
Aad
Uude rfh a rge
RECORD OF NOTICES
To Consignee _ ___
_ _ To Sh ipper _ ____ ___ _ ____ ____ _
'
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE
.
(OVER )
�f
\
AFFIDAV IT FOR ARDENT SPIRITS FOR
PERSON AL USE
S T A TE 0~' Vrn G INIA ,
C OU NTY O~' - - - --
-
--~--
l , - - - - -- - -- - - - ~ - - - ~ - - , - - - - -, IJeing duly sworu, depose and
say th at I am
the consig 11ee of a cert ain shipment of ard ent spirits, as specified on other side
of thi s form, this day
delivered to me by the Sout hern Express Company , from
.
; t hat I am not a
student or ·minor, and, if a femal e, I am t he head of a famil y ; that the ardent
spirits so r eceived by me
were broug,ht into the State on my written order, and that I have not, within
the thirty days previou s
heret o, received any ardent spirits of any kind what soever, from any person or from
any place what soever , in
excess of t he quantity allowed by the provisions of the Act of the General Assembly
of Virginia, app roved
March 10, 1916, or contrary to law, and t hat the ardent spirits so r eceived by me
a re for m y own u s e , at
my own hom e, and th at the said ardent spirits will not be used in violation of Ja
w.
:-;worn to and subsc ribed befo re me ,
thi ~
_ day o~ - - - - - , 191_ ,
_1\ !.{e11 t f ur S outhe rn F.xpre:--s Comp:u1 .r .
�FORM 370•VA
SOU THER N EXPR ESS COM PAN
Y
( Iucorpo rated)
SPEC IAL LIQU OR
RECO RD
PREPA ID
COLLECT
,)
RECO RD OF NOTIC ES
To Consign ee ___ ___ __
_
_ - ~ __ To Shipp er _ _ _ _ ___ _
___ _ _ _ _ __
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERS ONAL USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
STATE 0~' YIRG } Nl
COUNT Y OF
l
,
=<'l..,(ig
•
'/'C,-6 U
9
,
[,
&'~
PERSONAL USE
/;
,
being duly swor,j, depose and say that I am
the con~ignee of a cert ain shipm ent o[ ardei,t\ pirits, Rti specified o ot)rnr side of thi s form, thi s day
t
~ Ci,
;
delivered to me by the Southern Express Company, from /
l
that I"nm net n
titudent or minor, and, if a female, I am th e head of a famil y; that the arden spirits so r eceived by me
were brought into the State on my written order, and that I have not, withl):i the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allo~ed by the provisions of the Act of the General Assembly of Virginia, approved
March 10_, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that th e said ardent spirits will not be nsed i u violation· of law .
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
( Incorpo
rated}
7
"),, (.
Affidavit No. _ _ __c_/_
RECOR D OF NOTIC ES
To Consignee _ _ _ _ _ __
_
_ _ To Shipper_ _ _ __ _ _ _ __ _ _ _
__ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
(OV ER}
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL llSE
being duly swo rn , ilepose a nd say th at I am
spirits , as spec' fl ed 01¼ ol her side of ~hi s form , this day
&
·
·
that I a m not a
delivered to me by the Southern Express Company, from
student or minor, and, if a femal e , I am the head of a family; that the rd ent spi rits
r eceived by me
were brought into the State on my written order, and that I have
t , ;vithin th e thi1·ty days previou s
hereto, received any ardent spirits of any kind whatsoever, from any person or from uny place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia , approved
March 10, 1916, or contrary to la w, and that the ardent s pirits so received by me al'e fo r m y own use, at
my own home , and th at the said ardent spirits will not be ed in violation oE l!!'L
S worn to and subscribed before me ,
th is ___c,L~d ,y of
J' ( r
, 19L.;2 .
.A~e 11 t fu r Su uthei-11 F.xpress Comp:u1 y.
v~
f ~,
�FORM 370•VA
SOUTH ERN EXPRE SS COMP ANY
(I ncorporate d)
SPECI AL LIQUO R
RECO RD
Received at. _ __:::....:=---~ -=:::..--'c- - - - - , - - - - Date.
_ _ _ __ _ _ 191 _
Affidavit No. _
/
__c_),_ ~___,U
..,t:J
=--
/_~-1'___
:J __ Weioh~
'---'---'----'--..:_...:=:::...,....- -- -Amoun L__ _...
'- -----"'-------'==---=----~ -~'-L,'__ 191_
Advnuf'ea to
Collect
_ _ Jbs.
From _ _ __ _ _ _ _ _ __
EXPRESS CHARGE S
PR EPA ID
COLLECT
A~d
Undercha rge
RECOR D OF NOTICE S
To Consign ee _ _ _ _ ____,_ _
_ _ _ _ _ To Shipper _ _ _ _ __ ____ __
_ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(ov,rn)
�AFFIDAVI T FOR ARDENT SPIRITS FOR
STATE Ob' VIR GINIA'
C OU NTY OF _ __ _ _ _ __ _ _ _ ,_
'
PERSONA L U SE
l,
~
<----'-----~- - - - -, being duly sworn, ue pose and say that I am
\h e consignee of a cer.l;ain shipment of ardent spirits , as_ specified on other side Qf thi s form , this day
delivered to me by the Southern Express Company, from _ _ _____ _____.c.c__ ; that I am not a
student or minor, and , if a fema le, I am the head of a family; th at the ard ent spi rits so r eceived by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
l1ereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of t he quant ity allowed by the provisions of t he Act of the General Assembly of Virginia, approved
:March 10, 1916, or contrary to law, and that the ardent spi r its so received by me are fo r m y own nse, at
my own home , and that t he sa id ard ent spirits will not be used in violation of law.
,t~
S woru to and subscribed before m e ,
th is _~_day o~-- - - -, 191_
.
Kj,~ -- J\ie~ U ti
for Sm1thern Rxpress Cmnpn n.r.
�FORM 370-VA
SOUTH ERN EXPRE SS COMPA NY
(lucorporu t ed)
;;
SPECIA L LIQUO R RECOR D
Received at,___
f ~
J ~t--,,c,~~ ~-
-r-=c-- --- -=- -
Date
191 -2
Kind of Ardent Spirits, _ _ _ _
Am oun
Affidavit No.
I
Weiaht
"id'+
, ,,
lbs.
I
Way-Bill No. _ _ _ _ _ __ __
191_
To _ _ _ _...:..,=.."-".:....-"--'"-"-=--- -- - ~- - -
Advnucee to
Coll ec t
I
From
EXPRESS CHARGES
PREPA ID
COLLECT
-'.A dd
Under charge
RECORD OF NOTICE S .
To Consig nee ____ ____ ____ ____ __
To Shipper____ ____ __ _ _ _ _ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL USE .
(OVXR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
=
PERSONAL USE
,
l,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as sp citied on ot er side of this form , this day
l
.,_.
C;
uelivered to me by the Southern Express Company, from
1.
,:,
that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent ,spirits so r eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any perso or from ~y place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use , at
my own home, and th at the said ardent spirits will not be used in violation of law.
ul
l
S worn to and subscribed before m e,
I
thi s _,:Jt__day o ~ - -~ -
C
.ft~~ ~ ,(
, 191_.
:__
=
.,\L,••er1t for Sontllern Exin·es. C om11nny .
D rt~ 0 cfG
�- - - ~----- - ~-
--- -
FORM 370-VA
SOUTHERN EXPRESS COMPANY
( Incorporate d)
LIQUOR RECORD
Received at, __:.=_
_
-?--------''--- - - - - - - Date,_ __,"'-----~--- 191 _
Affidavit No'---"-------'---=----
Consion ee - - ~~--L-.::__ .:;...,--__:~~~~ :!..
/i..:__::_____,'-_ _ __:/_ _----,-------=_ _-,---·_
....:...._
_
/ I?..
Kind of Arde nt Spirits,~ - --F-- ~ ----+-~ - - - -- - Am oun ' - - -- - ' - - - - - - Way-Bill No, _ _ _ _...:...~-'--To
•- - . C . . . . . C . - ~.
~--- -==-=-c_:_~'-""'-'- ---=----= ----
. . . . .::.. ---,1/_
-,
Ad vonre s t o
Co l lec t
_ __ _ __
I
' --'---
lbs.
191-fEXPRE S S CHARG ES
C OLLE CT
Add
Unde r charge
RECORD Of' NOTICES
To Consianee _ _
To Shipper _ _ _ _ ____ ___ _ _ _ __ _ _
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONAL USE .
(OVER )
�ARDENT SPIRITS FOR
PERSONAL USE
J,
,
, being duly swol'll, uepose and say that I am
the consignee of a cert ain shipment of ar<leut spirits, as specified on other side of this form, this day
f
delivered tome bythe So uthern Express Company, from
' ~ -+~ ~ -~ ~ ; th at I am not a
~tud~nt or minor, and, if a female, I am th e head of a fami ly; th at the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within th e thi1·ty days previous
hereto, received any ardent spirits of any kind what soever, from any person or from riny place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and th at the said ardent spirits will not. be used in violation of law ,
:-:iworu to and subscribed before me,
thi s 1 __day o
1,
, 191_,
I'
J\~eut fur Southern Ex J)re ss C<Hll l)a11y .
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(l uco
rpo rated)
Affidavit No.
Advour-es t o
Collec t
RECOR D OF' NOTIC ES
EXl'RES S CHARGE S
PREPAI D
COLLEC T
,
To Consign ee ___ ___ ___ ___
To Shipper _ _ __ _ _ _ _ __ _ _ _ __
AF'F'ID AVIT F'OR ARDEN T SPIRIT S F'OR
PERSO NAL USE: .
(OVllR)
�ARDEN T
SPIRIT S FOR
PERSO NAL USE
r,
- -- ~l\~:_.------,,l)_.t-~"".".:!(-Jltt,~~;;,....-- - - -, being duly SWOI'
II, de pose and say that I a m
the consig11e e of a certain s hipment of ardent spiri_~~ at1 specif
i~n/ 6111er side of thi s fo ·m, this dayuelivere d to me by the Souther n Express Compan y, from
f
; that I am not a
8tudent or minor, and, if a femal e , I am the head of a family;
that the ar ~ t spi ri ts so received by me
were brought into the State on m y written order, and that I
have not,
thin the thi1·ty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that t he ardent spirits
so received by me are for m y own use , at
my own home, and that the said ardent spirits will not be used
in violation of law.
v'f ~
I
0
�SOUTH ERN EXPRES S COMPA NY
FORM 370•VA
( lucor poratc d )
LIQUO
Received atr---4,~L-.:....:_:::_:..__!_=~~=='-""--=--r...:_..:___ Date V :,,(
RECOR D
l
I
2.
191-1.
I
Consignee - - - ----=---__.__:,__:___J_-'-C---'--""""'""---'"""'"""""""""--- -- - - - - - - - - -- - - --
Advnure s t o
Co ll ect
PR EPA ID
RECORD OF NOTICES
To Consi gn ee _ __ _ _ _ __ _ _ _ _ _ _ _ __
To Shipper_ _ _ __ _ _ _ __ _ _ _ __ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE .
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
___,4-:......,.~:_..L,~[.J::;~•_J.~~~~~"'- "'L-- -, being duly sworn, .:le pose and say that I am
specified on otper side of t is form, this day
delivered to me by the Southern Express Company, from _ _,,_...,_---='-"---',c_"=------r'---=----'"--~ ; ht1t I am not a
~tudent or minor, and, if a female, I am the head of a family; that the arde t spirits so received by me
were brought into the State on my written order, and that I have not, wi1!\!1n th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
M:arch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and th at the said ardent spirits will not be used in violation of law .
.V~ ~-
~
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½
~"::)
l.;o u s i~ue•.
�SOUTHERN EXPRESS COMPANY
FORM 370•V A.
(lnco rporat.ed)
SPECIAL LIQUOR
RECORD
, _ _.....c.;.._ _ _, _
Way-Bill No._ _~_ _ _ ___ Date _ ____:c...,.:..::::...;_....t....c_
To ___-,c="'---'-C-----'-''-''-' --'--~~~"--- ---
_ __
_
A,tvnu cee to
Collect
l91_
_
191__2
Allid avit No. _ _
o_.,.k::.___
_
From,_ _ _________ _
EXPRESS CHARGES
}'REPAID .
A<ld
Unde r cba rR e
RECORD OF" NOTICES
To Consign ee, ________ __ _ _ ______
To Shipper______ _ __ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�AFFIDA VIT FOP ARDEN T SPIRIT S FOR PERSO
NAL USE
STATE OF Vrnopa i , .
J
COUNTY OF _ _~____,.__ _ _,4
:..;c_.::(===c -
✓ , I • __.,,_<1-----=-- --'-....:... :o.__ __, being
I,
duly sworn, depose and say that I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
)
(
delivere d to me by the Sonther n Express Compan y, from
r-.---.,- - - - ~ ;
at I am not a
student or minor, and, if a female, I am the h ead of a family;
that the ardent spiriis so re eived by me
1
were brought into the State on my written order, and thai I
have not, within the thirty days previous
hereto, received any ardent spiriis of any kind whatsoe ver, from
any person or from any place whaisoe ver, in
excess of ihe qnantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that ihe ardent spiri1.s
so received by me are for my own use, at
my own home, and ihat the said ardent spirits will not be used
in violation of law.
\J
Sworn to and subscrib ed before me,
this-.- -day of _ _ _ _ _ , 19L. l .
(
AK')n, for Southern Express Company .
�~--- --- - -- --- ----- ----- ------ - ----- ----- -----S01.JTl-fER N EXPRESS COMPANY
FORM 370•VA
(Incorpo rated )
SPECIAL LIQUOR RECORD
V
__J-_
Affidavit No. _ _ _
Consign ee _ _ __:___-!!.__!_c'--__!!___~.!.__E':2'~~- - - - -- - -- ---c- -=~ __ _ _ __
_ __ __
Kind of Ard ent Spirits _ ___ - - --
--'----=:c.,:..~ __.__:::___
_
Amoun .__ _ _/ _ _~ ___;L__ ; _ __
Advnures to
Coll ect
EXPRESS CHARGES
A ad
6 ude r c-barg e
RECORD OF NOTICES
To Consignee ______ ______
_
__ To Shipper_ _ _~ -- -- ___ __ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE: .
(OV!tR)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO NAL
USE
STATE 0~' YIRGINIA ,
CouNTY m'-.,--..!,-- -...::....;::..:-__;..,,"'----='-'I.
l, - -- ~ - - ~ ~-~-'- -'~~~ = - ~-"~ --, being dLdy ~worn , de
pose and say that I am
the consigne e of a certain s hipment of nnleut spirits, a~ spec ifi ed
on othe r sid e of thi s form , this day
delivered to me by the Southern Express Company , from _ _ ~ ~ ~- . ~ - - -- - - ; thllt I am not a
~,udent or mino1·, and, if a female, I am the head of a family; th at
the ardent s p irits so received by me
were brought into the State on my written order, and that I have
not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
}larch 10, 1916, or contrary to law, and that the ardent s pirits so received
by me a re fo r m y own use , at
my own home, and that the s aid ardent s pirits will not be nsed in violation
of Jaw .
~Ad _
~worn to and subscribe d be fore me,
.
tl11 s_ _
)
_
day o~ - - - - -, 191_,
I
(
,
�- - --
- -~- --~- ---- ----- ---- - ---- ---- ~--- ---- ---
FORM 370•VA
SOUTH ERN EXPRES S COMPA NY
(l u corpor
alied)
LIQUOR RECOR D
Affidavit No._7_ _ __ _
.
l
Kind of Ard en t Spirits_ _ _ _~ -~ ~ - - --.--- - -Amoun ~ ' - - - " - - - - - ~ -- Weioht- ~ - -- lbs.
Way-Bill No._l _ _~ ~C........'- --- - ~ - ~ -- - ~/_ _ _ 1!)1 _
From_......___ _ _ _ _i--""---T
/ ~ -A-d-,n-u-r e-,-to- ~ - -E-X-P~R~E~S-S~C~H-A~R~G-E-8- - ~ ~ ~ - - ~
O - - - ~c...c.:=:....:e:.==-==a-:- --'-- -- - - - Coll ect
COLLECT
RECORD Of" NOTICES
To Con signee ____ ____ ____ ____ __
Af"f"IDAV IT f"OR ARDENT SPIRITS f"OR PERSON AL USE.
(OVl! R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE 0~' VIRGINIA,
COUNTY O~'- - - -- ---"--=---_.,__--'--'----=~
l, - ~ - - - - - ' --===:.-~_ _,.,_~=-~ ~
the cousiguee of a certain s hipment of 11rde11t spirits, a8
being duly sworu, depose and say that I am
ecified on other side of this form, this day
delivered to me by the Southern Express Company, from
' ; that I am net a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thi1·ty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person oJ from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for m y own use, at
my own home, and th at the said ardent spirits will not be used in violation of law .
Sworn to and subsc1;ibed before me ,
,,
thi s-2 _ day of
/
, 191_ .
.-\ i,CtS 11t for S outhern F; xpres s~Comp1u1y.
�TO BE FILED
WITH CLERK
OF COURT
now
Sub?
bed and sworn to before
,,u 1-11'
I
e this
191trfl,,1 ~ '
bi!'
(Agent
O
Railway Company)
NOTE-Uc _.i D,...aiats mul Superinteacle ata of Hoapitale m&J'
receln arcleat IIPlnta u defined
in circular of lnatnactiona. Licemed Superilltende nta of Chemical Lalioratariee
ma)' onb- ncel,,e pure araln,
ethJ'I or pure fruit alcohol
order-•
��SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Incorpo rated)
SPECIAL LIQUOR RECORD/
Received at,--,,,,.__-1---=--=-,,.--'--"----::....:..c=---~- - - -- - Date
0
/
(. t (
I
(,,
191./ -
ef___ WeiohtL_"_ __ lbs.
Amoun, ~ ___/_ _('..
___._ _
From, _____ _ ~-=--- -.1"-',_
RECORD OF NOTICES
To Consignee _ __
_
To Shipper _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�ARDENT SPIRITS FOR
STATE 0~' VIR
/
PERSON AL USE
/
l'--0
1
"-l_fi'-'---'~"-""-~·-+tl"-.1._ _.. .t'"':-/c.:4,,.
:..+-'="=-- , being duly sworn, depose and say that I am
couN·rv o~'- ~--..-F- -u~ ~ <0~
l, ----'------- "'the consignee of a certain shipmen t of ante t spirits, as s ecified on °,lher side
of this form , this day
1
delivered to me by the Southern Express Company, from
(
that I am not a
student or minor, and, if a femal e, I am the head of a family; that the arden /
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or fr 1m
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Ass embly
of Virginia, approved
),larch 10, 1916, or contrary to law , and that the ardent spirits so received by me
are for my own use, at
my own home, and th at the said ardent spirits will not be used ii/violation of Jaw.
t ;
~
('
v
•
~worn to and subscribed before me,
thi s
C
~
0
/
_ day of_~I____ , 191_.
~
-
I
�FORM 370•V A
SOU THE RN EXP RESS COM PAN
Y
( Incorpo
rate d)
SPE CIAL LIQU OR ' REC ORD
' -!,'-""'--'--=-i.e...,~ -'--"-- ~--- ,'-------'--'- Date._
To _ ___;,,..=:.___::_...:..,:__,""""-==;£-+-----""-== ------=•
Shipper·~ ~ ~ ~ ~ ~'----~
~
-
__,A
'---'-_/,_1.. ,~ ..~
(J'
AdC~l'i~~~ t o
-.:!..~ ~~ {J
z._v
. _?_
- 191 _l
Affidav it No. __
I
PREPA ID
A dd
COLLE CT
Oude r charge
RECO RD OF NOTI CES
To Consi onee ___ ___ __
To Shi pper _ _ _ _ _ _ _ _ __
_
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE .
. ...
(OVER )
__ __
�FOR ARDEN T SPIRIT S FOR
STATE
PERSO NAL USE
m' Vrn
COUN'J'Y
ol
1:,
~.J
---- ---- -, being duly ~worn, depose and say that I am
the consign ee of a certain
11rdent spirits, as s~ fied on other s id e o.f this form, this
day
1
delivere d to me by the Souther n Express Compan y, from
; that I am not r;
:,
student or minor, and, if a female, I am the head of a family;
that the ardent spi ts SQ. received by me
were brought into the State on my written order, and ilfat I
have not, within
e thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are for m y own use, at
my own home, and ·that the said ardent spirits will not be nsed
in violation of law .
W l Lt-/ l..~ •~
luwib J
S worn to and subscrib ed be fore me,
L
1
thi s):__d ay of,Zl':
j
~ lk1
, 19L2
"
f
'' -l
--
.
____:_
l_ - - - ' - - -
..\J;t:tmt for Sou th e rn Rxpros:s Company .
':frJJ,
�- - '- - --- - ~-f'ORM 370•V A
SOU THE RN EXP RESS COM PAN
Y
( Incorpo rat
ed )
Affidavit No.
Advn u re e to
Collect
Add
udc r c ha rge
RECO RD OF NOTI CES
To Consian ee _ ___ ___ ___ ___
___
_
To Shi pper _ _ _ _ _ _ _ _ _ _ _
_ _ __ _
AFFID AVIT FOR ARDE NT SPIR ITS
FOR PERS ONAL USE.
(OYIIR}
�SPIRITS FOR PERSON AL US
- - - - - ~ + " ' -~---"--'--' c!---b-'---= -'--'-,.._-"----'= "Y=-- ,
being duly sworn , depo~e and say that I am
sp/ cJ fie~_ on t'her side of this form , thi s day
delivered to me by the Southern Express Company, from
~
'£
«
; that I am not a
titudent or minor, and, if a femal e , I am the head of a family; that the ard t spirits
so r eceived by m e
were brought into the State on my written order, and that I have not, w~hin
the thii·ty days previous
-)1ereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me
are for my o,~n use, at
my•~ horn,, , nd that th, ,aid ,Nlant sp;,;t, wHI
•c t;,, : •~:--
'J'"' ;,
\Jou sj(:u t:e.
S worn to and subscr ibed before me ,
thi s _
day of~
~
f
, 191~
LJ'-i.
.
�SOUTHER N EXPRESS COMPANY
FORM 370•VA
( lucorporat ed}
?-____
Affidavit No._ _
Way-Bill No.~A-L --'-+~=---To - - -V--:-'--'---:.._~+--J=---.;.. F-_,_---=---- -
RECORD OF NOTICES
To Consign ee _ _____ __ __ _ _ _ _ __
To Sh ipp er _ _ _ _ __ ______ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL US£.
,l
(OVER)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
,2·
¼
Q. • uJ. ; ~ ~ -
PERS ONAL USE
STATE Ob' VIRG N
COUN TYm'
!
,
1
being duly sworn , depose and say th at I am
th e con~ig nee~ a certai nship: :e ; ; ; ~ir
its, as specifi ed o ollic :r;
hi s form, this day
delivo ced to me by the South ern Expre ss Compa
ny , from }
{t
. , ; that I am not a
ijtuden t or minor , and, if a female , I am the head
of a fam il y; that the a dent spirits so r eceive d
by me
were broug ht into the State on my writte n order,
and 1ihat I h ave not, within th e thirty days
previo us
hereto , receiv ed any ardent spirits of any k ind whatso
ever, from any person or from any place whats oever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law , and that the
ardent spirits so receiv ed by me a.re fo r my own
use, at
~
my• ~ hnm,,
7
end th,t th, ssid s,d••.•spi,its w~ •
din.: st••: •~
t:vu s i1:n ee.
1,,/c.,....,
�..------~~- FORM
~~-
-- -- SOUTHERN EXPRESS COMPANY
370-VA
(lu co rpornt ed)
LIQUOR
Received at_--'-~----'-=---c.--'----'-'------'--'-=~---- -- -
t
Date
RECORD
r
')
Consionee _____ _=:~-'-=--=-_-_c=:= .:c...__=cc,------- - - - ~----,,--- -
~ ~ ~~ - -- - --
Way-Bill No.·-f---~"---'= ---~-
To
-
~ -
- - - - -- - --
+
Amount._~T~/--._ __,}__ __
-1
___:/_
~..c....c.=' - -_
__::___'----~=-= """=~---''--- -- - - -
:S__/:___
Mfidavit No., ___
191_
Advnnres to
Collect
191 _
EXPRESS CHARGES
PREPA ID
RECORD Of" NOTICES
To Consignee _______
__ _
To Shipper______ ________ __ _ _
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONA L USE .
(OVER)
�FOR ARDENT SPIRITS FOR
PERSONA L USE .
l, - - - - -- -----,...~- ~~~- -- - - - - -, being duly 8 WOl'JJ, depose and say th at
lam
the consignee of a certain shipm ent o[ nr<l eu t spirits, as s ecified on other side of thi s form,
ibis day
delivered to me by the Southern Express Company, from - - - ~ ~ ~ ~-~ -- - - ~~; that
I am nei a
student or minor, and, if a femal e , I am the head of a famil y ; th at the ard ent spirits so received
by me
were brought into the State on my written order, and that I have not, wit hin the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person o from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia
, app roved
lfarch 10, 1916, or contrary to law , and that the ardent spirits so r eceived by me are fo r m y
own use, at
my own hom e, and that the sa.id ardent spirits will n ot e used in violation of law.
I
I
Sworn to and subscribed befor e me,
thi s ____ d ny of~- ·- - --
, 191_ .
.1\j:e 11 t fo r Southern F..xpr e ~s Comv:m y .
I
�SOUTHERN EXPRESS COMPANY
FORM 370• VA
(I ncor porated)
LIQUOR RECORD
Received at·- --''----'-"~ - -- - - - - - - - Oate
I
_,,,,.,.,.
2 6 191 _
't,_ {J;~- -
Affidavit No., __
Consignee - - - ~...:::...--'-'----"-------C---'-~-"-=cc.... .c=--"---(' - - - - - -- - - - - -- -- -- - - -
/~
"'---"-"-''-'-c.. ....-- - - --
Am oun '--- - - -- - -- - -Weio h.__~ ~ -1bs.
Way-Bill No.-1,1-----1--~--"'= - - To --J:..,
/_
J__---,-,____:.:... ==~
_:.:_:_....,.LI-- ---
Advn11res to
Collect
EXPRESS CHARGES
Add
Oude rc harge
RECORD OF NOTICES
To Consignee __
_ _ _ _ _ _ _ _ _ _ _ _ To Sh ipper _ _______ ___ _ _ _ _ __
AFFIDAVIT f'OR ARDENT SPIRITS FOR PERSONAL USE: .
(OVXR )
�ARDENT SPIRITS FOR PERSONAL USE
/_
-+--+"""...,.'-'-'= - - - -, being duly sworn, ue pose and say that I am
s ·ec ified on ot her ide of tbi s QJ:m , tbis day
~
at I am net a
.;
{..,. I , . - /
( (:
delivered to me by t he Sout hern Express Com pany, from
by me
received
so
rits
spi
nt
arde
the
that
;
y
famil
a
of
head
he
t
am
I
,
e
femal
st udent or minor, and , if a
were brought into t he State on my written order, and t hat I have not, /~thin th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any pers&nor from any place whatsoever, in
excess of t he qu ant ity allowed by the provisions of the Act of the Gener al Assembly of Virginia, approved
March 10, 1016, or cont rary to law , and t hat t he ardent spirits so r eceived by me are fo r m y own use, at
my own home , and tb at the sa id ardent spirits will not be nsed in violati on of Jaw.
\
'
�-----
.
--- ----- -~-~ - - - ~
-
SOUTHERN EXPRESS COMPANY
FORM 370•VA
(I n corpo rated)
£)
LIQUO ,., , R_,,E CO~D
Received at,_ _,(
:-+---,_,._...:
Jtl l,...,.,t"'--;...•- ~·-'---- - - ' - -Consignee
Date-¼-~ -"---'----- 191 _
Affidavit No . _
__,_-':"--_O=-,(
---- -"-(--'jCL.~"--"-.....-..:....c.----,--c,------'------ ---- ----- - -
RECORD OF NOTICES
To Consignee __~ - - - - -
To Shipper_ _ _ __ ______ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVKR)
�AFFIDAVI T FOR ARDENT, SPIRITS FOR
PERSONA L USE
- - - - - - - - - , being duly swom , uepose a1id say that I am
of ardeut spirits, as s ec ifi ed on other s ide of thi s form, thi s day
I .I
I
delivered to me by the Southern Express Company, from _ ~ - ~ - ~ - •
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ard ent spirits so received
by me
were brought into the State on my written order, and that I have not, wit in the thi1·ty
days previous
hereto, 1·eceived any ardent spirits of any kind whatsoever , from any person or from any place
whatsoever, in
excess of the quantity allowed by th e provisions of the Act of the GenE)ral Assembly of Virginia,
approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for m
y own use, at
my own home, and th at th e said ardent spirits will not be used in violation of law .
~worn to and subscribed before me,
f
'
~
;\,:e11t fnr Ruutl,ern Rxpress Company.
(.;ousia;cu1::e .
�FORM 370-VA.
SOUT HERN EXPRE SS COMP ANY
(Incorpor at ed)
RECOR D Of" NOTICE S
To Consignee _ _ _ __ _ _ _ _ _ __ _ __
To Shipper _ _ _ _ __ _ _ _ _ _ __ _ _
Af"f"IDA VIT f"OR ARDEN T SPIRIT S f"OR PERSO
NAL USE.
(OVE R )
�AFFID AVIT FOP ARDE NT SPIRI TS FOR
PERS ONAL USE
STATE OF VIRGI
COUNT Y OF-..- -t-~_. __--~-
I,
1 , being duly sworn, depose and say that I am
the consig nee of a ce1:tain shi ment of ardent spirits
, as SP,ecified o , other side of this orm, this day
deliver ed to me by the Southe rn Expres s Compa ny,
from
t.,
;l t at I am not a
studed or minor, and, if a female , I am the head
of a family ; that the ard nt spirits so receive d by
me
were brough t into the Siate on my written order,
and that I have not,~ · in the thirty days previo
us
hereto, receive d any ardent spirits of any kind whatso
ever, from any perso
from any place whatso ever, in
excess of the quanii ty allowe d by the provisi ons of
the Act of the Gener
ssembl y of Virgin ia, approv ed
March 10, 1916, or contra ry to law, and that 1.he
ardent spiriis so receive d by me are for my own use,
at
my own home, and that the said ardent spirits will
nQt be used in violati on of law.
Z6./IJ-.,
(
Sworn to and subscr ibed before me ,
this-1 .i._day of , /.
,
19L;L.
Consiainee.
�FORM 370•VA.
SOUT HERN EXPR ESS COMP ANY
(lucorpor
a,e d)
/J..
Rece'.ved at
Consignee
SPEC IAL LIQUO R RECO RD
, /,
J ~L
Kind of Ardent Spirits, _ _ _ _
To
(I
/'J,,.....,,,~, -fl:•~
Shipper
ftv:/
(l ,-,
Date
t>
'"'I
lI
191 J
1
/
I
=
t/l:
_ _-~Y,,_-_:3~~-~''-'/ _ _ _ _ _ Amount _ ____,,~_
Q.._ 6.
Weigh '----'= --")
t
,....
,_-_ / f
Date_,_ __,,i«--.l-=--.,..__.,
, i., )..,___ _ -"----J-J_1 9 1L Frnm,_--',c..'i- •- -=----'--"-'-'"-'' -
Way-Bill No.
r\•
?B~ -: G ~
·
~ k :..;: :.; V.. ~
1
Ad•an e".et to
Collect
,
EXPRES S CHARGE S
COLLEC T
RECOR D OF NOTIC ES
To Consignee ___ ___ ___ __ _ __ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAi USE.
(OVER)
�AFFI DAVI T FOR ARD ENT SPIR ITS
FOR PERS ONA L USE .
I, --~l .L-- ~~ .L-~ '11, ,,== -~~
---- --, being duly sworn , depos e and say that
the consig nee of
I am
as specip,ed on other s· e of his form, this
day
C::.(n
delive red to me by the South ern Expre ss Comp
/
any, from _ _ _ _ __ ,-....
___
.,_
_
_
~_jV
that
I am not a
stude nt or minor , and, if a femal e, I am the
head of a family ; that the ar nt spiri ts;,
receiv ed by me
were broug ht into the State on my writte n
order, and that I have not, within the thirty
days previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
whats oever , in
exces s of the quant ity allow ed by the provis
ions of the Act of the Gener al Assem bly of Virgi
nia, appro ved
March 10, 1916, or contra ry to law, and that
the arden t spirit s so receiv ed by me are for
my own use, at
my own home , and that the said arden t spirit
s will not be u sed in violat ion of law.
----
,L
A~nt for Southe rn Exvres s Compa ny.
�ESS COM PANY
SOUT HERN (lEXPR
uco rporote d)
FORM 370•VA
LIQU OR
~
-¥-'="""- - - " -~
Kind of Ardent Spirits _ _
Way-Bill No.
/
~~
ECOR D
f_, L__ 191.i2
-,--- ---=- ---Date _ ~?_ _
'-_..,.7'--
Affidavit No. ------c__
_lbs .
i
lL_O V
To ~ - . - - - ~ ~
Arl vnure s t o
Cull e•·t
EXPRE S S CHAR G ES
PR E PAID
COLLECT
Shipper _ _
RECO RD OF NOTIC ES
To Consign ee
_ To Shipper _
FOR PERSO NAL USC.
AFFID AVIT FOR ARDE NT SPIRI TS
( Q \ " F.R )
�A F FIDAVIT FOR ARDENT SPIRITS FOR PERSON AL USE
)
STATE OF VIRGJNIA,
COUNTY OF_p;~ .__:::.!_l
l,
,,
1
±~~~-/
l l
the consignee of a certain
, being duly 1sworn, depose and say that I am
ardent spirits, as sp bified on other side of this form, t his day
/1 ! (
delivered to me by the Southern Express Company, from
1
{;
; that I am net a
student or minor, and, if a femal e, I am the head of a family ; that the ardent sp
irits so received by me
were brought into t he State on my written order, and that I have not , within/
the thirty days previous
h er ~t o, received any ardent spirits of any kind whatsoeve r, from any person ov'lr m
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of t he Gen eral ~ sembly
of V irginia , approved
March 10, 1916, or cont rary t o law, and t hat t he ardent spirits so received by me
are for my own u se , at
my own home, and that the said ardent spirits will not be u sed in violation of law.
Sworn to and subscribed before me ,
thi s &
day of~ ~ = --..---
;¼:eut fo r Southern Expres s Compa ny.
Consi.:nee .
�...;__......;.._ _ _ _ _ _ _ _ _ _ _ _ _ __
1 uUPLI CATE )
the Prohibiti on Act of
of Vir¥i!>ia to CONSIGNEES, 0TH ER
THAN HOTELS, DRGUGISTS,SUPERINTENDENTSthe State
HOSPITALS, OR CHEMICAL UBURATOR!ES
AND MANUFACTURERS OF FLAVORING EXTRACTOF
S,
Etc,
Both this duplicat e and the oriirinu1
hereof muat be aiirned by the comiirne e and thi• duplicat
e ma• t be filed on or before the
fifth day of the followin a mo,th with the clerk
of
the
circuit
ration court, with a clerk thereof in which delivery is made. court. or if there be a co,ia made a miade111~ ~r. See circu~r~ f ina~ctio ns aovernin Failure to file this dUPlicat e
a.
TO BE FILED
WITH CLERK
OF COURT
/
Railw ay Comp any
NOTICE TO DELIVE RING AGENT S: Thia form isto be uaed
when makinir deli••i••
of ardent apirita under
· ··
~ . ,,_, A .., ,J, A Y, ✓ ..
irgini9 I depos e and say that I am the consi gnee of____
___._L ,_ fi_;_(..;(,'--,\. _
of_ _=-..:~
,
(Quantit y)
::..::;.__ _...:;-_ _ _ of
which I now desire to take delive ry from
- - - - -- =-"-'---- -- - - -- Railw ay Comp
that I am a male
(or if a femal e, that I am the head of a family ); any;
that I am not a stude nt
at a unive rsity, colleg e, or any other schoo l in this
State, nor a mino r;
that said shipm ent was order ed by me and broug
ht into this State
upon my writte n order ; that I have not receiv
ed any arden t spirit s
of any kind whate ver, includ ing said shipm ent as
if alread y receiv ed,
from any perso n or from any place whate ver in
exces s of the quant ity
allow ed by Act of Virgi nia of March 10, 1916,
or other wise contr ary
to said Act, withi n thirty days prec_eding the
date of this affida vit;
that the arden t spirit s conta ined in said shipm ent
are for my own use
at my own home and will not be used i
iolatio n of sa'd Act.
(Kind l
h.
J
~
'
(' , <
(Si nature ~ ~o
19 17
_ ~ubsc ribed and sworn to before me thisLC .J1-~
-~~ ~ -day of
LJ ', l,
191_
/
.
f
.J
"~.___
��F'ORM 370•VA
SOUTHE RN EXPRESS COMPAN Y
(I ncorporated)
SPECIAL LIQUOR
RECORD
Date
191_
.;)
Affidavit No
Am oun
/,a
Way-Bill No,, - - r - -- --'---~
To - - - -=-=---"''--.--'-'==·--,-,.--c,--=..-"' --cc---
.Advnuree to
Col lect
Weiah ---=-- lbs.
191_
Fro
EXPRESS CHARGES
PREPAID
COL L ECT
Add
Undercha rge
RECORD Of' NOTICES
To Consig nee _ __ _ _ _ _ _ ,_ _ _ _ _ _ _ __
To Shipper _____ _____ _ _ _ _ _ _ __
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONA L USE .
(ov,rn)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE ,
l , ----~-~~- ---~- ~ -~_._----+-- -- , being duly s worn, Jepose and say th at I am
the consignee of a cert ai 11 shipment of ardent spirits, as specified on other ide of thi s form , this day
delivered to me by the Southern Express Company, from _ _ _ _____~ ~~ - -- i that I am not a
student or minor, and, if a femal e, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and ihat I have not, within the th irty days previous
hereto , received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and th at the said ardent spirits will not be u sed in violation of law,
I
I
~M
_,.,.,_____.t=Wl~~I~t--+-C~~l-----...j,,__6~7~t~J
S worn to and subscribed before me,
thi s
_ day of.____,}'------, 191 _,
I
I
.,\~tmt l'o1· Son th ern F:xvress Comp:m ,r.
¥,. .
�FORM 370•VA
SOUTH ERN EXPRE SS COMP ANY
(I ucor po r uted)
SPECI AL LIQU0/4 RECO RD
Received att_....i.!:~ ~ ~~~~: :'.!__-'-7"- - ----,-,c---=-.!:..- Date._' - - - - - -~- 191_
Affidavit No._.....:::='---'/L -_
y
¥--"'------'---='-----""~- =!.!_---"c::._- - Amoun L___ _ _ _ _ _ _ _
;___Weio ht_ _ _ _ lbs.
Way-Bill No. _____~._,_~ ~~From, ___1'-"/-'-,- /. --"--'"--~- .'._., __
I V
E X PR E SS CHARGE S
To - ---"------'~---'---- .-'-"--"""'i--;:_-- - ~ - -- - Advnur e e to
Co l lect
P REPA I D
COLLECT
Shipper_ __ __,__---.;.>~ ~::...>::___c::f" - - - - - - - -
...
RECOR D OF NOTICE S
To Consign ee _ _ _ _ _ _ __
To Shipper_ _ _ __ _ _____ _ _ _ _ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE .
( OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL.
ST~-~RGINIA, l
C OUNTY
us~
~ -
m ' - - -~ ----'----""'=-'-"....,_,
:r, - - -~- - ~~- ~~-- -~.,..,~~---==- , being duly sworn, depose and say that I am
the cousignee of
snecified on other side of tbis form, this day
l(
delivered to me by the Southern Exprk C mpany,_bom
C. ,
l.
; tbat I am net a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, with'n the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person o.lfrom any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General A::ssembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my
m
Mm,, ,nd th,t th, s,;d ,Nont ,pMt,
y:::::;:
,;,E,n
/
:::i worn to and subscribed before me,
this
,.
~ day of~- -- - -, 191_.
.,\1-:,mt fnr S outhern Exvref..s
:i:6,
Co 111pn11y.
U
•-<-~=- t:ous it;:u~e.
�SOUTHERN EXPRESS COMPANY
(lucorpo ratcd )
SPECIAL LIQUOR
RECORD
Affidavit No.
Way-Bill
No,_~')- -~ - - -
To - - - - -- - - ~ - - -- - - -- - - -
Advnnrc a to
Co ll ect
E XPRESS C H ARGES
PRE P AID
CO LL EC T
Add
Unde r cha rge
RECORD OF.' NOTICES
To Consionee ____________
To Shipper_ ___________ __ _ __ _
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL US£ .
(OVJIR )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STaTE OP VIRGINIA,
COUNTY OF _ _ _ __A_ _~~=~-
:r, ~ ~ - ---~ - -~-
______ ____
being duly sworn, depose and say that I am
the consignee of a certain s hipment of ard ent spirits, as specified on other side of th is form, this day
1
delivered to me by t he Southern Express Company, from _ _ _~ - - - - - ~ ~ - -- ; that I am not a
student or m ino1·, and, if a femal e, I am the head of a family; that the ardent spirits so r eceived by me
were brought into t he Stat e on m y written order, and that I have not , within the thirty days previous
hereto, received any ardent spirits of any k ind what soever, from any person or from any place whatsoever, in
excess of t he quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
).farch 10, 1916, or cont rary t o law, and that the ardent spiri t s so received by me are for my own use, at
my own home, and th at the said ardent spirits will not be used in violation of law.
::;worn to and subscribed before me,
th i~ --L-Lc_day of _ _____ , 191_.
f
.•\1!~11t
for S ,mtJ1ern F.xpross Compnn y.
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(luco r porat cd)
SPEC IAL LIQUO R
RECO RD
Way-Bill No, _ ___,__~ ~~ - -- Oate. _ _ ~ ~ -~
- - -- - - 19 1_
To - -- - -~ ~ ~ ~ - ~-- - - - - - - -
From '---- - ~ - - - - --
, - - - - - - , - - - -E-X-. P-R- E-"S_S_C_H
_A
_R
_G
_ ES
Adc:~11~~~ to
PREPAI D
- . . . . . - - -A- d_d_ - - ,
COLLEC T
Unde r cha rge
RECOR D Of' NOTIC ES
To Consign ee _ ___ ___ ___ ___ ___
___
To Shipper _ ____ _ _ _ _ ___ ___ _
_
Af'f'IDA VIT f'OR ARDEN T SPIRIT S f'OR
PERSO NAL USE .
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
S TATE Ob' VIRGINIA,
C OUNTY O~'- - - - - --===::;=
), -------~~-----.0-~,;,....;,,,,....,_______ , being duly sworn, depose and say that I am
the consignee of a certain sh ipment of ardent spirits, as specified on oth er s ide of thi s form , this day
delivered tome by the SouthernExpress Company, from _ _ _-'-----,~-=-----,,---' - - ; that
not a
~tudent or minor, and, if a female, I am th e head of a fami ly ; that the ard ent spirits so r eceived by m e ·
were brought into th e State on my written order, and that I have not, within the thirty days previou s
hereto , received any ardent spirits of any kind what soever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Gener a l Assembly of Virginia, approved
}Iarch 10, 1916, or contrary to law , and that the ardent spiri ts so r eceived by me are for m y own use, at
my own home, and th at the sa id ardent spirits will not be used in violation of la w.
~worn to and subscribed before me,
thi s
__ day o ~ - - - - - , 191_,
\i.:e 11t for Sou thern Expre~s Vo 1111m.ny.
.1
�SOUTHER N EXPRESS COMPANY
FORM 370•VA
, (l u co r porated)
RECORD
Shipp er _ _ __ _ __ _ _ _ _ _ _ _ _ __
RECORD OF NOTICES
To Consionee _ __ _ _ _ __ ______ ____
To Shipper_ _ _ _ ____ ___ _ _ __ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
. ~(OVER)
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
I
STATE 01' VIRGIN IA,
C OUNTY OF_- - = - - - -~---, ~--..
1,
the consign ee of a certain
spirits, ati
deliver ed to me by the Southe rn Expres s Compan y, from
_ _ -"---'"-----',-,::---= .:::='4-4 4<r,.---''---"student or minor, and, if a femal e, I am the -.head of a family;
were brough t into the State on my written order, and that
I have not,
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any perso r f om any place whatso ever, in
excess of the quantit y allowed by the provisio ns of the Act
of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and that the ardent
spirits so receive d by me al'e for my own use , at
my own home, and th at the said ardent spirits will not be
used in violatio n of law.
Sworn to and subscri bed before me,
,,
({' ' ct· .){
thi s _ f -day o.._~ - - -, 1911_,
.;\!:tHlt for So11tl1e rn F.x1woss Co111p1m,r.
.....
Jfi ;Gr
::.•..~
�FORM 370•VA
SOUTH ERN EXPRE SS COMP ANY
(l ucor porated}.- -
SPEC IAL LIQUO R RECO RD
Kind of Ard ent Spirits,_ _ _ _ ~'--~~ ~'-----'-----''----
Way-Bill
Am ou n~ - ~/
'---~----+- - --
No,_ l.,. -..+- --- --
To _.,;.:..._ _.:,.....,:=:::.....::==--;-==-'--- ~--''---=" - - -
Advauce a to
Coll ec t
EXPRESS CHARGE S
PREPA I D
RECOR D OF' NOTICE S
To Consign ee ___ ___ __ ,_ _ _ _ _ _ _ _'_
To Shipper _ _ _ _ __ _____ _ _ _ _ __ _
AF'F'IDA VIT F'OR ARDEN T SPIRIT S F'OR PERSO
NAL US£ .
( OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
------",--'--"-J..'__,,,LJ,l__
PERSONAL USE
IJeing duly sworn, uepose anu say that I Rlll
as specified on ot re r side of this form , this day
_ ,__,,I'--~"'--.;-,~~ - - . , ;,,
<--- ,
.,I,,,
, .
,L
'
.
_ delivered to me by the Southern Express Company, from _ _
•
/U4-., ; that I a m not a
student or minor, and, if a female, I am the head of a family ; that the ard e/t spirits so received by me
were brought into the State on my written order, and that I have not, w·/ in the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person orfrom any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved ,
March 10, 1916, or contrary to law , and that the ardent spirits so received by me a re for my own use , at
my own home, and th at the sa id ardent spirits will not be used in violation of law.
·
,._J4c
S worn to and subscribed before me ,
thi s...L._.__ day o,Lf~ - - ~ ~ ,' 19Lf ,
l\~ent f,,r S ,H1ther n Express Co n1J.>.'l11y .
�-~ - ---- FORM 370•V A
~
- 7
SOU THE RN EXP RESS COM PAN
Y
(lu co rpo m ted)
SPE CIAL LIQU OR
Receiv ed a,1L- -"-''-"-''-"'--".e.__-'-'-----'- =-- - - - - ate
Way-Bill No·- - - ~ - ~ ~~ -
/
0
•ate_ _--'---'-'::c:....- . _ _ _ _ _ 191_
To - .,_==---''---':..-:C-L-"--"'--'"'""'=-'--- c--=:----~
,,--- -
J
REC ORD
•
A d vo u re e t o
Co ll ec t
191_
Affidavit No._ _ __ _:__
From1~ :.L.1,µ~~.la !J;da ,L>eo ~A.~
PREPA ID
RECO RD Of' NOTI CES
To Consi gnee _ _ _ _ _ _ __
_
_ _ __
To Shippe r_ _ _ _ __ _ _ ____ _
_ _ __ _
AFFID AVIT f'OR ARDE NT SPIR
ITS FOR PERS ONAL USE.
(O VER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
l, - - - - ~- - -- -~ - - ~ - ~ - - - - - -, being duly sworu, d epose a nd say th at I am
the consignee of a c~~ a in shipm ent of ardent spirits, as specifi ed on other side of thi s form , this day
deliver ed to ;~,;y ,tlie"Soµthern Express Company, from _ _ _ _ _ __ -- -- ~ -- ; th at I am not :i
student or minor, and, if a female , I am the head of a family; that the ard ent spirits so received by m e
were brought into the State on my written order, and that I have not , within the thil'ty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spil'its so received by me are fo r m y own use, at
my own hom e, and th at the said ard ent spirits will not be used in viol ation of law.
Sworu to and subsc ribed be fo re m e,
thi s/_.!. _ day of ,
J,
, 191_,
r '
l ~ (,
.1\ ~ 11 t
fn r Southern F.x pross Com1mn.r.
�SOUTHE RN EXPRESS COMPAN Y
(l uco rporated)
_Shipper _ __ __ _ _ __ _ _~ - - - - - -
).
RECORD Of" NOTICES
To Consi gn ee _____ _____ __ _ _ _ __ To Shipper _ _____
______ _ _ _ __
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONA L USE .
(OVER)
�SPIRITS FOR
PERSONAL USE
delivered tome by the Southern Express Company, from ~ ~~-----_,.,......_.,._-<=.---'-~ ; t h I am not a
student or minor, and, if a femal e, I am th e head of a famil y; that the a ent spi its so r eceived by m e
11
were brought into the State on my written order, and that I h ave not, ithin th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever , from any perso or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Virginia, approved
) farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my owu u se, at
my own hom e , and th at the said ardent spirits will not be used in violation of la w.
V
..,
,_~-- - - - ~.. ------
.i\~tmt for S ou ther n Ex1n·e~s Com pnn .r .
�SOUTHERN EXPRESS COMPANY
FO RM 370-V A.
(I ncorpora t ed)
SPECIAL
Received at
0
0 ,L
·--+~~--+--...- 191--f-
~lti davit No.
7
7
f
Co nsign ee ___ _ ____...,?:,-,.' --'------'-'-,--"-"--==---=----- - ---lb<---- - - -- - - -- - -- lbs.
Way- Bill No. _________
To ----+--_.::;..;....:=='---"'-="-~~- ~"-'-',.,.__--L---
A tl v nn<'ea to
Coll ec t
7
Ad d
1.rnd erch a r ge
RECORD Of" NOTICES
To Consignee ________ __ _ __ _ _ __
To Shipper ____ _ _ __ _ __ _ __ _ _ _
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE .
(OV ER )
�AFFIDAVI T FOP ARDENT SPIRITS FOR PERSONA L USE
l
STATE OF VIRGI~ / ,
COUNTY OF
b- I
J·
/
/
I,
"r ( •
, being duly sworn, depose and say that I am
the consignee of a certain shipment of arden spirits , as pacified o~ other side of this form,
this day
delivered to me by the Southern Express Company, from Y lJ
; that I am not a
student or minor, and, if a female, I am th e head of a family; that the rdent spid ts so received
by m e
were brought into the State on my written order, and that I have not within the thirty days
previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any pers nor from any place whatsoever,
in
excess of the quantity allowed by the provisions of th e Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and t ~
e ardent spiriis so r e eived byr
me;
are for my own u se , at
my own home , and th at the said ardent spmtl will not be sed in io tion o la .
,., ,
'
~l
/
Sworn to and subscribed before me,
t his....,........._da y of- .-1..,,..c.~-- 191__!,
(
/
I
Ai:ent for Southern Express Company.
-
/,
✓,;:_
Couai2~lfe.
�FORM
370•V A
SOU THE RN EXP RESS COM PAN
Y
(l ucorpor
at ed)
LIQU OR REC ORD
Receiv ed ate._...c..._----'----''-------'-------'--'------'-----·- + - - - - Date
rn1L
)
Affidavit No. _ -L/_
- - ~ - ~ -- -- -- Amoun .__
_ _ _ _ __ _ __
Way-Bill No., _~- ---- -'- - --
- ---'- ---'--~ - - - - - 19 1_
To - - - - '-='---'--==-=.c~:,,c.-- -L~---
Advau,..e s to
Collect
..:,_--.:,,
CJ e:_
L- ~ - - lbs.
From,_...,f'-,-Z.-'--- ---" --'---"l"',"----'"'
EXPRE SS CHARG ES
PREPA ID
COLLE CT
.
RECO RD OF NOTI CES
To Consignee ___ ___ ___ ___
___ ___
_ To Shipper _ _ _ ___ __ ___
_ _ _ _ _ __
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE .
(OVER )
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
STATE OF VIRGIN IA,
C ouNTY
m'- - - -- ----=--,,:;=:.===:.,-,·,_..,.,...'OA._
l,
.(} 1
, being duly sworn, tlepo8e and say that I am
the consign ee of a certain s hipm ent of art.lent spirits,
a · specifie d Of! other side of thi s form , this day
I
A
delivere d tome by the Southe rn Expres s Compan y, from~
- - - - - - - - - - - -~ i that I am not a
student or minor, and, if a female, I am the head of a
family; that the ard ent s pirits so receive d by me
were brough t into the State on my written order, and
that I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the qua1:tit y allowed by the provisio ns of the
Act of the Genera l Assemb ly of Virgini a, approv ed
March 10, 1916, or contrar y to law, and that the ardent
spirits so receive d by me are for m y own u se, at
my own home, and that the said ardent spirits ~
ot be u sed in violatio n of Jaw ) / ,
r
J;
·
0_,c r,d 10
~wo rn to and s ubscrib ed before me,
this
_ day OL.f---'-'--=-- , 191_ .
.,\1.,~ 11t for Southe,·n F:xpro/o;s Company .
IT/2L:.
t_L d
Uvnsi au~e.
�FORM 370•V A
SOU THE RN EXP RES S COM
PAN Y
(lucor
porate d)
REC ORD
Way-Bill No,_ ___,~~ - - -To
Adva n ces to
Coll ect
EXPR ESS CHAR GES
PREP A I D
COLL ECT
Add
Unde r cha r ge
REC ORD Of' NOT ICES
To Consignee __ __ __ __ __ __
__ __ ___
To Shipp er _ _ _ __ __ _ ___
_ _ _ _ __ _
Af'f'I DAVI T FOR ARD ENT SPIR
ITS f'OR PERS ONA L USE .
(OVllR )
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
S 'l'A'l'E OF V IRGl !- I A ,
COUNTY m' _ ___ _ __c....___:__::..,e::"""-= =1.f.,KA ..._...
I, - - -+-r-'-'-- --1f-c-.>. ---'--~~-=~ -- -- -~ ~ -, being duly sworn
, <l.epose and say th at I am
the consigne e of a certain shipment of urdeut spirits, ai:1 specified on
other side of thi s form , this day
delivered to me by the Southern Express Company , from _ _ ____
~ ~ - - - - ~ ~ ; that I am not a
student or minor, and, if a female , I am the bead of a famil y; th at the
ard ent spirits so received by m e
were brought into the State on my written order, and that I have not,
within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person
or from any place what soever, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia , approved
ifarch 10, 1916, _or contrary to law, and that the ardent spirits so received
by me are fo r my ow n use , at
my own home , and th at the said ard ent spirits will not be used in violati
on of Ja w .
::;worn to and subsc~ip ed oefor e m e,
thi s
;\ge 11t for Simthern Ex J)re~s Com1)a 11 .r .
�· SOUTHERN EXPRESS COMPANY
FORM 370•VA
( luco rpo ra t cd)
Y ~L.,,,L-1,~ ~ ~ ~ = -":.....:...~::___
Consignee. --'-~
LIQUO R1 RECORD
Date ,
;~_/4, . e}
191 "')
Affidavit No.
)__. Q
%
~ =-=~~~..-F----V--"""'="""'-"""--""'""""'·----=-1-.,..---=-r~--- - - -- - -
COLLECT
Shipper_____ _ _ _H - - - - - - - - - -
RECORD OF NOTICES
To Consigne e ________ ________ __
To Shipper_ _ _ _____ ___ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVE R)
�SPIRIT S FOR
PERSO NAL USE
delivere d to me by the Souther n Express Compan y, from _ _ _
__,,,"--'-"'- -"--"-+--r- '...i---'-\student or minor, and, if a female, I am the head of a famil y
;
t spirits so received by me
were brought into the State on my written order, and that I
have not, wit in th e thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any perso ~ from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of the
Genera '.Assembl y of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so received by me nre for my ow use , at
my
homo, ond thot tho ssid anlent sphi~
,,sod · • ,iolatioo of I
•=
l: ous ia;:uee .
�SOUTHERN EXPRESS COMPANY
FORM 370-V A.
(Inco rporated)
)
SPECIAL LIQUOR
RECORD
~~.......---._,._.----- -,~--+--~/
_____---=___________
Consignee - - ---"'~ .....
Kind of Ardent
-
-----ICL......---'--- -"-·,.,,___::_-=,_ _ _ _ Amou nt _
Way-Bill No.,,.-j,--...,.;.- '--==,--- - To
_ -1-/'---- ~~-'- - -Weigh.c__,___ lbs.
From, _ -"/-'-- ---'---'-'- -- ~ ·
£1.
A.ilvan(" C8 t o
Collect
EXPRESS CHARGES
COLLECT
.Arld
Under charge
Ship per ___..<---'"----'---"--'=--'+'--=-=-...._-=,__....._~,::...
RECORD OF NOTICES
To Consign ee _ _ _ _ _ _ __ _ _ _ _ __ __ _
To Shipper _ _ _ _ __ __ _ _~ - - - -- -
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OV ER )
�AFFIDA VIT FOP ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE OF VIRGINI . ,
COUNTY OF-- - ~- -/
----
I, - - - - -- ~ ~ ~ -- -- --~-- --~~~ ~-, being duly
sworn, depose and say that I am
the consign ee of a certain shipmen t of
as s,pecified on ,other side of ~his form, this day
1
delivere d to me by the Souther n Express Compan y, from
1
; , hat I am not a
student or minor, and, if II female, I am the head of a family;
that the ardent spirits so received by m e
were brought into the State on my written order, and that I
have not, w:ithin the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quanUty allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spiri1s
so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used
in violatio n of law.
l
Sworn to and subscrib ed before me ,
this- 2day of __ ,,_ __ "
I
CoDBie:nee.
/
1
I (
Ait6nt for Southern
press Company .
�FORM 370•V A
SOU THE RN EXP RES S
COM PAN Y
(I n
cor po rate d)
SPE CIA L LIQ UOR
REC ORD
Way-Bil l No. _ _ _ _ __ _ __
To --- "--" --'----''--'..=.,-.L.--=---'~C---
--~~--
Advnu re s to
Coll ect
A~d
Onde r cha rge
'/
REC ORD OF NOT ICES
To Consionee _ __
EXPR ESS CHAR GES
PREPA ID
_ _ _ _ To Shipp er _ __ __
__ __ ___ _ _
AFF IDAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
(OVlt R)
_ __ _
�AFFID AVI T FOR ARDE NT SPIRI TS FOR
PERS ONAL U SE
1, _ _
,1
, bein€f duly sworu, depose and
say that I am
the cousig nee of a cert ain shipme nt of ardent spirits
, as specifi ed on other side of this form, this day
deliver ed to me by t he Southe rn Expres s Compa ny,
from_ _ _ __ __ V
bat I am not a
studen t or minor, and, if a femal e , I am t he head
of a family ; that the ard ent spirits so receive d by
me
were brough t into the State on my written order, and
that I have npt, within the thirty days previo us
hereto, receive d any ardent spirits of any kind whatso
ever, from any pe'rs nor from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
t he Act of t he Genera l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and t hat t he ardent
spirits so receive d by me 11re for my own nse, at
my own home, and that t he said ardent spirits will
not be used in violati on of Jaw.
Sworn to and subscr ibed before me,
I
thi s
_ day o~ - -- -- , 191_ .
' ,
~
;\~e11t f1, r
S•mther n Exprcfis Compn11y.
�-- ---- ---~--FORM 370•VA
- --- ------ --- ---~ -
SOUTH ERN EXPRE SS COMP ANY
(Incorpor ated)
RECO RD
2_ <-_,/,~~
,_ _ _ _ _ __ 191-7
Affi davit No., __
Consignee _____::e....:=c...::--=--::..::.-=-.:..;.----+--=----=-----:......=.__._,"----'-__
.__ _ _ _ __ _--,----= -- -1--- - - --
-
-
----1'-----=~ ' -- c..:,.,c.-c__ ..:__
Am oun'--- - --'/- --"'-------'-- - - -
_
Advnuree to
Co·l lcct
EXPRESS CHARGE S
COLLE CT
I
RECOR D OF NOTICE S
To Consignee _ ~ - - - - - - · - - - -
- - -
To Shi pper ___ ___ __ ___ _ _ _ _ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL
use: .
'
(OVER)
I
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _ _ _ _ _ __ _ _ __
l , ---.-~- ~~ ~c...c___ r-'----L...,'-----"--------'~-- , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as sp;jified on olher side of tb1 s form, this day
l'. -0
,
delivered tome by the Southern Express Company, from
1 t hat I am net a
student or minor, and, if a female, I am the head of a fam ily ; that the a ent sp irits s received by me
were brought into the State on my written order, and that I have not, ithin the th irty days previous
hereto, received any ardent spirits of any kind whatsoever, from any p ;rsoq. or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Genera1 Assembly of Virginia, approved
"March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my uwn home, and that the said ardent spirits will not be used in violation of Ja,Y .
S worn to and subscribed befo1·e me,
✓
.,\i.:tmt for S outhern F.x1n·oss Com11any.
(Jousieuee.
�FORM 370•V A
SOU THE RN EXP RES S COM PAN
Y
( l aco
rpo ruted }
SPE CIAL LIQU OR
Consign ee _ _ __
REC ORD
-'.L- '--"= -~- ' - ~ - - - - - - -
___c______::._:_-= --=->,.; c... _ _
I
- - - __ _ __ __
J,.,/. ~·-.,. ___ __ __ __ Amoun c___ __ __ __ __ Weigh t___,_ _ __
Ki nd of Ardent Spirits_ _ _
, _ _ lbs.
Way-B ill No·-- --"- ----- To
---, --- -=~--"""--'-""""~......,-:-----~ ~- - -
Arlvn 11 ree to
Coll ect
I
RECO RD OF' NOTI CES
To Consign ee _ _ _ _ _ __
_ _
EXPR ESS C HARG ES
PRE PA ID
COLL ECT
I 1
1
A dd
Uurlc rcb ur ge
I
To Shipper ___ ___ ___ ___
__
AF'F' IDAVI T F'OR ARDE NT SPIR
ITS F'OR PERS ONAL USE .
(OV!r.R )
-I
_ __
�AFFIDAV I T FOR ARDENT SPIRITS FOR
PERSONA L USE
8'l'A'n~ Ot' VIRµ INIA ,
C OUNTY O~' - - --
-
-
~ ~ ~-,'-',-
l, - -- - ~ --;.;~~.-----<1--..-~~= ~~- -- - - being duly s worn, Lle pose and say th at.I am
the consigu ee of a certain s hipment of a nle ut spirits, as s pec ifi ed on oth e r side of thi s form , this day
delivered to me by the South'ern Express Company, from ___~-~~·- - -- - - - ; th a t I am not a
student or minor, and, if a femal e , I am the head of a fami ly; th at the ardent spirits so received by me
were brought into the State on my written order, and that I h ave not , within th e thirty days previous
hereto,•received any ardent spirits of any k ind what soever, from any person o r from any place whatsoever, fn
excess of the quant ity allowed by the provisions of the Act of t he General Ass embly of Virginia, approved
) farch 10, 1916, or cont rary t o law, and t hat t he ardent spirits so rec eived by m e arn fo r m y own use , at
my own hom e , and th at the sa id a rdent spirits will ·not be nsed in viol ation of la w .
c;:7ki I I~.?.
S worn to and subsc ribed befor e me ,
thi s _
_ day o ~ - -- -- , 191_
.
~.~
1.:0,~'";",-,r.-•• .-
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(lucorporated)
.
SPECIAL LIQUOR' )RECORD
,____,...,,;.c_-----'-=--------=-- '---"---~ . - - - - - - gate
~,
/'
')
J- 2. 191 +
7,,
v CJ
Affidavit No,, _ _ _ __ _
Consionee - ---='---"'-~:=--"+c" --'---"'.:.---.J.._~,-->(,,_,._._
-t"',1."'---"1,4'--""."'-•--'-,'--',._-·- -- - - - - -- -- -- -- - - -
---L/____,/,
____
' -- - -----"'---__L= --~=-=-'--- - AmountL
Advaur e s to
Collect
RECORD OF NOTICES
To Consignee _ _ _ _ _ _ _ _ _ _ __
To Shipper _ _ _ _ _______ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE:,
(OVl<R)
�FOR ARDE NT SPIR ITS FOR
S'l'A'l'E OP
PERS ONAL U SE
Vrn
COUNT Y OF-"- =-=--= ---=--= =~,..' -'"-(•
---F-~==="1-~-Ji'---Y--.:'-✓-'~\-<--1.l.c::tLc:i.:t+--=...._,___
shipm ent of ~ nlent spiri~
, being duly sworn , uepotie and say that I am
" sppi_f ed on other side of thi s form, this day
0
delive red to me by t he South ern Expre ss Comp
any, from
~"\
that I am not a
~tuden t or minor , and, if a fema le, I am the head
of a fami ly; that the arden t spirit
receiv ed by me
were broug ht into t he State on my writte n order,
and that I have no (r ithin th thirty days
previo us
hereto , receiv ed any ardent spirits of any kind whatso
ever, from any per on or from any place whatso ever,
in
excess of t he quant ity allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
),!arch 10, 1916, or contra ry to Jaw, and that t
he ardent spirit s so receiv ed by me a,·e for m y
own use, at
my own home, and that the said ardent spirits
will not be nsed in violati on of law.
S worn to and subscr ibed before m e,
this _ _day of
)L.
&
/ ';
'60
V"'~ ~~~·~ -l.L-, --l+-, ~--=- -=-.µ= _.~·,_
'.\JI , 191_ ,
1\:,::e11t fo r Soutl1er n Expre~s Co 1111>n11.r.
__,_- 1-L-
(.;vn.sie-u~tl.
�r
FORM 370•VA
SOUT HERN EXPR ESS COM PANY
( lnco
rpornted )
SPEC IAL LIQU OR
Received at•---,'--"--..c.__---'--'--"..c.__~~ - -,--- - ~
RECO RD
Date._ __ _ _~_ _ 191 _
- ---- =--' -~--C .-"-- -f--- -- Am oun c___~
Way-Bill No , - - - ----''- ------' ~-To - - - -- - -~~ ~~ -- - - -- - - -
I_
Affidavit No. /
d
J
___ _ _ _ _ Weioh c___.,_ __ lbs.
From,_,_
, - - - - -- - - --=--
Advn ur oe to
Coll ect
EXPRES S CHARG ES
PREPAI D
COLLEC T
Add
Ouder charge
u
RECO RD OF NOTIC ES
To Consignee
To Shipper_ ___ __ _ _ ___ _ ___
__ _
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERS ONAL USE: .
(OVER)
�SPIRITS FOR PERSONAL USE
l,
_
_ ______ being duly sworn, depose and say that I am
the cousiguee of a certain shipm ent o[ ' arde ut spirits, as specified on other side of thi s form , this day
delivered to me by the Southern Express Company, from 1
; that 'r am not a
student or minor, and, if a femal e, I am the head of a family; that the ard ent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any p'erson or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and th at the said ardent spirits will not be u sed in violation of Jaw.
S worn to and subscribed befo1·e me ,
thi s _ _ day o~ - - - -- , 191_,
.i\l,!'tmt fo r South e rn F.!i pre~ s (]() mJlany.
l:on s ili:JU::e .
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(lnco r~or a t ed)
SPECIAL LIQUOR
RECORD
Received at _ _ _~_ _ _ _ _____ _ _ __ Oate~ - - - - -+-- 19J _)_
Consionee
Affidavit No_ _ __ _ _
- - - -- -~-~--1' 1.-\.....- ---- -/----- ~---- - -- - -- -
Ki.nd of Ard en t Spirits _ __ _L_t~~L~~·~.,,=---,,,_~~9/~--- -Am oun ~ ~ / - ~ - - ~ - - --
Weioh ~ '-'-,L
_ _ lbs.
Way-Bill No.~---"'-- --~--Date_ _ ~-,.'------ - ~"'- - - 1!llTo
Advnures to
Collect
EXPRESS CHARGES
PREPAI D
COLLECT
Add
Ouile r cbnr~ e
RECORD OF NOTICES
To Consignee _ _ _ _~ - -
_ _
To Shipper_ ______ _____ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE: .
(OYER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE I
\,,._t.;
...._~---"-.c- - - - - - -, being duly sworn, depose a nd say that I am
ardent spirits, as specified on other side of thi s form , this day
W'• ,: ,
. \ ; that I am not a
,
delivered to me by the Southern Express Company, from
1 ,
student or minor, and, if a fema le, I am the head of a family; that th ardent s pirits so received by me
were brought into the State on my written order, and that I have n t, within the thirty days previous
heret o, received any ardent spirits of any kind whatsoever, from any pjirson or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
:lifarch 10, 1916, or contrary to law, and that the ardent spirits so received by me a re fo r my own use, at
my own home, and that the said ardent spirit s will not be used in violation of Jaw .
~eou si,::u~e.
~worn to and s ubscribed before me ,
thi s _
_ day o.___.:._-==---- , 191_.
I
:,\1:e r1t f, 1r
S untJ,ern Ex1>ross Compnn.r.
�~--~-- --- --- ---~--- ---- -.
FORM 370•VA
SOUT HERN EXPR ESS COM PANY
(l ucorpo
ratcd)
Affidavit No.,_ _ _.,:.
Y__,o.,,
u
PREPAI D
Shipper_ _ _ _ _ _ _ __ _---- "------ -
.A d d
Und er cha r ge
RECO RD OF NOTIC ES
To Consignee ___ ___ ___ ___ ___ __
_
To Shipper _ _ ___ ___ ____ _ __
__ _
AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL
( O VER}
use: .
�r
AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
delivered to me by the Southern Express Company, from_~ - ~ - - - - - -- ~ -- ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ard ent spirits so received by me
were brought i nto the State on my written order, and that I have not, within th e thirty days previous
hereto, reeeived any ardent spirits of any kind whatsoever, from any person or from a ny place whatsoever, fo
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirit s so received by me are for my own use, at
my own home, and that the said ardent spirits wi11 not be used in violation of Jaw .
.
,
S worn to and subscribed before m e,
f
thi s
.A.:tm t for Sonthe t•n F:xpre~s Compnu.r.
�SOUTH ERN EXPRES S COMPA NY
FORM 370•VA
(lucorpo rated)
LIQUOR
J
• - -- -~ ~~~- ~ -- - - - --
Way-Bill No,, _ _ _ _ __,__;c___
RECOR D
Amoun c_____ ____ __ Weigh c_---'-'=------ lbs.
_
From, ____ ____ _---=..__,'-
To - - - -""--"=---= -""=.!..-'-- -,--'--- =--- -
Advnnr e a to
Collect
EXPRESS CHARGES
PREPAID
COLLECT
Add
Oude r c barge
RECORD OF NOTICES
To Consignee _____ _____ ___
_
___ To Shipper _ _ _ ____ _ ___ _ _ _ _ __ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
(OVE R)
use: .
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
S TATE OF YIR GLNI A ,
C OUNTY OF _________,- --
- ~ ~ ~ ~-
l, ----=
-~--~-~~ -- - --~~ - - - - -, being duly sworu , uepotie and
say that I am
the consign ee of a cert ai11 shipm ent o[ unle ut spirits,
ati specifie d ou oth er side of thi s form , this day
delivere d to me by t he Southe rn Expres s Compan y, from
___ ___~~~_ _ ___,__ ; that I a m not a
student or minor, and, if a femal e , I am t he head of a famil
y; that the ard ent spirits so r eceived by me
were brough t into the State on my written order, and that
I have not, within th e thirty days previou s
hereto , receive d any ardent spirits of an y kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisi ons of t he Act
of t he Gener al Assemb ly of Virgini a , app roved
)farch 10, 1916, or cont rary to law, and that the ardent
spirits so receive d by me a re fo r m y own u se , at
my own hom e, and th at t he said ardent spirits will not be
used in viol ati on of law.
f
!:i worn to and subscri bed before me ,
th is~
day o~ - - - -- , 191_
J
t:o u ::1 i(:u t=e .
.
.,\~"'U ll t fo r S out hern F. x 1n·e~ s Cmn pa11 .r.
�FORM 370-VA .
SOUT HERN EXPR ESS COM PANY
{I
u co rpo rate d )
Way- Bill No.2
To
!\ll!!!!ll!l!!CIU,:s_J__(.
~~~. ..L.,~ !...-;~ """-- -"'¥.- -,~... _..--- -
{
RECO RD OF" NOTIC ES
To Consig nee.___ ___ ___ __ _
_ __ _ _
To Shipper ___ ___ ___ ___ __
_ __ _
AF"F"IDAVIT F"OR ARDE NT SPIRI TS
F"OR PERS ONAi USE .
(OVll:R)
�AJf lDA VIT FOR ARD ENT
SPI RIT S FOR PER SON AL
;
USE
.
8TA TEO FV7[ · A, ,,• ~ ·
COUN TY OF
I.
f
•
·
cy •
\
i
. ,,.
j)'.
i\
t,t; ,
,
I,
, '•
,/'V
being duly swor n, depo se and say that
the cons ignee of a certa in 18~m ent
I a~
of arj4Iit spi r its, as f~ec ified o ~ther
sid~ of this f ~
this day
deliv ered to me by the Sout hern Expr
e;i Co~p any, from
•
that I am not a
stud ent or mino r, and, if a fema le,
r am t ~e head of a fami ly ; th at the
araJ µ t spiri ts so recei ved by me
:were brou ght into the State on my
~ tt e_JJ' orde r, and that I have
t, with' in the thirt y days prev ious
heret o, recei ved any arde nt spiri ts of
anyk ind what soev er, from any perso
n or 6-om any place what soev er, in
exce ss of the quan tity allow ed by the
prov ision s-of the Act of the Gene ra
semb ly of Virg inia, appr·oved
Marc h 10, 1916, or cont rary to law
, and that the arde nt spiri ts so recei
ved by me are for my own use, at
my own home , and that the said arde
nt spiri ts will not be used in viola ion
of law.
I/I } () L-✓ .,
~
A ;
V
7L ( .<. /,
Swor n to and subsc i;ibed befo re me,
t h i s- ~day of
/
,
~
· 'rt(~
VY..
Y,
I
.
191~ .
_J-l ,. A
Z-.
A2ent for South ern Exvre ss Comp
any.
�FORM 370•V A.
SOUT HERN EXPR ESS COM PANY
(I ncorpora ted
)
Way-Bill No·- - - - ~~ - - To
1
AtlVllil(" C B
Co ll ect
to
]' REPAID .
Ad d
Unde r ch a rge
RECO RD OF NOTIC ES
To Consignee_ _ _ _ _ _ __ __ _ _ __
__ _
To Shipper _ _ _ __ _ _ _ _ _ _ __ _
__ _
AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE.
(OV II R )
�AFFI DAV IT FOP ARD ENT SPIR
ITS FOR PER SON AL USE
STAT E OF VIRG INIA,
COUN TY OF-- :----;-
-,,.._.-----i,"-e--'r.;__,,.:'-- rc:'r• ~
t \,
I,
•
, being duly sworn , depos e and
say that I am
the consi gnee of a certa in shipm ent of
arden t spirit s, as sye; ified on other side
of this form, this day
deliv ered to me by the South ern Expre ss
Comp any, from ~
t
}
; that I am not a
stude nt or mino r, and, if a femal e, I am
the head of a famil y; th! t the arden t spin
ts so :i:eceived by me
were broug ht into the Sbte on my writt
en order , and that I have not, withi n
the thir y days previ ous
heret o, receiv ed any arden t spirit s of any
kind whats oever , from any perso n or from
any place whats oever , in
exces s of the quan tity allow ed by the provi
sions of the Act of the Gene ral Assem bly
of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law, and
that the arden t spiri1.s so receiv ed by me
are for my own use, at
my own home , and that the said arden t
spirit s will not be u sed in viola tion of law.
¥
)
Consie:nee ..
Ai:ant for South ern Expre ss Compa ny.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Inco rporat ed)
SPECIAL LIQUOR RECORD
Received a1IL--'-'"'----'--'--=-==-::=-- scc--- - - - - Date._ __,_/_ _
~_
_ _ l 91 _
Affidavit No.
Way-Bill No. _ _.__ _ __ _ __
To - - - - -----"----"'----'--"=--":....,-- - - - -- --
Advalll"'CS to
Coll ect
EXPRESS CHARGES
PREPAID
COLLECT
.Md
Oudercba r~e
RECORD OF NOTICES
To Consignee _ _ ______
_
___ To Shipper______ ______ __ _ ___
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFF IDAV IT FOR ARD ENT SPIR
ITS FOR
STAT E
m'
PER SON AL USE
VIRG INI. ,
C OUNT Y Of'
l,
....__
, being duly swor n, depo se and say that I
th e consi gnee of a certa ·n shipm ent
am
of arden t spirit s, as ' pacified on other
side of this form , this day
deliv ered to we by the Sout hern Expr ess
Comp any, from _~_ cc_c=..-....,_cc... ..,___~ ~- - - i that I am not a
stude nt or mino r, and, if a fema le , I
am the head of a famil y; that the arden
t spiri ts so recei ved by me
were broug ht into the State on my writt
en order , and that I have not, withi
n the thirty days previ ous
heret o, recei ved any arden t spirits of any
kind what soeve r, fro m any perso n or from
any place what soeve r, in
exces s of the quantity allow ed by the
provi sions of the Act of t he Gene ral Asse
mbly of Virgi nia, appro ved
Marc h 10, 1916, or contr ary t o law,
and that the arden t spiri ts so recei ved
by me a.re for my own use , at
my own home , and th at the said arden
t spiri ts will not be used in viola tion of
law.
~ worn to and subsc ribed befor e me ,
thi s ;c _
da.y of~ -- - - - , 191 _,
.,\~c11t f,,r South er n Rx-uro!-'.S Coin
l)an y.
l:ollsia:uee.
�FORM 370•VA
SOUT HERN EXPRE SS COMP ANY
(I ncorporate d)
SPECI AL LIQUO R RECO RD
Date
191_
Affidavit No.
J
Am 0trnt
Way-Bill No'- - - ----'~ ~ --
191_
To _ _ __ .:..,._:="--- -1~~=.:. ...=--=-~ --=~ ~ ~-
Advnurea to
Collect
I
r·
.(
From
EXPRESS CHARGE S
PREPAID
COLLE CT
Add
Uud 8(churge
RECOR D OF NOTICE S
To Consig nee ____ ____ _____
_ _ _ To Sh ipper _ _ _ _ __ _____ _ _ _ _ _
_
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(OVER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
S'l'ATE OP VIRGINI A,
COUN'l'Y
m'- - - - -- -~ ~ - -
1, - - ~ -- - ----'--------'-- -~ ~ + - - - - - - - - , being
duly sworn, uepose and say that I am
th e consign ee of a certam shipmen t o[ ardeut spirits , ati specified
on otb er side of thi s form , this day
delivere d to ·me by the Souther n Express Compan y, from -<-~- - - · - - - - - - - ; th at I am not a
student or minor, and, if a femal e, I am the head of a family;
that the ardent spi rits so received by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of the
General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so received by m e are for m y own use, at
my own home, and th at the said, ardent spirits will not be used
in violation of law.
::iworn to and subscrib ed before me ,
.,\g1:mt for Southe rn F.xpre~s Compauy .
�l'ORM 370-VA.
SOUT HERN EXPRE SS COMP ANY
(I
ncorpo rate d )
Affidavit No.
RECOR D OF NOTICE S
To Consigne e_ _ _ __ _ __ _ _ _ __ _ _ _ _
To Shipper _ _ _ __ _ __ _ _ _ _ __ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
( OVltR )
�AFF IDA VIT FOP ARD ENT
SPI RIT S FOR PER SON
AL USE
deliv ered to me by the Sou ther n
Exp ress Com pany , from_.1,t.~~
~ ~a,;~~~ 1,,!'-._....~
stud ent or mino r, and, if a fema
I am not a
le, I am the head of a fam ily;
nt spir its so r ecei ved by m e
were brou ght into the Siat e on
my writ ten orde r, and that I have
not, i in the thirt y days prev
here to, r ecei ved any arde nt spir
ious
its of -a ny kind wha tsoe ver , from
any person from any plac e wha
exce ss of the quan tity allowed by
tsoe ver, in
the prov ision s of the Act of the
Gen er al Asse mbly of Virg inia , appr
Mar ch 10, 1916, or cont rary to
oved
law, and that the arde nt spiri1,s
so rece ived by me are for my own
my own hom e , and that the said
use , at
arde nt spir its will not be used in
viol ation of law.
Colllliltnee .
ss Com pany .
�FORM 370•VA
SOUT HER N EXPR ESS COM PANY
(
luco r poruted)
SPEC IAL LIQU OR RECO RD
Affidavit,,No.
7--
Io
Way-Bill No. _ _ _ _ _..,_,___ _
To ___ ___:_-!.--:+------>"----'---"-"-~- - - - - - ' - -'-
-
Shi pper _ _ _ __ _ _ _ _ _~ /_
_ _ _ _ __
Arlvnur ea to
C oll ec t
•
EXPRE SS CHARG ES
PREPA ID
COLLE CT
RECO RD OF NOTIC ES
To Consignee _ __
_
_ _ _ _ _ _ _ _ _ To Shipper _ _ _ _ __
_ _ _ _ _ _ _ _ _ __
AFFID AVIT FOR ARDE NT SPIRI TS
f'OR PERS ONAL USE: .
(OVER)
�AFFIDAVIT FOR ARDE-NT SPIRI T S
FOR
PERSONAL USE
"7
- -~ - - -~=~-,..--+-_,.'---r-,-- - --'-~.-.._- , being duly s worn, ll epotie and say that I am
a certain s hipmerit o[ a n leut s pirits, a~ s pec ified on oth e r side of thi s form, t his day
del ivered tome by the Southern Express Compa ny , from - - ..;-~- ~~ - -- - ~ - - ; that I a m no t a
student or minor, and, if a fema le , I am t he head of a fam ily ; th at the ard ent spirits so received by me
were brought into t he State on my writt en order, and that I have not, within th e thirt y days previous
hereto, received any ardent spirits of an y k ind whatsoever, fro m a ny p erson or from a ny place whatsoever, in
excess of the quant ity all9wed by the provisions of the Act of the Gener al Assembly of Virginia, approved
March 10, 1916, or cont r ary to Jaw, and that t he ardent spirits so rec eived by me are for m y own use, at
my own hom e , and that the said ardent spirits will not be nsed in violation of law .
A
S worn t o and subsc ribed before me ,
f _ __ _..,..,_ , 191_
thi s -+tr--day oL
.
I'
• ..\~tH 1t f,,r S1mthe.-n E x 1)re:o-;s C ou 11, a1 1y.
t: vmd auee .
�FORM 3TO•VA
SOUT HERN EXPRE SS COMP ANY
(luco rporated)
.,
SPECI AL LIQUO R RECO RD
Consignee - - -------"---'---''--'-'-~-'-'-'::.c...- ---='----'-----''----- "----- - - - -,- - - ,L.
- ~ - - - -- - - - Kind of Ardent Spirits, _ __ _ -l'--------_L__----"- -c-';..- -- -Amoun .___ _~ ~ - - - - - -Weigh .__-----''-- lbs.
Way-Bill No ., __\ "---~ -_.,.,_ _ Date _ _ '--'-.....:::::....::....,'+---- - - - - 191_
From, ____ _ _ _c.,,_~ - -
r
To - - - -==~: .....::..:: .:_=· -- -- -=:.... ..--
~-- --- --- --- --- --- --- ~
Advnure a to
Co ll ect
EXPRESS CHARGE S
PREPA ID
COLLECT
Add
Oudc r c b tirg e
•
RECOR D OF NOTICE S
To Consignee _ _ _ _ _ _ _ _ _ _ _ _ __ ___ To Shipper _
____ ____ __ _ _ __ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(OVE R )
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE 01,' VIR G IN!;\,
C OUNTY OF-
-
- - r - - - - -- - - - - ' ~~
l, - - - - - - - -~-__._._,....,,.....,-;.-,--~""--~- - - -, being duly sworn, uepose and say th at I am
the consignee of a certain shipment ti[ ardent spirits , as specifi ed o,n other side of thi s fo,rm , this day
delivered to me by the Southern Express Company, from _ _ ____________ ; that r~am not a
~tudent or minor, and, if a femal e , I am the head of a famil y; that the ard ent spi rits so r eceived by m e
were brought into the State on my written order, and that I have not, within th e th jrty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me nre fo r m y own use, at
my own hom e, and th at the said ardent spirits will not be used in viol ati on of law.
Sworn to and subscribed before me ,
th i s-" _
day o~ - - -- - , 191_ .
.,\~"tmt for S outhe rn Rxpre~s C0 111p:m y .
�FORM
370•VA
SOUT HERN EXPR ESS COM PANY
( lucorpor ated}
SPEC IAL LIQU OR
RECO RD
Date
191 _
\
Kind of Ardent Spirits, _ _~"'"
Way-Bill No,_ _ _ _ _O
_ ~_
Am ou n
Oate, _ _ _c..,__.:____
_ _ _ _ __
To
Advnure a to
Coll ect
Affidavit No.
'I
191_
Weight
1-
I
lbs.
From
EXPRE SS CHARG- ES
PREPA I D
COLLEC T
Add
Onder cb11q; e
RECO RD OF NOTIC ES
To Consig nee ___ ___ __
_ _ _ _ __
To Shipper_ _ _ _ __ __ _ ___ ___ __
_
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERSO NAL USE.
(ov1m)
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERS ONAL USE
S TATE Ol,' VIRGIN IA,
COUNT Y OF - - - --
-
-=--=-- =--'-"
l, - - -- - -- - ~ - - - - - -- ~ - - - - -, l.Jeing
duly s woru, uepose and say that I am
the consig nee of a certain s hipm ent of aruent spirits,
as
specifi ed on other side of thi s form , this day
ueliver ed tome by t he Southe rn Expres s Compa ny,
from _ _ _ _ _ ____ _ _ __ _ ; t hat I am net
a
studen t or minor, and, if a femal e, I am the head
of a family ; that the ardent spirits so receive d by
me
were brough t into the State on my written order, and
1ihat I have not, within th e thii·ty days previo
us
hereto, receive d any ardent spirits of any kind whatso
ever, from any person or from any place what soever
, in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
:\farch 10, 1916, or contra ry to law , and that the
ardent spirits so receive d by m e are for m y own use,
at
my own home, and th at the sa id ardent spirits will
not be u sed in violatio n of Ja,L
:-;worn to and subscr ibed before me,
this _ _day o ~ - -- -- , 191_ ,
.•\1:11:mt for ~1111tJiern F.xpre~s Co 1111-.a11 ,r ,
�FoRM 370•V A
SOUT HERN EXPR ESS COMP ANY
(Inco rpo rat
ed)
LIQUO R
Received at--,,--"-:+c...:::....:,c.__,_c.==--c, _ __-:-;-~ --'-- - Date
RECO RD
I
191 _1_
I
Kind of Ardent Spi rits------,--l-"- '---~- - - =c:.:..;:;:c___-c---,----Amoun
Way-Bill No.__,_i~, _,__
/ ~ \- -~ --
(
Affi davit No.
I'
Consignee - -~ - - ---J'-- -l.!'-'--"c_.;...........::..:.::....=;;;c:,------ --
/
Date _ _ _,---r--- - -- - - 10 1_
Weigh
Fro m
...------,---=-=EXPRES
==~S .,,,.,.=
,.,,,.
-~-- ,---- ,
CHARGE
S
To
Advau("ee to
Coll ect
PREPAJ D
COLLEC T
A~d
Unde rch arge
RECOR D OF NOTIC ES
To Consignee _ _ _ _ _ _ __
_ ___
To Ship per_ _ _ _ _ __ ____ _ _ _ _ __
_
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
(OVER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE OP YIRGINI A,
COUN'J.'Y OP _ __..!._...:___~ ~::..:_: ~~~-]/
1,
- - - - ~ - - - ' - , - -- ..;,-.pc.~J ,-+---'- ----~-- - -, being
duly sworu, depose and say that
I am
sp c i6 ed on other s ide of thi s form , this day
the consigu ee of
delivere d to me by the Souther n Express Compan y, from _ _
-'--"'-- --_._- --'-"-~ - · t hat I am net a
titudent or minor, and, if a femal e, I am the head of a famil
y; that the a1·dent spirits so received by me
were brought into the State on my writt en order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent sp iri
ts so received by me are for m y own use, at
my own home, and th at the said ardent sp irits will not be u sed
in viol ati on of law .
Swo rn to and subscr ibed be fo re me ,
.~---, --- , l !Jl _ .
'r '
J\ge ut fnr Sou thern F.x1n·e~s Corn rmny.
�FOAM 370•VA
SOUT HERN EXPR ESS COMP ANY
(lncorpo rntcd)
RECO RD
· - - -- -- ~
191_
Affi davit No_...::2.
_ ::...:_____:1/:_
I
Advnure s to
Collect
RECOR D OF NOTIC ES
To Con sign ee _ __
_
_
To Shipper _ _ _ _ __ ___ __ _ _ _ _ _
_
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE: .
(ov1rn)
�AFFI DAV IT FOR ARD ENT SPIR
ITS FOR
11..-,,t.,
PER SON AL USE
T,
• I,
being duly s worn, ,lepos e and say that
I am
the cousi gnee of a cert aiu s hipm1ent of
ardeu t spirit s, _a s J pecifi ed on ot her s id
e of thi s form , this day
deliv ered to me by the Sout hern Expre ss
Com pany, from
ti.mt I a m not 11
s tuden t or mino r, and, if a fema le, I am
the head of a famil y; that tl!e ;.den t spirit
s so r eceiv ed by me
were broug ht into the State on my writt
en order , and that I have ot, ithin
th e thirty days previ ous
heret o, receiv ed any arden t spirit s of any
kind what soeve r, from any perso or from
any pl ace whats oever , in
exces s of t he quant ity allow ed by the provi
sions of the Act of t he Gene ral Assem bly
of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law, and
t hat the arden t spirit s so receiv ed by m
e are for m y own use , at
my own home , and that t he said arden t
spirit s will not be used in violat ion of law
.
,{_ /
,
/A.[ 7:
~,
1
::;worn to and subsc ribed befor e me ,
thi s
day of.- '\l,,,,.,,)c.:•=== --
.1\J,.ruut fur Sou thern J.: xpro:-:s Co tup."\n
_r.
0 ""'
;
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(lucorpo rate d)
SPEC IAL LIQUO R1/, RECO RD
I r
l
Rece_ived at•--=--- -----''----"------' ~--- - -- Date _ _____,__ _ _ _~_ 191 _
Consion ee
_ --4/~v..,.....__.,.J:. ._1---=i..._,__r.+-J..-~= =-=,, --,~-
To
/
r,
Shipper_ _ _ _ __ _ __ _ __ _ _ _ __
_1·
/ ..ce;=-.,;c - ~ - - - Amoun L__,__.
Date_ ~ ~~-+-.-___,___-=
/ _ 1./
_ _ _ 1!) 1_
- - - -~=~~~= #~ - - - - - - - - -
From, __
-=--- -'--- ---.---- ----. ----- ----- -----.--, --,-- --.1'
A d vnu ccs to
Collt,c t
_
EXPRES S CHARGE S
P REPAJD
COLLEC T
t
Add
Oude r chargt:
RECOR D OF' NOTIC ES
To Consign ee _ _ _ _ _ __
7
- - - -'- - - - -/ -· - - -- -- - - --
Kind of Ard ent Spirits _ __ _ .,__..,_.LL..-----'-"'--'=c....c'
---""- - -Way-Bill No,, _ _/' -"'--'-- - _ _
,
Affidavit No._ __..d,::__--=--
_ _ _ __ To Sh ipper_ _ _ _ __ _ _ ___
_ _ _ _ __
AF'F'ID AVIT F'OR ARDEN T SPIRIT S F'OR
PERSO NAL USE: .
(OV!t R)
�AFFtD AVIT FOR ARDE NT SPIR ITS
FOR
PERS ONAL USE
STATE 0~' VIRGIN IA,
COUNT Y
m·- -\,,.-- -~~ ~...........
lv'
°f,
, being duly swo rn, uepose and say th at I am
the consig nee of a cert a in s hi pme'nt or nrueut
spirits , a:s specifi ed on oth er side of thi s fo1·m,,. this
day
\
.
delive red to me by the South ern Expre ss Compa
ny• from
l
1 1,, • . ,
; th at I a m not a
studen t or minor , and, if a female , I am the
head of a family ; that the arden t spir its so receiv
ed by me
were broug ht into th e State on my writte n order,
and that I have not, within the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind
whatso ever, from any person or from any pl ace
whatso ever, in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
)farch 10, 1916, or contra ry to law, and that
the ardent spirits so r eceive d by me are for m
y own use, at
my own home, and th at the said ardent sp irits
will not be used in violati on of law.
Sworn to and subscr ibed before me ,
i
thi s_~ __day of'---'- "= = ~, 191
1
~f
t:ous i"u~e .
.
.•\ :.:~ ut for Southe rn F.x1wc.-.: s Compan y
.
�FORM 370• V A.
SOUTH ERN EXPRES S COMPA NY
(Incorpo rated)
LIQ.,M
R~ CORD
l
J91
b1L
Received at __~ ~~c-T- - •....,._,...-,-~---1-- - Da~ - U
f •
Consig nee - - ~ ~~ ~ __._- -,c.-1- ~L
,!"!'_"'_"_"-_~_i,_-r_,(J._____ ____ ___
Affidavit No._
_,,@"'--_--'/'---
~ _____ ___ _
Advnnces t o
Coll ec t
RECORD Of" NOTICES
To Consignee ____ ____ _ __ _ __ __ _
To Shipper _____ _ _ __ _ _ __ _ _ _ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE .
(O VJIR )
�AFF IDA VIT FOP ARD ENT
SPI RIT S FOR PER SON AL
USE
~:::;:,v'~
-; ;U;
w ~~
,
I,
bein g duly swor n, depo se and say
the cons igne e of a certa in ship men
that I am
t of arde nt spiri ts, as spec ified
on othe r side
form , this day
deliv ered to me by the Sout hern Expr
ess Com pany , from -JQJ~ - '.& ~~~
J,., ~"" -~~
stud ent or mino r, and, if a fema
le, I am the head of a fami ly;
dent spiri ts so rece ived by me
were brou ght in1io the Stat e on my
wri1iten orde r, and 1.hat I have
n t, ithin the thirt y days prev
here to, rece ived any arde nt spiri ts
ious
of any kind what soev er, from any
per
or from any plac e what soev er, in
exce ss of the quan tity allow ed by
the prov ision s of 1.he Act of the Gene
ral Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
and 1.hat the arde nt spiri is so rece
ived by me are for my own nse, at
my own hom e, and that the said
arde nt spiri1is will not be used in
viola tion of law.
I
Conai1:nee.
xpres s Comp any,
�F'ORM 370• V A.
SOU THE RN EXP RES S
CO MP ANY
( Incor
porated)
l _ _Rece ived at _
+ - - - - - ---
-., ____ ,
Affidavit No.
2 7<1
I
Way-Bill No.,- - - - - ~ ~ -
To
__ j - ~.4~ ~.':" t!'e~ ~!!!' .J.-. -L__ ::,.__ _
REC ORD OF NOT ICE S
To Consign ee,_ __ _ _ _ __
_ _ __ _ _ __
To Shipper _ _ _,__ _ _ __ _
_ __ __
AFF IDAV IT FOR ARD ENT
SPI RIT S FOR PER SON
AL USE .
(OV l<R )
_ _
�AFFI DAVI T FOP ARD ENT SPIR ITS
FOR
PERS ONA L USE
I, - - - -~ - - - - - - -.......-'--'-- '---- --'----- , being duly sworn , depos e and say that
the consig nee of a ceriai n shipm ent of arden
I am
t spirits , as spycified on other side of thi
orm, this day
delive red to me by the South ern Expre ss Comp
any, from
hat I am not a
stude nt or minor , and, if a femal e, I am the
head of a famil y; that the arde t spirit s so
receiv ed by me
were broug ht into the Siate on my writte n
order, and that I have not, ,itjiin the thirty
days· previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso oJ from any place
whats oever , in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgin
ia, appro ved
March 10, 1916, or contra ry to law, and that
1;he arden t spiril s so receiv ed by me are for
my own use, at
my own home , and 1.hat the said arden t spirit
s will not be used in violat ion of law.
,if
/t1
&o ./) ~
Sworn to and subsc ribed before me,
I
thi s ___ day of __~"- -~
AKtlnt for Southe rn Expres s Compa ny.
(_ 1
I J/l -
~
, ;
i
r;...
�FORM 370•V A
SOU THE RN EXP RES S COM
PAN Y
(Incor
por ate d)
SPE CIA L LIQ UOR
Consign ee - - - -- --'-'=--.:._
=----::..cc::=-;;c -,-= =--= =-=
Kind of Ard e~ t Spirit s__--+---- --=~
-~--Way-Bill No·- - ~ - -~ - -To
REC ORD
---- --- ---- ---: ;--; ---- --
- - - -- -- - -
- -- - -- -Am oun ~ __ __
__ __ __ Weioht_ _ _
lbs,
'J
- - ~;r,-~'------- - - - 1912Advnu ree to
Coll ect
EXPR ESS CHAl tGES
PR E PAI D
REC ORD OF NOT ICES
To Consign ee __ __ __ __
To Shipp er _ _ _ _ __ _ _ _
__ _ _ _ _ __
AFFI DAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
(OVKR )
�FOR ARDENT SPIRITS FOR
- - - - -- ~ ---'+~~... 1,__~_ __
.,
PERSONA L U SE
being duly s woru, de pose and .say th at I a m
pacifi ed on other ·side of thi s form , this day
~ ~ - - - -,
spirits, as
f
f ,
·;
:i
delivered to me by the Southern Express Company, from
0
< ,
{hat I a m ne t
student or minor, and, if a femal e, I am the head of a family ; that the ard'e nt spirits so received
by m e
were brought into the State on my written order, and that I have not, within th e thi1·ty
days p r evious
heret o, r eceived any ardent spirits of any kind whatsoever, from any person or from any pl ace
whatsoever, in
excess of t he quant ity allowed by the provisions of the Act of t he General Assembly of Virginia,
approved
March 10, 1916, or contrary to la w, and that the ardent s pirit s so r ec eived by me are fo r m
y own use , at
my own hom e, and th at th e said a rd ent spirit s will not be nsed in violation o f Ja.w .
S woru to a nd subsc ribed be fo re me ,
thi ~ ~
d ay o ~ - -- - - , 191_
~
.
---=--~=, -- ----==--
_;\~fmt fo r S •m the rn Rxp1·e ~s Co mpn11 ,r .
�FORM 370•VA
SOUTH ERN EXPRE SS COMP ANY
(lucor po rated)
Affidavit No.
Amount,_
A dvrmres to
Col lect
~
___,/~~G"-\-""..A:~·•
"' I
7.,.. <.../
1~1-f
'I.
From_-4---1,----'--=-'-_:_-'--- -','---- ,
PREPAID
Aad
g ndercharg e
RECOR D OF NOTICE S
To Consig nee
_ _ _ _ To Shipper _ _ _ ___ __ ___ _ _ _
_ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(OVXR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
l, - - - - ~- ~~P.------ir-.._ _~~~~~==--,~ - , being duly sworn, depose and say that I am
the consignee of
ati specified on other · side of tbis form, this day
/J
a 0 , ..
delivered to me by the Southern Express Company, from
I
t; that I am not ~
titudent or minor, and, if a female, I am the head of a family; that the ardent spiri ts so received by me
were brought into the State on my written order, and that I have not, with"n th e thirty days previous
hereto, received any ardent spirits of any kind whatsqever, from any person r from any place whatsoever, in
excess-of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
:March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own us e, at
my own home, and th at the said ardent spirits will not be used in violation of law.
:-:iworn to and subscribed before me,
,7
,
1911 .
I
;\~~11t f,,r Sin1tl1ern F.:x 1>re~ s Con11,an.r.
<..:ouSi6ru ee .
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
( lucorpo rat.ed)
VD L
RECORD OF NOTICES
To Consign ee _ _ _ _ _ __
_
_ _ _ To Shipper _ _ _ _ __ _ _ __ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL
(OVE R)
use:.
�AFFID AVIT FOR ARDE NT SPIRI T S
FOR
PERS ONAL USE
l, -----,,1 -~_,," ---""-- --'-'=~=-11"'- -~"'-'-= -'-''-'--- -"'-•:•
being duly sworn, uepose and say that I am
the consig nee
sp citied on tlrnr side of thi s~
t his day
deliver ed to me by the Southe rn Expres s Compa ny,
from _ _ _ _ _-='- ._::--" +---"--" "-"~ ; that I am not
a
studen t or minor, and, if a fema le, I am the head
of a family ; that the ardent ~pirits so receive d by
me
were brough t into t he State on my writt en order, and
t hat I have not, within the thirty days previo us
hereto, receive d any ardent spirits of any kind whatso
ever, fro m any person o 1 ~om any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
t he Act of the Genera l .A:ssem bly of Virgin ia, approv
ed
March 10, 1916, or cont rary to law, and that the
ardent spirits so receive d by me are for my own use
, at
my own home, and th at the said ardent spirits will
not be used in violati on of Jaw.
::;worn to and ,· u scribed before me,
�.- - - - - --- - - - -~ --- --- --~---- --- ----- - ----- ---- ---- -~FORM 370•VA
Advn u r e e t o
Col lec t
RECORD OF NOTICES
To Consignee _ _ _ _ _ __
_
~
___ To Shipper _ _ _ _ _ _ _ _ __ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE .
(OVER )
�FOR ARD ENT SPIR ITS FOR
PER SON AL USE
Vrn
Co u NTY m' _ .;,,..:_..__JL-.....,,=--.c:e.......:=-----S T A TE OE'
de livere d to me by the South ern Expre ss
Comp any , from
(•
,; t hat I am not a
8tude nt or mino r, and, if a fema le , I am
the head of a famil y ; th at the arde nt spi
rits so received by me
were broug ht i nto the State on my writte
n order , and that I have not, withi n the
thirty days previ ous
heret o, r eceiv ed any ardent spirits of any
kind whats oever , from any persoffor from
any place whatsoever , in
exces s of t he quan tity allow ed by the provi
sions of the Act of the Gene r I Assem bly
of V irgini a , appro ved
) farch 10, 1916, or contr ary to law, and
t hat the arden t spirit s so receiv ed by m e
are fo r m y own use , at
my own home , and th at the sa id arden t
spirit s will n ot be nsed in vi olati on of Jaw.
~
S wom to snd so~
th isL7 -,day of
. /~~----,/2<--.CV·.__.J..=~---'--,ry:{'~"-L~
il,o; ~ofm· , ms,
1
,
1911.
r~ ✓ -C,
,,
.
..._ _
_;\ i.:u 11 t ti ~r Ri,ntl1 e rn F.x pro~s <..::o
m11an y.
-=-'-Cuu oi g u e e.
�FORM 370•VA
SOUTHE RN EXPRESS COMPAN Y
(l ucorporute d)
LIQUOR RECORD
.Advouree to
Collec t
EXPRESS CHARGES
PREPA ID
Aad
Onrle rcbarge
RECORD OF" NOTICES
To Consignee _____ ___
~
~
_
To Shipper _ _ _ _ __ ______ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
(OVER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
7
~::::::~~-~-IR_G
.,_/_N
_iLA
-,£L•- =.:......=== I
"1 ,1
4l
PERSO NAL USE
i
A.~,:
C
/ ,
/:.J
, being duly sworu, depose and say that I am
a ce rt ·u s hipm entt f r u.eut sp irits, as speeified on other
~ide Q.f this form, this day
delivere d tome by the Souther n Express Compan y, from _ _
_____,~__,(_"'-/_ _ __.,__-'-'---- r--'- i ' hat I am net a
student or minor, and, if a female , I am the head of a family
; th at the ardent spiri ts so received by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind what soever, from
any person or from any place whatsoe ver, in
excess .of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
) farch 10, 1916, or contrary to law , and that the ardent sp irits
so received by me a.re for my own use , nt
my own home, and that th e said a rdent spirits will not
be used in viol ation of law.
f
//.
'
thi s
,, I
.-\~~11t for Southern Rx1n•oss CoulJ)a11.r .
-
/"
t
·'.// I / ~
{
?l
�SOUTHE RN EXPRESS COMPAN Y
FORM 370•VA
(Incorpo rated)
SPECIAL LIQUOR _. RECORD
RECORD OF NOTICES
To Consign ee _ _ _ _ _ _ __
To Shipper _ _ _ __ _ _____ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE:.
-
(ovx a)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
l, --+----.--~+c-----+-----"="'--.c.;.-"--1.~ ~ - - -- - - -, being duly s worn , de pose and say th at I am
the cons ignee of a certaiu shipment of ardent spirits , as specifi ed on oth e r s id e of thi s form, this day
delivered to me by the Southern Express Company, from
J
; \bat I am not a
student or minor, and, if a female, I am the head of a famil y; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within th e thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from a ny place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Gene al Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use , at
"'' own homo,
on d " ' '
tho ..,.
o,dont
spirit. '"?::,,ll;iolotio:
will
S worn to and subscribed before me,
thi s ~
day o ~ - - -- - , 191_,
_;\~1:mt fo r So uthern F.x in·e:--: s Com1,m1 y.
S'L t :
L' ou ~jr:uee.
�FORM 370•V A
SOU THE RN EXP RES S COM PAN
Y
(Inco rporate
d)
LIQ uoi, ; REC O ~ D
Received al---:c.____..cc'-- -=-- =---- --'= '--'---'-,j ,__-- Date
(./!--l.
- -- - --- - ~ -- -
191;
!
Amoun _ __ _ __ _ __ _ _ Weigh
_ _ _~ lbs.
- ~--'- -,---- ~'-' --- --- 19 1_
A dvnu res to
Coll ect
RECO RD OF NOTI CES
l/__f_ _•_
Aff: avit No. _ _
I
Fro m_~ -~ --'' -'---~ '-'---' --+•
EXPR ESS C H ARGE S
PRE PAID
,
To Consig ne e_ _ _ _ _ _ __
___ _
To Shipper _ _ _ __ ___ ___
_ _ _ _ __ _
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONA L
(OVER )
use.
�AFFIDAV IT FOR ARDENT SPIRITS FOR
PERSONAL U S E--.
1, ~,,__ _.....,,,.._~~~~-·+--"~~~- - - - - - - being duly sworn, ilepo,;e and say that I am
the cousi
arileut spirits, a:; specified on other side of thi: fo m , this day
delivered to me by the Southern Express Company, from / /
- -~ ~ -- - ; ~iiat am net a
:;tudent or minor, and, if a female, I am t he head of a family; that the ardent spirits so r eceived by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, fro m any person or from any place whatsoever, in
excess of t he quantity allowed by the provisions of the Act of t he General Assembly of -Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for m y own use, at
my own home, and tb itt the said ardent spirits will not be used in violation of law .
Oousieu~e.
�FORM 370•V A
SOU THE RN EXP RESS COM PAN
Y
(lucorp
oratud)
SPE CIAL
Affidav it
Advaur es to
Coll ect
No.,_ ~_ .:./
---'-----_7__
EXPRE SS CHARG ES
PREPA ID
COL L ECT
RECO RD OF NOTI CES
To Con sign ee _ ___ ___ ___ _
_
To Shipper _ _ _ _ ___ _ __ __
__ _ __
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE .
(OVJIR )
_
�A RDE NT SPIR ITS FOR
l,
-
-
-
PER SO NA L USE
--L."-',.J'----~ --'--P --'-4' """' _.__,
,,,__- +_ _ _ , being duly
swor n, depose and say that I am
o arden t spi_ri\s, as speci fied on oth~r
sicle f th is form , this day
deliv ered to me by the Sout hern Expr
ess Comp any, from { /
(
that I am not a
~tude nt or mino r, and, if a fema le, I
am the head of a famil y; that the ard
~nt spiri ts so recei ved by me
were brou ght into the S_tate on my writt
en order , and that I have not, withi
n the thirty days previ ou s
heret o, recei ved any arden t spiri ts of any
kind what soeve r, from any perso n or from
any place what soeve r, in
exces s of t he quan tity allow ed by the
provi sions of the Act of the Gene ral Asse
mbly of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law, and
t hat the arden t spiri ts so recei ved by
me a.re for m y own use, at
my own home , and that the sa id arden
t spiri ts will not be used in viola tion of
law.
the consi gnee of a certa in shipm L
l,_,
;-;worn to and subsc ·ibed b efore me ,
;
I
<..::vusieu ~e .
�-- ----- - - FORM 370•V A
SOU THE RN EXP RES S COM PAN
Y
(Incor
porated )
2----o ,.7
Affidavit No. _ _ __ _ _
Advtrn res to
Collect
P REPA I D
COLLE CT
A~d
Uuderc bo rgc
RECO RD OF NOTI CES
To Consignee ___ ___ ___
To Shipp er_ _ _ __ __ _ ___ _ __
_ __ _
AFFI DAVI T FOR ARDE NT SPIR
ITS FOR PERS ONAL USE .
(OVKR )
�ARDE NT SPIRI TS FOR
PERSO NAL USE
1, --~-~ ~-~-~ --.'-- -''-t~ =---- --,--- ~--,
being duly sworn, uepose and say th at I am
the consign ee of a certain shipme nt o ,udent spirits,
as specifie d on other side of thi s form , this day
delivere d to me by the Southe rn Expres s Compan y , from
__,/:-,. .(_--= ----=- -----'- -- i that I a m not a
student or minor, and , if a femal e , I am the head of a famil
y; that the ardent sp irits so r eceived by me
were brough t into the State on my written order, and that
I have not, within th e thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisio ns of the Act
of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and that the ardent
spirits so r eceived by me are for my ow n use , at
my own home, and th at the said ardent spirits will not be
nsed in viol ation of Jaw.
::i worn to and subscri bed before me ,
I
J
thi s _._l._d ay o ~ - - - -- , 191_.
.,\:,:tH 1t
t'1, r Southe rn R~ 1n·e~s Com pan y.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(l uco rpo rated)
LIQUOR
Received at.~---~ :...i..t!:U:......,~ .L.,;.L."""~ +-+-~ ~
RECORD
Date~'l
-.....c:;.-- - -
191 _
Affidavit No., _ _
V,
"--'-/_C/
__
Kind of Ardent Spirits _ _ _ _
I
•
From, ________ ___ _
Way-Bill No,, _ ---'-- ~ --=---- Date _ -=="''---"--"'-~ ------,-- - - 19 1_
To
1
·•.·
t
Shipper
I
I
/
EXPRESS C H ARG ES
Advoul"' e 8 to
Co ll ect
PR E PAI D
I
I
COLLEC T
I
.Arld
Uudc r cha rge
I
RECORD OF NOTICES
To Consignee _ __ _
_ _ To Shipper_ _ _ __ _ _____ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OV!tR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
STATE OF YIRGINL~,
COUN'l'Y OF
~
A
I
.
L(...-t.,~
PERSONAL USE
I
h
l,
)
(,
, ~-~=..-- ---- - , being duly sworn, depose and say that I am
the consignee of a cert aiu s hipm J n.f of nnlent spirits, as s pecified on other Hie of thi s form , this day
UJ (;
(t,,..,..., -
delivered to me by the Southern Express Company, from
.5'+ that I a m not a
student or minor, and, if a femal e, I am th e head of a family; that the~,IJ,l' - nt spirits so received by me
were brought into the State on my written order, and that I have not l w· bin the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any pers or from any place whatsoever, in
excess of the qua ntity allowed by the provisions of the Act of th e General Assembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for my own use, at
my own home, and th at the sa id ard ent spirits wil ot be nsed in violafon of law :
J
:-,worn to and subscribed before me,
th is ~ _day of_~- - - - , 191
_;\:.:;e 11t for
~outhern Rxprcss Compnny.
'
J' .J' .
Cuusieuee .
�FORM 370•VA
SOUT HER N EXPR ESS COM PANY
(
Incorpo rat ed)
RECO RD
'-+----=----.Y<---,_/_,0=--- 191.1_
/
Affidavit No._..:.._____:_:_----=-=--
I
Consign ee - - --f~ .,__---!....:.___ -e.:::,..,._ ____c__.,__
,_,__ _::;__!!E_c::,'-"£'- ------'L -.-- - - -/- i- - - - - -- --
Way-Bill No,_ _
/ f't ;
-<-- ' --;:___ __
'~
~
~
- - ~ - 19 1_
To - - -- "'---'---L.'._'..~ == ------ ''----=-_.,,,_,___
Shipp er____ _ __ _ _ _ _ _ _ _
_ _ __
~ro~
/
lbs.
~ al ~ }k
EXPRE SS CHARG ES
PRE PA ID
Weich
Add
Unde r c harg e
RECO RD Of' NOTIC ES
To Consign ee _ _ _ _ __ _ _
To Shipper _ _ __ __ __ ___ _ _
_ _ __
Af'f'ID AVIT f'OR ARDE NT SPIRI TS
f'OR PERS ONAL
(OVER)
use.
�AFF IDAV IT FOR ARD ENT SPIR
ITS FOR
PER SON AL USE
STAT E OP VIRG rNi A,
COUN TY Ot'-
---#---.--_!___~ ~ ~ ~ ~ ~ I .
l1,.,f u ( l .
r,
I -'!
• ' being duly swor n, depo
se and say that I am
the consi gnee of a cert ain shipm ent
oC arden t spirit s, as spz ified on other
sid of thi s form , this day
deliv ered to me by the Sout hern Expr
ess Comp any, from _-+ -- - - ' •
· that I am not a
stude nt or mino r, and, if a fema le, I
am the head of a famil y; that the arden
t spiri ts so ·ecei ved by me
were brou ght into the State on my writt
en order , and i hat I have not, withi
n th e thirty ays previ ous
heret o, received any arden t spiri ts of any
kind what soeve r, from any perso n or from
any place what soeve r, in
exces s of the quan tity allow ed by the
provi sions of the Act of the Gene ral Asse
mbly of Virgi nia, appro v ed
lfarc h 10, 1916, or contr ary t o law, and
that t he arden t spirit s so recei ved by
me a.re for my own use, at
my own home , and that the said ard ent
spiri ts will noi be used in viola t ion of
law.
~ worn to and subsc ribed befor e me,
thi s -7'-_ _ RY
of- <~l__.,.1__ ,
{
_;\~1;,ut
191 _.
I
•
f
I
J
fnr South e rn F.xvre ~s Co mpa11y .
�FORM 370•VA
SOU THER N EXPR ESS COM PAN
Y
(lucorp o roted)
SPEC IAL LIQU OR
Kind of Ard en' t Spirits, __--=---:::.__.-,= - - -~ -- - - --
Arnoun ~ - - - - - - - - - -
1
Way-Bill No,- - - ~ -- - -To
~ --
.'._'.._.'...c::....,:_=--::____~
RECO RD
'- ---"- '-- -- - -- - 1n1 _
_
___,__
r:_ __
Advnur ea t o
Colltict
EXPRE SS CHARG ES
P RE PAID
COLLE CT
eA~d
Uudercb a rge
RECO RD OF NOTIC ES
To Consignee _ ___ ___ ____ ___
___ __
To Shipper _ ___ __ _ _ ___ ___
___
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERS ONAL USE .
(OV ER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OP VIRGINIA,
COUNTY OF- - - - --
-~~--
T, - - -- - - - - - ~ - - - - -- - - - - - -, being duly sworn, t.lepose and say th at I am
the consignee of a certain shipment of nr<lent tipiritti, ati specified on ot!Jer side of this form, this day
delivered to me by the Southern Express Company, from _ ________ _____ ; tha I am not a
titudent or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my writt en order, and t hat I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of t he General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and t hat the ardent spiri t s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
:-:iworu .to and subscribed before me,
�FORM 370•V A
SOU THE RN EXP RES S COM
PAN Y
( luco rpornt ed)
SPE CIA L LIQ UOR
Received a,t._--'/ 4?
--'--'-----"-'--'-C...-'-------""-- •- --+-- -Consi gnee - -..., .L-- - ' -='-'- --''--c _~-----=:...
?
REC ORD
Date. __ __ __ __ l 91_
I
::...__ _ _ _ _ _ _ _ _
__
Kind of Arden t Spirits _ __
4
Affidavit No.,_ _____:....=__ _
_ _ _ _ _ _ _ _ _ __
/r.: ~-,~~, -==-- -.=..c:---=-'-- -- -Am oun
c___ _ _ _J
---'
Way-Bill No . ~ ~ -- --- '-'~ ~-
To _ __ _ ____1:~~':'.::- --
...:
:;_
Shipp er _ _ __ _ _,...
~
-+__,;::;'~...;;-"
--r
.
~~---
,
'----"
' - ---"- -'=-'- ----
I
EXPR ESS CHAR GES
Adva ure e to
Collec t
PREP AJD
I
I
REC ORD OF NOT ICES
To Consignee _ __ _ _ _ __
COLL E C T
{\
~
I
To Shipp er__ __ __ __ ___
AFFI DAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
(OVER)
_ __
----· Weigh t_ _I _ _ lbs.
Arld
O~d e r c bn.rg~
I
_ _ _ _ __
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONA L USE
STATE 0~' VIRGINIA,
COUNTY Ot'- --
- , - - -----'--'---"'c.e.._ -
l, - -- - - ---"-'-'s=~---'----'----- -'--'--~-----'"--- --- , ueing duly sworn, depose and
say that I am
th e eousignee of a eertain shipment of ardeut spirits, as speci6 ed on other side of this form,
thi s day
delivered to me by the Southern Express Company, from _ ~ - - - - - · - - - - - - ~ i that
I am not a
student or minor, and, if a fe mal e, I am the head of a fami ly; that the ardent spirits ~o received
by me
were brought into the State on my written order, and t hat I have not, within the ,thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
)farch 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law,
S woru fo and subscribed before m e,
this _
_ day of
Jr
, 191_.
_.\~tmt for.- Sou thern F.xpross Co1111,a11 y .
�f'ORM 370• VA
SOU THE RN EXP RES S
CO MP ANY
( luco rpo
ratcd)
SPE CIA L LIQ UO R
REC OR D
Kind of Ard ent Spirits _ _ _
Way-Bill No·- -- ~-'---- - - -Date·_ _ _~-'- ---- - -- - To - - - -- - ~- - - --- - - -- - - Shipp er _ __ _ __ _ __
_ _ _ _ _ __ _ _
Advu nces to
Coll ect
PREP .AID
COLLECT
A dd
Ourlc r c barg e
REC ORD OF NOT ICE S
To Consignee __ __ __ __
__
__ __ __ __
To Shipp er _ __ _____ _
__ _ _ _ ___ _
AFF IDAV IT FOR ARD ENT
SPIR ITS FOR PER SON
AL USE .
(ov n )
�AFFIDAV I T FOR ARDENT SPIRITS .FOR
PERSONAL USE
S T A TE OF VIRG INIA ,
Cou N·r v
OF-~ -- - -- - -~ =
r, ---,'----'~ = ~=--- -
th e consign ee of
being duly sworn , <l epose and say that I am
ar<l eut spirits, as specified on other side of thi s form , this day
+------'---------"'--~ ,
<l elivered to me by the Southern Express Company, from _ _ ~-'--"~-=-----=--"----''--"-_,_-"--_ ; that I am not a
student or m inor, and, if a femal e, I am the head of a famil y; th at the ard ent spi rits so r eceived by m e
were brought into the State on my written order, and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the qu !;J,nt ity alloweii by the provisions of t he Act of the Gener al Assembly of Virginia, approved
March 10, 1916, or contrary t o law, and t hat t he ardent spirits so r eceived by me :ne fo r my own use, at
my own hom e , and th at the said a rdent spirits will not be nsed in violati on of law.
~wo rn to and subscribed before me ,
t his ~
_ day o~- -- -- , 191_ ,
.,.\~c11 t for Sonth e J' n F. x 11r e~s Conipn11 y .
C..: ousie:uce.
�SOUTH ERN EXPRES S COMPA NY ;
( 111
FORM 370•VA
c o r po rntt!d )
SPECIA L LIQUOR
"J
RECOR D
_ __ ____ Date v'
I
___:_,.,,_ 19 1
Affidavit No.
l
' -- - L - - - - - ' c . . . i . ._ _ _ _
·-- ~ ~ - !~!Arlvn n res t o
RECORD OF NOTICES
To Consignee
.
I
1-1
7-.
_ lbs.
From-=
C=----'---'-~-'-- - ~ ~~ EX P R E SS CHARGES
- i -Co l lect
Shipper
WeiahL
P im P AIi}
I
_ To Shipper_
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
Add
U 1uten·btt ri,;c
COLLE C T
use.
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
)
· STATE OF VIRGINI{ ,
COUNTY O F - - - - - - ' - - "-
"---''----~
l, - - - -~ - -- -- - - -"---- - - - - -- , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardef t spirits, as specified on other side of this form, this day
·delivered to me by the Southern Express Company, from '
; that I am net a
student or minor, and, if a female, I am the head of a family; that the ardent spirits o received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any p~rson or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw.
Sworn to and subscribed before me,
,-
this _ __ day OLf---==---'-- - , 191_.
I
Aeeut for Southern Express Company.
Consienee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
( Incorporated)
RECORD
Affidavit No. _ _ _ _
Adveu re e to
Co ll ec t
EXPRESS CHARGES
PREPAID
COLLECT
__c,/_
Add
Oude r c bttrge
RECORD OF NOTICES
To Consignee _ _ _ _ _ _ __
~- _
To Shipper_ _ _ __ ______ __ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
I
(ovxa)
�AFFI DAV IT FOR ARD ENT SPIR
ITS FOR
STAT E
o~•
PER SON AL USE
VIRG INIA,
COUN 'l'Y OF- - - - --'-- -'--'==
.:.---r" v,_'
-_
I, - - -~~ -~- -~-+ ~ - -- - - - - -, being duly sworn , t.lepos
e and say that I am
the consi gnee of a certa in s hipm ent of
arden t_spirit :;, a:; specif ied on oth er side
of this form , this day
deliv ered tome by the South ern Expre ss
Comp any, from _ _ _ _ _ __ ___ ___
__ ; that I am not a
stude nt or mino r, and, if a femal e , I am
the head of a famil y; that the arden t spirit
s so r eceiv ed by me
were broug ht into the State on my writt
en order , and that I have not, withi n
the thirty days previ ous
heret o, receiv ed any arden t spirit s of any
kind whats oever , from any perso n or from
any place whats oever , in
exces s of the quan tity allow ed by the provi
sions of the Act of the Gene ral Assem bly
of Virgi nia, appro ved
:\'.[arch 10, 1916, or contr ary to law, and
that the arden t s pirits so receiv ed by me
are for my own use , at
my own home , and th at the sa id arden t
spirit s will not be used in violat ion of law.
S worn to and subsc ribed befor e me ,
-=::---__,,........,__ __~ -~ -~ --
thi s ___ day o ~ - - - -- , 191_
.
J\~t:lllt for Southe r n F.x1n-e~s Comr,:
rny.
- ---1. --::~ -~-fl l
/' I
~vm:,ji=.uee .
�FORM 370•VA
SOUT HERN EXPRE SS COMP ANY
(lnco rporuted)
LiQUO R RECO RD
~ .tf?
Received at._,/"'---=--='-'-'---'c...::c=--='--'-"--'---.,..L-----"----- Date
Consionee
- - -+--<f-- '-'----"--' '--+-"'--" "~~ ~ , c _ -
~ ~ ~-·_
I!
191 _
Affidavit No,, _ __,,-=------'-----
_,_(_ _ _
(;/}_ _~ - -
- - - - -- - --
Way-Bill No ., _ ~ ~ ~ ~--+ --To - - - ---'"'---"-c-'-i---"----'"'--'=-- - - - - - - - -
Advourel!I to
Collect
EXPRESS CHARGE S
COLLECT
Add
Undercha rge
RECOR D OF NOTICE S
To Consigne e ____ ____ ____ ____ __
To Shipper ___ ___ ___ ___ __ _ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(OVER)
;-
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERS ONAL USE
S TA'l'E OE' YIR GINI.} ,
CouNTY
m'_-~l~ l~ -~="" -'...-~' --V-'- -
J,
,
- - - - - -.+-- ---, being duly sworn, depose
and say that I am
the consig11ee of a certain shipm ent of ardent spirits
, as sp cified on other side of tbi s form , this day
deliver ed to me by the Southe rn Expres s Compa ny,
from
V
.. ; {hat I am not a
studen t or minor, and, if a femal e , I am the head
of a famil y ; th at the ardent spirits so r eceive d by
me
were brough t into the State on my written order, and
that I h ave not, wi h in the thirty days previo us
hereto, receive d any ardent spirits of any kind whatso
ever, from any persoi r from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
)farch 10, 1916, or contra ry to law, and that the ardent
spirits so receive d by me· are fo r m y own use , at
my own hom e, and th at the said ardent spirits will
not be used in violati on of law.
~ ,vo rn to and subscr ibed before me ,
this )
~
1
d s y oL~
, 191
<-t,.
U om;i(,!ui:,e.
�~~--~~------------,--r-- --r-- --- ---- --- - ·- - --- --- ------ -----FORM 370•VA
SOUT HERN EXPR ESS COM PANY
( Incorpor ntcd)
SPEC IAL LIQU OR
Consign ee
RECO RD
- - - ---'~--'-o~ ~--'~- -~~ ~-= --~ ----
Kind of Arderit Spi rits- . & ~.,___ _ _
__
---- ----- - - - - -- - --
_ __ Am oun .__ _ _ _ _ _ _ _ _-'-Weioh ~
- ~ - · lbs.
Way-Bill No. -,,-,'-- ----"-/ _,_,' ---To - - ~ ---=c'- "'~--1,. '-'--"~= - ~ - r - ~ , - --
-
.Advnur es to
Collect
PREPAI D
Add
Onrlc r cburgc
RECO RD OF NOTIC ES
To Consignee _ _ _ _ _ _ __
_ _ _ _ _ To Shipper_ _ _ _ __ _ _ ___
_ _ _ _ __
AFFID AVIT F'OR ARDE NT SPIRI TS
F'OR PERSO NAL USE.
(OVER)
�..
..,.
,.
AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
STATE Ok' VIRGIN IA,
COU N'l'Y QF _ _ _ _ _---=.-=-:=::..=......,:'--'l.,.
r,
- - - ---~~----"-,,
, being duly s woru, t.lepose and say that I am
the cousigu ee of a certa i u s hipm ent o( art.leut spirits,
as s pecifi ed on otl\er s id e of thi s form , this day
delivere d to me by the Southe rn Expres s Compan y, from
_ _ _ _ _ _ _ _ _ _ _ _ _~ ; that I a m not a
student or minor, and, if a femal e , I am the head of a
fami ly; that the ardent s pirits so r eceived by me
were brough t into the State on my written order, and
that I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any pl ace whatso ever, in
excess of the quantit y allowed by the provisio ns of the
Act of the Genera l Assemb ly of Virgini a, approv ed
1farch 10, 1916, or contrar y to law, and that the ardent
spiri ts so receive d by m e a re for my own u se, at
my own home, and th at the s aid ardent spi rits will not
be n sed in violatio n of la,c
:-i worn to and subscri bed before m e,
thi s ___ day of1___ _:::=-'- -, 191_
.
.,\~e 11t for Southern Bx1wo!-;s Company .
�/ 1_
[_ !.
��FORM 370•VA
SOUTH ERN EXPRE SS COMP ANY
( Inco
rporated}
LIQUO R
-1,<~:.....::.~-'--'--"'----.'...=.!:...._._;c...,,c...__~ - Date, _ _
RECO RD
4-/_ _ _ _
l 91_.l_
L_----"= --lbs.
4..
Advnures to
Collec,
RECOR D OF NOTICE S
To Consignee ___ ___ __
___ __ To Shipper _ _ _ _ ___ _ ___ _ _
_ _ __ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE .
(OVIIR)
�AFF DAVIT FOR ARDENT SPIRITS FOR
PERSON AL USE
1,
J
/
, being duly sworn, depose and say that I am
the consignee__of a certaiu shipm nt of ardent spirits, a:s? s ,ecified on other si
of this form, this day
'
{
J ;
delivered to me by the Southern Express Company, from
(
~ (,j _
t that, I am not a
student or minor, and, if a female , I am the head of a fami ly; that the ara J nt
spirits so received by me
were brought into t he State on my written order, and that I have no , wi~in
the thirty days previous
hereto,.received any ardent spirits of any k ind whatsoeve r, from any person efr from
any place whatsoeve r, in
excess of t he quant ity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
~farch 10, 1916, or contrary to law, and that t he ardent spirits so received by me
are for my own use, at
my own home, and th at the said ardent spirits will not be n sed in violation of law.
!::i worn to and subscri ed before m e,
j c;
thi s +
day of '
I
,
, 191_ .
0
I
.,\~fj1 1t f'1,r ~outher11 F.x 1n·e:-;s Cornvan.r.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Inco rporate d)
___
J,o
Affidavit No. ___
Consign ee - -
-
-VCLL--'--~~L__--,"=-+"¥"""-""--' '-='77'~---L_------.---
Kind of Ard ent Spirits _ __ _~~~~-~~-4- -- -Amount._
/_~(S). . .___~-+I-----
4
Advnu,es to
Collec t
RECORD OF NOTICES
To Consignee ____________ _ __
_
To Shipper_
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVl<R)
- -- - -- --
lbs.
�A F- DAVIT FOR ARDENT SPIRITS FOR
STATE
PERSONAL
us ~ -
o~· Yrn
COUNTY O~'-il_~'.':.!,~:Z,~ ~ ~ ~ /
_ _..=L-J...Jc+;.-i----,1e>;a""°',.._.t-L = " + - ' - - - - - , being duly sworn, depose and say th at I am
as specified on other side of thi s form , this day
delivered to me by the Southern Express Jiompany, from _ _ __ _ __ ~ - - - - - - i that I am not a
student or m inor, and, if a femal e , I a!rl1the head of a family; th at the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thi1·ty days previous
hereto, received any ardent spirits of any kind what soever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
)farch 10, 1916, or contrary to law, and that t he ardent s pirits so received by me are for m y own use, at
my own home, and that the said a rdent spirits will not be used in violatiop of law .
~A,v(,,_
Swo rn to and subscribed before me,
th
isl L/-day of
~
1r~
1/
, 191}
,
' ,~ .. , '•" S ......... ~ ~OmM.. >
------;;;;::-
�-- -- -- -- -- --- -- -------- -- -- -FORM 370• VA
---~
SOU THE RN EXP RES S
CO MP ANY
( Incor
porat ed)
Received-at
Consignee
/{;J ~ -..-,--•"
LIQ UO R
REC OR D
Date
'/.r
191-lAmoun
Way-Bill No'- '--' --~ -~ ~ -To
I
- -~ ~~ ~~ ~-_!~ ~- -__
:__
Advau r-ea to
Colle ct
/
Affidavit No
/I
191_'_
From
(£_
PRE P A ID
Weich
2....J
J
lbs.
~d
Unde r charg e
REC ORD O f' N OTI CES
To Consio nee __ __ __ __
__ __ __ ___
To Ship per_ _ _ _ __ __
___ _ _ _ _ __ _
Af'f' IDA VIT f'OR ARD ENT
SPIR ITS f'OR PER SON
AL USE .
(OVE R)
�AFFIDA V-I T FOR ARDENT SPIRITS FOR
PERSON AL USE
S T A TE OE' V IRGINIA,
C OU NTY Ob'----'--- ----'--=-= =-..:-=__..=-
l , - - - - -- ----'-- ------- '------ ---, being duly sworn, depose and
say that I am
the consignee of a certain shipment of a rdent tip irits, a~ s ~ecified on other side
of th is form , this day
delivered to me by the Southern Express Company, from
./
'
; t hat I a m not a
titudent or minor, and, if a fe male , I am the head of a fami ly ; that the ard ent spi
r its so r eceived by me
were brought into the State-on my written order, and th at I have not, within
the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoeve r, fro m any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of th e Gen eral Assembly
of Virginia, approved
)farch 10, 1916, or cont rary to law, and that the ardent spirits so r eceived by me
are fo r m y own use, at
my own hom e, and th at th e said ardent spirits will not be used in violat ion oflaw.
ld:vi
:::i worn to and subscribed befor e m e,
th is __l.,_day of
, 101--J-.
dt Cv
a:Az
t·
�~--~-~--------- ---------~-------- -~--SOUTHERN EXPRESS COMPANY
FORM 370•VA
(l uco r p o ru t ed}
SPECIAL LIQUOR
Received at-l.---1--=-=-'--'-'-_:_=--==c::_____ _L--_ _ _ Date \
RECORD
¥-.,
)_-
1
1
?
I
191 _2
Affidavit No.
)/
J---
Consionee - - - -- +'----=c==-=---"-=c::----- - - ---+f- - --=-' --.- -- - -- - - -- -
. -
,rJ j
•-
Kind of Ardent Spirits - -- - ~- -- -=---='-=-cc-- -- -Amoun - - ~ - -- - -- - Way-Bill No.~_-'--'~-~ - - -Date - - ~ ~ ~ r,--+--__,(~
~r_ _ TQ 1_1_
I
To
-~,,_- -c--- - ~ ~ -----;r------@
=-
Shipper _ _
-=---=--'--=-4-='---"--"'---
Advnuces to
Collect
~ ~I - - lbs.
From_--+t_,1bo---'----'-'-----'-I--L,('h--t~
~•~
EXPRESS CHARGES
PREPAID
_,._-__.__,--,-c.,~ - - - - '
RECORD Or NOTICES
To Consign ee _____________~ - - - - To Shipp er _ ___________ __ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�F"F"I DAVI T F"OR ARD ENT SPI
RITS F"OR
PER SON AL U S I;.
- - ~+- ~-~- -~ ~-- ~-- ---- ~ - -, being duly swor n, depose and say
that I am
a certa in shipme 1t ·of nrdeu t spirit
s, a:; speci
fied on oth er side of t his fo1·m , this
day
1
deliv ered to me by the South ern Expr
ess Comp any, _from
{
f
;
th at I a m not a
stude nt or mino r, and, if a fema le , I
am the head of a famil y ; t hat tlie arden
spiri ts so recei ved by me
were broug ht into the State on my writt
en order , and that I have not, with ~
th e thi~·ty days p revio us
heret o, recei ved any ardent spiri ts of any
kind what soeve r, from any perso n ori''l'o
m any place what soeve r, in
exces s of t he quan t ity allow ed by the
provi sions of the Act of the Gene ral Asse
mbly of Virg inia, appro ved
?lfarch 10, 1916, or cont rary to law,
and t hat t he arden t spiri ts so r eceiv ed
by me are for my own use, at
my own home , and th at the said ard ent
spiri ts will not be nsed in violat ion of
law.
f
~wor n to and subsc ribed befor e me,
.Uv usi ~uee.
,
t h i~_j __dR.y of_ _ _ _ _ , 191_
'
,
_;\:.!~ li t fo r S 1111 tli e n1
Expl'e ss Co ml):Ul Y,
�FORM 370•V A.
SOUTH ERN EXPRE SS COMPA NY
( Inco rporated)
SPECIA L LIQUO R
Rece ived at -"---'--'--'-=__,,_.'---=--'---"-"-"CO..-,, .
•1
Consignee
,71
Kind of Ard ent Spirits. _ _ _ _.c...::c._
Way-Bill
To
NnY / V
tZ3'.
S'
.-'---,F---JL -~ - Date
RECOR D
I J-J / I.
..,__ _ _ __ _ __ _ __ {~ - - -- - - - - - - -- - __
__:_---i .~--- - - Am oun c__ _. !j'---J.
-'-'-__;. '----Weigh c_.-...___ lbs.
---F----"'---"'-=-'.,__ _::...__t __
Advnncea t o
Coll ect
J91 _
1
from -L/....:l:_'~
O__,
'--L=---,-=-_., .,c_. ....:te0c_--=--
EXPRESS CHARGES
l'UEPAID .
Add
_,
Undercharg e
RECORD OF NOTICE S
To Consignee _ _ _ _ _ _ __ __ __ _ _ __ _
To Shipper _ _ _ _ __ __ _ _ _ _ __ _ _ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL USE .
(OVllR )
�V1T FOP ARD ENT SPIR ITS FOR
j
,·
PERS ONA L USE
f (';I, - -= ~-"-+--"'---'"""'"""=,._-+----'' - - - - - - - - , being duly sworn , depos e and
say that I am
the consig nee of
arden t spirits , as : ecified l ;~o-ther side of
this form, this day
delive red tome by the South ern Expre ss Comp
any, from ~
--~
t,.
•
that I am not a
stude nt or minor , and, if a femal e, I am the
head of a family ; that the artlen t spirit s so
receiv ed by me
were broug ht into the Siate on my writte n
order, and that I have n t, V11ithin the thirty
days previo us
hereto , receiv ed any arden1; spirit s of any kind
whats oever , from any perso n r from any place
whalisoever, in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgin
ia, appro ved
March 10, 1916, or contra ry to law, and 1;hat
the arden t spirii s so receiv ed by me are for
my own use, at
my own home , and that the said arden t spirit
s will not be used in violat ion of law.
Con.ai2nee.
A1:ent for Southe rn Expres s Compa ny.
�F'OIIM 370-V A.
Revise d -J une, 1918-
SOU THE RN EXP RES S COM PAN Y
( I ncorpor
ated)
P. 0. Address
RECO RD OF NOTIC ES
To Consignee
To Shipper
(OVJ:B.
.
�.
STATE
o~ v iiwrnt+,
,
COUNTY OF
,,
,,.
;'
r. _t d(.' &. {,. ~ ' (~,~
·1}
{J.. 1...J..+ v .;),:.._
,
I,
-,,
f"-·~
being duly sworn, depo~e and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
--"J
!•
/i
/ t) "'el. .e,., to.. .&'?.
delivered to me by the Southern Express Company, from
~ h, !{ that I am not
a student or minor, and, if a female, I am the head of a fakily; that the ardent spin'\s so.received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
'
Q,
{ :'lt'~~ 4,
by me (or
J
•
.
(,-•.,t ~ - )-..
purposes at my own home, and in con-
(State wether for Scientific~SaeramenJi, Medicinal or Mechanical)
formity with law.
'
Itn.
Con sicn le.
Sworn to and subscribed before me,
this4
day of
cc-:f-.. ' 191ff.
<' ~t-; kf .
J
Aeent for Southern Express Conu,aey.
�J
7
•, . . 7
ALDHIZER & SON
THE DOWN-TO-DATE DRUGGISTS
BROADWAY, VIRGINIA
Office Address _
Retistry No. ___ .
t;-:_. __7-
'
�...
�F'ORM 370-VA .
Revised June, 1917
SOUT HERN EXPR ESS COM PANY
l 14 7
Advances to
Collect
COLL"ECT
lJuderc harge
To Shipper _ __ _ _ _ _ _ _ _ _ _ _ _ __
(ov1rn)
�COUNTY
1, -~-'!!!:__~ ~~~~J __!___~L~ ~~~ ~ ~ ~~~f. being
duly sworn, depose and say that I am
irits, as specified on other side of this form, thi s day
the consignee of
delivered to me by the Southern Ezpress Company, from
· ~ /~ " '
; that I am not
a student or minor, and, if a female , I am the head of a family; that thii~rdent
spirits so received by m e
were brought into th e S tate on my written order, and that I h ave no( within
the thirty days previous
hereto, rEceived any ardent spirits of any kind wh at soever, from any person or
from any place what soever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia ,
approved March -10, 1916, or contrary to ..J.aw, and th at the ardent spirits so r eceived
by me are to be used
by me for- - ~- - - - - - ~ - ~ - - ~~ ~ - - - - - -- - Purposes .
(S tate whether fo r S cientific ,
S acramenta l, ~ edicinal or Mecha nical)
Co ns i2nee .
911-9
7
Agen t for South ern Ex i,ress Company.
�G. S.
H . H.ALDHIZ ER.,PH. G .
ALDHIZER
ALD HIZE H & SON
THE-DOW N-TO-DA TE-DRUG GISTS
Tlte
3l~ 2t Store
BROAD" WAY, VA.
March lst-191 7.
St ate of Virgin ia, County of Roeking hamt o-wit:
I, J . J. Pennyb acker, a notary pu blic in and f or the county
of Rockingham,in the State of Virgin ia, do certify that H. H. A ldhize r of
of the firm of AAdhiz er & Son,did this day person ally app ear before me and
make affida vit that they had 191 Fluidou nces of Alcoho l o n hand on Feb. l at
1917 and that they receive d during Februa ry 1917 , 608 Fluidou nces of Alcoho l
and that they used during Februa r y 267 Fl uidoun ces of Alcoho l ,leavin g 532
F1uidou nces of ilcoho l on hand March lst - 1917 .
My commiss ion expires Nov. 28th• l920 .
Given unde r my hand, this ls
\
•
•
�,.
•
.
•
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 02
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Broadway in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
broadway
virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
1918
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box10-038
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Broadway, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/10db995b31212efc98d080570b8e6553.pdf
0f11a36bb8d59e04173488a512724e46
PDF Text
Text
DELIVERY FOR M
6 1
ADAMS
EXPRESS
To Consignee _ _ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR
COMPANY '
To Shipper _ _ __ _ _ __ __ _ _ _ __
DRUGGIST AND HOTEL MANAGER
?·.!,.:J'
::
.....,...
.I ...
�---- ------ --- ---- - --- -- ---- --- .-- --- --- -- --- -----AFFID AVIT FOR DRUG GIST AND HOTE L
MANA GER
'-.
--,..--""-'-l'-"",._.....,.,£.-...,_--'-'i.,.J'- "'4~i. ,,,ll~l ,q-.--- • being duly sworn,
depose , and say that I
_ . . . _-:--"-....,"'-':;;;1-, ~..,_.,,,_e,e_; that I
am
am the consig nee of a certain shipm ent of rdent
/
of this form, this day receiv ed by me t
~
Virgin ia, throug h the Adams E xpress Compa ny, fro
( , _ _,-- ,..
~
•the brandy :
whiskey, wine or beer, pure fruit or grain or ethyl alcoho
inclu
in
the
said
shipm
ent
is
to be sold,
dispen sed or used by me accord ing to the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed March 10, 1916.
Sworn to and subscr ibed ~efore me,
this -/-ff-d ay of
·-,;;,.
I. ~ , 191-zr,.
-f- 1/:
i (
,r b~~-,_
r Adams Express Compan y.
Consign ee.
�DELIVERY FORM 60
ADAMS EXPRESS
COMPAN Y
AFFIDAV IT FOR ARDENT SPIRITS~ OR PERSON AL
USE.
-.
.
(pVER )
�.,.
FOR PERSONAL USE
I, ---r.,"---- ----------::r-"-- -- - - - - , being duly sworn, epose and say that I am
ee of n certain shi~ nt of ardent spirits, as spe<tffi)ld_..o~ ~ ~ · of this form, this day
the con
~- - - - - r ' - - - - - - - ; that I am not a
delivered to me by the Adams Express Company, from_
student or minor, and, if a f emale, I am the head of a family ; that e ardent spirits so received t .:.,,me
were brought into the State on my writt en order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev'er, from any person or from any place whatsoever, in excess of t he quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to Jaw, and that the ·ardent spirits so received by me are for
my own use, at my own home,- ar_id that the said arde~spirits will not be used in violation of law.
. '), 11,~ ~
'
Sworn to and s u ~ e f o r e me,
t hi~Lday of .
rf7
, 191 "
.._____. .:. . ::..-~----------='-------,.
Consignee.
�DEL I VERY FORM 60
EXPRESS
COMPANY
Received_ -.H-- -,,~h,..._-----:A-----l-- ~~'-- 'r'Y'...,-#-- +_,,,__ _
1912
.
.. :...
.1
Affidavit-- ~-~'.: ~ ,
Add
Undercharge ,
To Shippe r
AFFIDAVl"l'. FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
'.
�ARDENT SPIRITS FOR PERSON AL USE
,__
, ,,,,,,_..,...
x··
_ _.,~ - - - - -- ~ - - - - - ~ - - - - - - , being duly sw rn, depose and say
that I am
ardent spirits, as s
ifi d o ~her side_f ~"?rm , this day
delivered to me by the Adams Express Company, fr._, ,._~--"" ------ -~;7h
at I am not a
student or minor, and, if a female, I am the head of a family; at the ardent spirits
so received oy _
,_
were brought into the State on my written order, and that ave not, within the
thirty days prevfous
hereto, received any ardent spirits of any kind whatsoev er, from any person or from
any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10, 1916, ·or contrary to law, _a,nd that the arden spirits so received
bY,-me are for
my own use, at my own home, and that the id
ill not )1e usea.in
ion of law.
Jf1.JPJ-spi ·
,
-✓ y,r.., .,,.
....
Sworn to and s u b s ~ o r e me,
thisad ay of
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�------ --ADAMS EXPRESS COMPANY
DELIVERY FORM 60
Received~ ~ .,}
Consignee ____
_____c_~~~;;:_:~~;..:.:';a.?iar.-~~- -----:,7,1Sl/ C-- -----;-- Adv3ncee to
Collect
:!
To Consignee ________ ______-.~. -12.. Shipper ________ _______ _
AF.f!q~VIT FOR ARl)ENT. S ~ IRITS FOR PERSONAL USE:
..---- --
•_..,,-.
- -... ,
I.
_,,,., ... .___
-,;.'"-
(OVER}
"'"'.
�AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE
I, - - - -- - - - -- - - - - - - - - - - , being duly sworn, depose and
say that I am
the_.c onsignee of a certain shipment of ardent spirits, as ~e.c ~
other side of this form,, this day
delivered to me by the Adams Express Company, from______
r v -_ · _- _ _ _ _ _ _ ;that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits
so r eceive(i_.iy me
were brought into the State on my written or,der, apd that I have not, within t he
thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person or from
any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10, 1916, or contrary to law, and that the ar;~ir its so. received
by me are for
my own use, at my own home, and that the said a ~ ; ~ ~ t i
o n of law.
Consignee.
gent for Adams Express Company.
�DEL~V~RY FORM 60
Affidavit No.
_J-:-{,
191 ,
Advances to
Collect
EXPRESS CHARGES
To Consignee __________ ______ _ To Shipper ______ _______ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS fOR PERSONAL USE.
- ----------...__
(_OVER )
�SwoJ
thi,1 .
'
and sub~d-hi,o.re ml-,
.,
day o f ~ l 9 1 "
[ ~
-·, r··n.J.--<t.-V
r Ada m s Expre ss Company.
.
,
�DELtVi=:RY FORM 60
ADAMS EXPRESS COMPANY
Affidavit
No,£,_J_
P REPAID
To S hipper
AFFIDAVIT FOR ARO.ENT SPIRIT$ f:,OR PERSONAL USE.
tyA4
___
( OVER )
;;;:...,,,._
-~--~-------------~---~.- -
�r
~ FFIDAVIT
y
STATE OF VrR ~
•
·., ·
, •
(,, • • .,../'r ,.. ·""' ,.
Cot.Jh"TY OF
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R .,fRDEN?
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SPIRITS FOR PERSONAL USE
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, being duly sworn, depose an~ay_ that I am
the consigni;{of a certain shipment of ardent spirits, as st>'fie~ on;t~~~ s'ide ~f t91~, this day
f
-delivered to me by the Adams Express Company, from ' ,,. ,,·. · '
'·
.. ' · ; that am not a
studen t or minor, and, if a female, I am the head of a family; that tpe ardent spirits so received by me
were brought into the State on my written order, and that I have'not, within the thirty days Pv vious
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatso.ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to .Jaw, and that the ardent spirits so received by me are for
my own us.e, at my own home, and that the said ;:;.;;;;;iri/111 3 ~ ~
;ion of law.
v
Consignee.
�DEL I VERY F O R M
60
ADAMS EXPRESS
COMP ANY
Received-- '-=:....it--:----.F --,.,...-- ---- -1'.Consignee ---=C,1-......_--'-...:_---'----"----- "---- - - --a=:o____.c.__ _.::== - - -~ ~~-b,-- - - - - ---
COLLECT
A dd
U ndercharge
To Consignee _ _____ ______ ______ T o S hippe r _ _ _ _ _ __ _ _ _ _ __
__
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVEK )
�FOR PERSONAL USE
STATE OF VIR
COUNTY gf•r·"'•-+.-----...,,...~--"'T
• • .
I .
I, · r ·"' •
, being duly sworn,
t he consignee of n certain shipment of ardent spirits, as sp
·)fflw'&;?tt~l'-1delivered to me by the Adams Express Company, fro '
tthat I am not a
student or minor, and, if a female, I am the head of a family; that e ardent spirits so recei-, A by me
were brought into t he State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to .Jaw, and that the ardent spirits so received by me are for
my own use, at my own home, and that the sai1 aro/nt s pirits willf;pt ~e(;
u;i,i \1:!-,violation of law.
.
.
(; L /
i.
(p , / ((_J.)LL.
✓L
Consignee.
Sworn to and subscribed Jfore me,
tbis ~day of
:t
~ ..,,,,,.. , 191~
......
�'
DEL t V E RY FORM 60
ADAMS
EXPRESS
COMPANY
To Consignee _ _ _ __________ __ _ _ To Shipper
AFFIDAVIT FOR- _ARDENT SPIRITS FOR PERSONAL USE .
(OVEI< )
,,. .
�,
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I
V ~.1/.%--:
STATE OF
~- - -"'- - - - - - - COUNTY OF--,
,_;-
·
1
. say that I am
l'-f.>:-Y,, I , being duly sworn; depose~
•
· • m, this day
the consignee of a certain shipment of ardent sp · ts, a ~ stfi.w:l,.~ o~ ei;i_id~ o
1,
'
-~-;•/.J~
; that I am not a
,t".
delivered to me by the Adams Express Compa y, fro
me
student or minor, and, if a female, I am the head of a family; thl],t the ardent spirits so received
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and th the ardent spirits so received by me are for
ts irLts wfil 'not be use ·n violation of law.
my own use, at my own home, and that the said
./
-·
�D EL I V E R Y FO R M
60
A DAMS
- - --
EXPRESS
COMP ANY
-,;,.__ __..,__.Amou nt~-----'-,---
- - - -',IF-- -- - - -191~
r=r'1' /11'",
-l.l)Lai~ l j - ~bs.
r
EXPRESS CHARGES
To S hi pp er
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( O VER )
.~
I •
t~
�FOR PERSONAL USE
Consignee.
�DE L DV ERY FO RM 60
ADAMS
Received, ____,,,,..,_--,;---'-=---.;Z'-,...____,-
EXPRES S
COMP ANY
.,.,..__
Consign ee _ _.__."---- ---"--- ---7"._,..--; . ~-
RECORD OF NOTICE S
To Consign ee
To Shipper _ _ _ _----'-- ----- - - -- AFFIDAV IT FOR ARDENT SPIRITS
(OVER}
�V
6
AFFIDAVIT,Of\ ARDENT llRITS FOR PERSONAL USE
STATE OF
COUNTY OF
~ (.!.., , ,_Vl-t!t✓
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✓~ .., •
:. ,·
;,,, \ ('
......,.1,1.
I,
;r \ '
.. ·
, being duly sworn, ~pose and say that I am
the consignee of a certain shipment of ardent spirits, as s
· d p otlieJ:i side of t hisrc~ rz_p. ••thjs day
., • ,, ,
~ ~?'
delivered to me by the Adams Express Company, from..
•
• ;~that 1~ m not a
student or minor , and, if a female, I am the head of a family; tha tt.lie ardent spirits so received by,J')e
were brought into the State on my w ritten order, and that I have not, within the thir ty days previous
hereto, received any ardent spirits of any k ind whatsoever, from any person or from any place whatsoever , in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved Mar ch 10, 1916, or contrary to law, a nd that the ardent spirits so r eceived by me are fo r
my own use, at my own home, and that the said ardent spiri~ wtll not ~b'rf1s!\d in violation of law.
I'
.:::.:
7('. e~~
Consignee.
Sworn to _and subsc ibed t/fore me,
4 _..i_
~his,-'day of
.1£~;it.-r,. '-·-191.....l..
-..,.
A g en t f or Adams Express Company.
.
~-
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DEL fV E R Y FORM 60
ADAMS EXPRESS COMP ANY
Affidavit No.
5-J
•
To Consignee_ _ _ __ ___ _________
ro
Shipper
1__
AFFIDAVIT
FOR ARDENT SPIRITS FOll PERSONAL USE.
-- ( OVER. )
(
y
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
\
Consignee.
Sworn to and subscribed before me,
thh, _ _ _ day o _ _ _ _ __, 191_.
Age nt for Ada'ms Expres s Company.
�DEL I VER Y
RECORD
F OR M
60
ADAMS EXPRESS COMP ANY
T o S hipper _ _ _ _ _ _ _ _ _ _ __ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
JFIE,j~....,.'H,-----,,-..--t~ll~~'7.h-;. ,.....;:.=,::.,,---, being duly sworn, depose and say, that I am
t' spirits, as speci ed on otrr side of this form, this day
' ~at I am not a
delivered to me by t he Adams Express Company, from
student or minor, and, if a female, I am the h ead of afam ; that e ardeptspirits so\.eceived. by me
were brought into the State on my written order, a1,d that I h a not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any p erson or from any place wha oever, in excess of the quantity allowed by t he provisions of the Act of the General Assembly ofVirgi.. a,
approved March 10, 1916, or contrary t o law, and that the ardent spirits so received by me are for
oy own use, at my own home, and that the saip ardent spirits will not be used in violation of law.
9f#~'I. CJ , ~ &,v6
'
Sworn to and subscribed before me,
this--l--day of ~
1--'
1
,
, , 191--t.
• r~
.f'A.gentJr
.
Adams Expr;,;~vany.
c1,.i{
~
.,~ee.
�DEL ~VER'Y
FORM 60,
ADAMS
EXPRESS
COMPANY
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�....
Sworn to and s ubscribed b efore me,
...
.,
1
/
II
�I
DEL ~VE;RY FORM 60
,
ADAMS EXPRESS COMP ANY
...,,......, --✓·~ , -.,.
Received_ '-~-"'- -c+-- ----,-,---- - - - ---Consi·g nee _ ----',- - - - - ,
P REPAID
I
To Shipper _ _ _ __ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR
(OVEll.)
�Sworn to and subscribed 1'efore me,
l ':i
f_.'j .i
thig_L_+--day of /
~
\L
, , 1917T.
/'
/
----...
Consignee.
�CORRESPONDEN CE FORM NO. 1
ADAM S EXPRE SS COMP ANY
~tt. ...........~ ....... .....
191,
···········--A ~-·······--··-·-·
/P"~- -
�,•
.,
A
�-------- -------- ---~ ---~----~-----------~-~
COMP ANY
SOUTH ERN EXPRE SS
O
F'0RM 370-VA .
R evised June. 1918
~
( hlcorporaM
,
,;_; .,., . -.
· - ·- ~- ~+-,.-•~ '~ ~ - --- - -'----,; '------~ --Ouantity _ ~
¥
: ...
#
191.+ ,
Ad-.ance • to
Collect
RECORD OF' NOTICES
To Consignee
~- - - - - - - - -~ ~ From ,,;._;_· -'-
=IWarT•~L-
'TD'T?~··~f""'T"'
EXPBl!.88 CHARGES
•
To •Shipper
'
~I
Add
�STATE OF VIRGIN IA,
- - , being duly sworn, depo~e _and say that I am
1, - - - - - -- -- - - - - -- - - - - ~
side of this form, this day
, as specifi ed on other
the consig nee of a certain shipme nt of ardent spirits
from _ _ _ _ _ _ __ _ _ _ _ _ ; that I am not
deliver ed to me by the Southe rn Expres s Compa ny,
a family ; that the ardent spirits so receive d by me
of
head
a studen t or minor, and, if a female , I am the
us
and that I have not, within the thirty days previo
were brough t into the State on my written order,
whatso place
any
from
or
person
any
from
ever,
whatso
hereto , receive d any ardent spirits of any kind
ons of the Act of the Genera l Assem bly of Virgin ia,
ever, in excess of the quanti ty allowe d by the provisi
the ardent spirits so receive d by me are to be used
that
and
approv ed March 19, 1918, or contrar y to law,
___ __ purpos es at my own home, and in conby me for ___ ___ ___ __ ___ ___ ___
or Mechan ical)
al
(State whether for Scientifi c, Sacrame ntal, Medicin
formit y with law.
0ons iguee.
Sworn to and subscr ibed before me,
-----
this ___ day of _ __.__ _ , 191- .
Aee11& for Sonther n Express Compap y.
�I
American Railway Exp;ress-:_ c,-
Adams Corresp. Form No. 1.
��
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 03
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Dayton in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
dayton
virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
1918
1919
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box10-039
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Dayton, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/e8641ca47ab7f44f3f2bf2c6c56cd133.pdf
6dccbefe8e072d845df4082173e28825
PDF Text
Text
---~-- --- --~--- -~ -~ --~ ~~- --- ---~-~--- --- --- --- -
RECO RD Of" NOTIC ES
To Consign ee ___ _ _ ______ ___ ___
__
To Shipper _ ___ ___ _ _ _ __ _ __
_ _
Af"f"ID AVIT f"OR ARDE NT SPIRI TS
f"OR PERSO NAL USE.
(ov,rn )
�SPIRITS FOR
PERSONAL USE
STATE OF VI
COUNTY OF_ _~<.~
- - --,,--- --
i, ---,,----- -- -- - - - ---~~~ ---, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this forn,, this day
delivered to me by the Southern Express Company, from _ _ _ _ _ _ _ _ _ _ _ _ _ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of a.ny kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own homn, ~d lhot lhn Mid rucdnnt opi<its wi!J?
n usn i f' '?•tion nf low. .
. /
Consiauee.
Swor to and subscribed before me,
I
M u ~·
/
A2ent for Southern Exvres s Company.
�FORM 370•VA
SOUT HER N EXPR ESS COM PANY
(lncorpo rl!ted)
'
,·
Shipper
//
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(
i
/.., /,,,,
EXPRE SS CHARG ES
PREPA ID
Add
Unde rcharge
,..I
RECO RD OF" NOTIC ES
To Consignee _ _ _ _ _ _ _ __ _ _ _ __
_ __
To Shipper _ ___ ___ _ __ _ _ __ __
__
AF"F"I DAVIT F"OR ARDE NT SPIRI TS
F"OR PERS ONAL USE .
(OVER)
�AFFIDAVI T FOR ARDENT SPIRITS FOR
PERSONA L USE
STATE OF VIRGINIA,
COUNTY OF _ _ __ _
:...=____.:::_....:__-'-'c.......:...
i, ------ -- - -- ----- ----- -, being duly sworn, depose and say 1ihat I am
the consignee of a certain shipment of ardent spirits, as specified on other, side of 1ihis form,
1ihis day
delivered to me by 1ihe Southern Express Company, from _____ _________ ; that
I am no1i a
student or minor, and, if a femal e , I am the head of a family; that the ardent spirits so received
by me
were brought into \he State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of ihe Act of 1ihe General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that ihe ardent spiriis so rec eived by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
Sworn io and subscri,bed before m e ,
this ___day oL--. - -- - , 191 _
All8nt fo r Southern Express Company.
Consicnee.
�.
~ ,J -V.,.!' _
.,,,,,.
Affi davit No. ,..-· _.
RECORD OF NOTICES
To Consign ee ____ __ __ ___________
To Sh ipp er_ _ _ _ __ __ ._ _ _ _ _ _ __
AFFIDAVIT FOR DRUGGISTS AND HOTEL MANAGERS
(OVER)
�AFFIDAVIT FOR DRUGG ISTS AND HOTEL MANAGERS
that I am the consignee of a
rtain shipmeni '?f ardent
I
I
spirits, specified on other side of ihis form, this day received by me at - - - ' - - - - - ~ - - - - Virginia, ihrough ihe Souihem Express Company, fro,....._ _ _ __ _ _ _ _---'----"--.Ji that the brandy,
whiskey, wine or beer, pure fruit or grain or ethyl alcohol included in ihe said shipmeni is to be sold,
dispensed or used by me according to the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916.
Swom io and subscribed before me,
Aiient for Southern Express Company,
Consi111ee.
�•
Affidavit No
Add
Unde rcha rge
RECORD OF" NOTICES
To Consignee
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
.
(OV ER)
. :...'
�•
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE OF VIRGINI A,
_____!'. .:.!._~~~ c--i, ---- --- - - - ----- ---- - --, being duly sworn,
the consign
COUNTY OF _
_ __
depose and say that I am
ee of a certain shipmen t of ardent spi;its , as specified on other
side of this form, this day
delivere d to me by the Souther n Express Compan y, from
✓
; that I am not a
student or minor, and, if a femal e, I am the head of a family;
that the ard ent spirits so received by m e
were brought into the State on my written order, and that I
have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from an y place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the Gener al Assembl y of V irginia , approve d
March 10, 1916, or contrary to law, and that the ard ent spiri\s
so r eceived by me are for my own use, at
my own hom e , and that th e said ardent spirits will not be used
in violation of law.
Sworn C and subscrib ed before me,
z .
this ___day o
Consi,:nee.
- - -- , 191 _
'
Aeenti for Southern Express Compauy.
�SOUTHERN EXPRESS COMPANY
(Incor porated )
RECORD OF NOTICES
To Consionee _ _______ _______ __
To Shipper ____ ____ ________ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVE R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _ _
_ _ _ ~_
_:___
_E==j";-·
i, -------- ------- -------,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from ________ ____ __ ; that I am not a
student or minor, and, if a femal e, I am the head of a family; that the ard ent spirits so received by m e
were brought into the State. on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from a ny place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw, and that the ardent spiriis so rec eived by m e are for my own use, at
my own ho:.n e , and that the said ardent spirits will not be used in violation of law.
Consianee.
Sworn to and subscribed before me, ,
this ___day oL- - - -- , 191 _
Cla. .&••·
Ae-eut for Southern Exvress Comvauy.
�FORM 370•V A
Received at
Advon re a to
Collect
;
'
I
/
EXPRESS CHARGES
Add
Underchar ge
11
RECORD OF NOTICES
To Consign ee ___ _ _ _ __ _______ __
To Shipper _ ________ _________
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFFIDAV IT FOR ARDENT SPIRITS FOR
STATE
m'
PERSON AL USE
VIRGINIA,
COUNTY OF _ _ _ __ __ _ __ _
i, ----- ----- ----- ----- --, being duly sworn, depose and say 1;hat I am
1;he consignee of a certain shipment of ardent spirits, as specified on other side
of this form, 1;his day
delivered tome by the Southern Express Company, from _____ _____ __
__ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by me
,:were brqught into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirit.a so received by me
are for my own use, at
my own home, and that the said ardent spirits will not 1, used in violation of Jaw.
v
Consi1:uee.
Sworn to and subscribed before me,
this _ _day oL-/ - - - - , 191 _
/
Ai:ent for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
(Incor porated)
Arlvau, e e to
Coll ec t
RECORD OF NOTICES
To Consignee _ __ _ _ _ ____ __ _ _ _ __ _
To Shippe r_ _ __ ______ _ __ __ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PE RSONAL USE .
( OVER)
�SPIRITS FOR
PERSONA L USE
---1-+~,.w=---'L..a'-----"'---'"---'~- =-':....i.--'-+ -lc,--'r,.....,,,q~,
-being duly sworn, depose and say that I am
spec"fied on other 11ide
is form, this dsy
delivered to me by the Southern Express Com a y, from
,,,- ......,
'- (4hllt I am not a
student or minor, and, if a femal e , I am the head of a family;
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Asse mbly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirits so rec eived by me are for my
own use, at
my owu hom e, and th at the said ardent spirits will not be used in violation of law.
·
Consii;: nee.
-
.. '"'
A2ent for ·Southern Express Compau y.
�Affidavit No,~ - - -- -
Add
Undercharge
RECORD OF NOTICES
To Consionee _ _______ _______ _ __
To Shipper _ _ __ _ ___ ___ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OV KR)
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR
STA TE OF VIRG INIA ,
COU NTY OF _ _ __ _ __
_ _ __
PER SON AL USE
._
i, -- -- -- - - - -- -- -- --- --- ,
the cons igne e of a cert ain ship
bein g duly swo rn, depo se and
say that I am
men t of arde nt spiri ts, as spec
ified on othe r side of this form
, this d ay
deliv ered tom e by the Sou ther
n Exp ress Com pany , from _ _
_
_
_
_
_ _ _ _ _ _ _ ; that I am not
stud ent or mino r, and, if a fema
a
le, I am the head of a fami ly;
that the arde nt spir its so rece
were brou ght into the Stat e on
ived by m e
my writ ten orde r, and that I
have
not, with in the thirt y days prev
here to, rece ived any arde nt spir
ious
its of any kind wha tsoe ver, from
any pers on or from any plac e wha
exce ss of the quan tity allow ed
tsoe ver, in
by the prov ision s of the Act of
the
Gen eral Asse mbly of Virg inia ,
Mar ch 10, 1916 , or cont rary to
appr oved
Jaw, and that the arde nt spir its
so rece ived by me are for my own
my own hom e, and that the said
use, at
arde nt spir its will not be used
in viol ation of law.
Swo rn to and subs crib ed befo re
me ,
- this __ _d ay of.- - --
, 191 .:._
A2en t for South ern Expr ess Comp
auy.
Cous icnee .
�SOUTHERN EXPRESS COMPANY
(Incorporated)
Arld
Uude r c ba r,ie
To Consionee___ _ _ _ __ _ _ _ __ __ __
To Shipper_ _ __ ______ _ _ _ _ _ _ __
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONAL USE .
(OVER )
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
PERS ONAL USE
STATE OF VIRGIN IA,
COUNT Y m• ____ ___ ___ _
~, ___ ___ _ _ _ __ ____ __ _ .:..__ _
_ _ , being duly sworn , depose and say that I
am
the consig nee of a certai n shipm ent of ardent
spirits , as specifi ed on other side of this form,
this day
delive red to me by the Sou them Expre ss Comp
any, from ___ ___ ___ ___ __ ; that
I am not a
studen t or minor , and, if a female , I am the head
of a family ; that the arden t spirits so receiv ed
by m e
were broug ht into the State on my writte n order,
and that I have not, within the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind whatso
ever, from any person or from any place whats oever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law, and that the
arden t spiri1.s so receiv ed by me are for my own
use, at
my own home, and that the said ardent spirits
will not be used in violati on of law .
Sworn to and subscr ibed before me,
this ___day oL. - -- , 191_
Ae-ent for Southe rn Exvres s Comr,ao.r.
Cousii;:nee.
�,,,,...,
,_,__,,.__,__-'--_ __ _ 191- /
Advn.n , ce t o
Coll ect
4"
_,,l,L,..rJ - _ ,__
Affi davit No, _
___::.:__..:cc___
Add..,
PRE PA ID
Und er ch a rge
..,/J- - -
RECORD OF NOTICES
To Consign ee ______ _____ _ _ _ _ __
To Sh ipper _ ______ ______ __ __
AFFIDAVIT FOR ARDENT SP I RITS F OR PERSONAL USE .
(OV ER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINI A,
COUNTY OF _ _ __ _ _ _ _ __ _
~, - - - - - -- - -- - - - -- - -- -- - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, fro
_; that l am not a
student or minor, and, if a femal e, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Asse mbly of Virginia , approved
March 10, 1916, or contrary to law, and that the ardent spirits so rec eived by m e a re for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
this ___day of...
- - --
, 191 _
Consi&:nee.
c ~-
A2ent for Southern Exvress Company.
d-- •
�F"OAM 370-VA
Affidavit No, _
A dvanre e t o
Co ll ect
PREPAID
_.:..::::_-'/'--'!!...-
Add
Underc harge
RECORD OF NOTICES
To Consionee ___ _ _ _ ______ __ _ __
To Shipper _ _ __ ____ ___ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFFIDAVI T FOR ARQENT SPIRITS FOR
7
A
PERSONA L USE
I
~,
,
, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as sp c~fied on other side ,o this form,
this day
delivered to me by the Southern Express Company, from
I
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever
, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
Sworn to and subscribed before me,
tbis...---da y oL _ _ _ _ , 191 _
Consie-uee.
7
Aeent for Southern Exvress Comvauy.
�SOUTH ERN EXPRES S .COMPA NY
FORM 370•VA
(Incorpora ted)
Affidavit No.
Advan re s to
Collect
PR E PAID
I
Add
COLLECT
Uudercharge
RECORD OF NOTICES
To Consign ee _ ____ ____ ____ _____
To Ship per _ ____ ___ __ _ _ _ _ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE .
( OVllR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
-,lr!,~Ll::::t,~- - .{.j.L..-~~~~~---,-__:_~~~~'r't1e i g duly sworn, depose and say that I am
s SP,ecified on other ~ e of this form, this day
:/:J, .ff
delivered to me by the Southern Express Company, from
C.. ~
that I am not a
student or minor, and, if a fem ale , I am the head of a family; that the ard ent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by m e a re for my own use, at
my own home, and that th e said ardent spirits will not be used in vi olat ion of law.
f
I
Sworn to and subscribed before me,
day ot
' this
I
j)'
1/
..:l':tk ,
191
I
I
.
,,A
Aaient for Southern E:xvress Compauy.
· Consh:nee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Incorpo rated}
RECORD OF NOTICES
To Consignee ___ _ _ _ _ _ _ _ _ _ _ _ _ __
To Shipper _ ______ ______ _____
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _ _ _ __ __ _ _ _ _
_., - - - - - -- - - - - -- - - - - - - - - - , being duly sworn, depose and say ihat I am
1;he consignee of ~ certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, f r o m - - ~ - - - - - - - - - - ; that I m not a
student or minor, and, if a female, I am the bead of a family; that the ardent spirits so received by--me
were brought into the State on my written order, and that I have not, within the thirty· days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
hi~dayoL - -- - , 191 _
Aeent for Southern Express Compauy.
�FORM 3TO•V A
SOUTHERN EXPRES S COMPANY
(Incorpor ated)
Affidavit No
Advau,ee to
Collect
RECORD OF NOTICES
To Consign ee _ _ _ _ _ _ _ __ _ _ _ _ _ __
PREPAID
To Sh ipper _ _ _ _ _ _ _ _ _ _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( ov1rn)
�AFFIDA VIT FOR Al:JDEN T SPIRIT S FOR
i, - ~ - ~-~'- '-:---,'f--·~~- --=-- ------ --,
of ardent spirits, as
PERSO NAL USE
being duly sworn, depose and say that I am
ified _o n 'other
of this QDII, this day
delivere d to me by the Sout hern Express Compan y, from
~ - that I am n a
student or minor, and, if a female, I am the head of a family;
that the arde t spirits so received by me
were brought into the State on my written order, and that I
h ave not,
in the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of t he Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spiriis
so received by me are for my own use, at
my own home , and that the said ardent spirits will not be used
in violatio n of law .
A2ent for Southern E:xvress Compauy .
�FOAM 370-VA
rniJ-
Affidavit No.
1
-~'(!__ __,.__
' {,/
~
Amount~- - ~ -<-?
Adva n res to
C oll ect
- -¥- ~·,.___""_' .
_ _ _ _ lbs.
j/;1
PREl'A ID
_ __
.A
_·
_\.;Q
Shipper_ ~~ "'- A-
.f
RECORD OF' NOTICE S
To Consignee _ __ __ ___ __ _ __ _ _ _ __
To Shipper ____ ____ __ ___ _ _ ___
AL USE .
AF'F'IDA VIT F'OR ARDENT SPIRITS F'OR PERSON
(OVE R )
•
,
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
.._, ---"----''--'=------~--..---=---'--------- , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirit s, as s~ecified on other i
of this form, this day
delivered to me by the Southern Express Company, from
I
; that I am not a
student or minor, and, if a female, I am the head of a family; t'tiat the ardent spirits so received by me
were brought into the State on my written order, and that I .have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used iu violation of law.
I
( I?
Consif?nee.
Sworn to and subscribed before me,
this __(_day oL-·'V"---"-"-'---
191__:/
I
A&"ent for Southern Exvress Comvany.
�FORM 370-VA
SOUTHERN EXPRESS COMPANY
(lucorpo ratod )
RECORD OF' NOTICES
Shipper_ ________ _________
To Consionee_________ _ ~ - - - - - - - - To
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE .
( OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
~, - - - ~ -- -- -- - - -- - -- -- - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent. spirits, as specified on other side of this form, this day
delivered to me by the Southern E xpress Company, froln:--- - - - -- - - - - - ; that I am not a
student or minor, and, if a femal e, I am the head of a family; that the ardent spirits so received by m e
· were brought into the State on my written order, and that I have not, within th e thirty days previous
h ereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Vi rginia , approved
March 10, 1916, or contrary to law, and that ·t he ardent spirit.a so r eceived by me are fo r my own use, at
my own hom e, and that the said ardent spirits will not be used in violatio n of l aw .
,v,
{_., ,___
Cous i~nee.
A2ent fo~ Sontti~rn Exvress Compau y.
�FORM 370•V A
SOUTHERN EXPRESS COMPANY
( Inco rpo rated )
LIQUOR RECORD
Z ... / 3
191'-
Affidavit No. _ _____,,J"'---
Advonres to
Colle ct
Shipper_ _ __ _ _ _ _ _ __ _ __ __ _ _
RECORD OF NOTICES
To Consianee ________ ______ _ _ __ To Sh ipper________ __ _ __ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVXR )
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
i' --~-#"-~-~ -~~--~ - - ~ - - -- - - , being duly sworn, depose and say ihat I am
as speeified on other side of this form, ihis day
,7
'
delivered to me by the Southern Express Company, from /j
•
; that I am not a
student or minor, and, if a female, I am the head of a family; tb,at the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so rec eived by me are for my own use, at
my owo homo, ,od lh,t Ib o s,;d ""'••I sph;t, wm
~ •d ;, v;o1,1wn of I~
Sworn 1;o and subscribed before me,
'L
-
~
~ , 191 _ ' )
Ae-ent for Southern Exriress Compauy.
~~;&
Consienee.
�FORM 370•VA
P RE PAID
RECORD OF' NOTICES
To Consig nee _ _ _ _ _ _ ____ ____ ___
To Shipper_ _ _ _ _ _ _ _ _ _ _ _ _ _ __
USE . ,
AF'F'IDAV IT F'OR ARDENT SPIRITS F'OR PERSON AL
!
.
( OV ER )
'
�,---
--------------------------~-------------------AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINI A,
COUNTY OF _ _ _ _ _ _ _ _ __ _
,
i, ------- --- ----------- -,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits , as specified on other side of this form, this day
delivered to me by the. Southern Express Company, from _ _ _ _ _ _ _ _ _ _ __ __ ; that I am not a
student or minor, and, if a female , I am the head of a family; thai; the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within th e thirty d ays previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from a n y place whatsoeve1·, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia , approved
March 10, 1916, or contrary to law, and that the ardent spiras so received by me a re for my own use, at
my own home, and that the said a rdent spirits will not b e used in violation of law.
Consh:nee.
Sworn to and subsel'i,bed before m e,
thi s ___day o1- - - -- , 191 _
A1tent for S outhern Exvress Compauy.
�SOUTHERN EXPRESS COMPANY
FORM 370•V A
( Incorporated)
•
Affidavit No.
Jj
j
.
A d van re e t o
Coll ect;
RECORD OF NOTICES
To Consionee _ _ _ _ _ _ _ _ _ _ __ __ __
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OV ER )
�AFFID AVIT FOR ARDE NT SPIRI TS
FOR
PERS ONAL USE
_._, - - - - -- -- - - = - -- - - -- - - -- , being duly sworn, depose and say that I am
the consig nee of a certain shipme nt of ardent spirits
, as specifi ed on other ·s ide of this form, this day
deliver ed to me by the Southe rn Expres s Compa ny,
from
'
• :_
; t a( I am ot a
studen t or minor, and, if a female , I am the head
of a family ; ttiat the ard ent spirit1;1 so receive d by
me
were brough t into the State on my written order, and
that I have not, within the thirty days previo us
hereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and that the ardent
spirits so r eceived by me are for my own use, at
my own home, and that the said ardent spirits will
not be used in violati on of Jaw.
.
Lu +-
Consiau ee.
/
Apnt fo r Souther n Exvres s Comvau y.
�SOUTHERN EXPRESS COMPANY
FORM 370-V A
(I ncorpo rated)
LIQUOR
RECORD
._~&lJ~~~~~~ i-=----- -= - - Amount,_ _
---1--~
:__-
~ ~ +>, -- -- -~
-_/__L_] _ 19 1_
~ __
From----=.._
_
Advamea to
Collect
,_
J---
__,~_ lbs.
~~-=-=::___:,
·..._.,,.
Arld
Unde rchar,;:e
RECORD OF NOTICES
To Consignee _ _ _ _ _ _ _ _ _ __ _ _ __ _ __
To Shipp er __________ ________
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
.......
(OV E R)
�AFF IDAV IT FOR ARD ENT SPIR
ITS FOR PER SON AL USE
i, -
-'----"-- '-'--
-
----"'---""
-""'-'- '-- --'=---- ~- - -::::_-- - , being duly swor n,
depo se and say Uiat I am
the consi gnee of a certa in shipm ent
of arden t spirit s, as speci fied on ot her
side of this form , t his day·
deliv ered tome by the Sout hern Expr
ess Comp any, from ~ - - ~- - - - ~ - -..,_,_~ ; that I am not a
stude nt or mino r, and, if a fema le, I
am the head of a famil y; that the arden
t spiri ts so recei ved by m e
were brou ght into t he State on my writt
en order , and that I have not, wi~h
in the thirty days previ ous
heret o, recei ved any arden t spiri ts of any
kind what soeve r, from any perso n or from
an y place what soeve r, in
exces s of t he quan tity allow ed by the
provi sions of the Act of the Gene r al Asse
mbly of Virgi nia , appr oved
Marc h 10, 1916, or contr ary to law,
and that the J rdent spiri1.s so rec eived
by me are for my own nse, at
my own hom e, and that the said arden
t spiri ts will not be used in viola tiou of
la~ .
Swor n t o and subsc ribed ~efor e me,
(
A,ient it(,,So ntheru Expre ss Comv auy.
�SOUTHERN EXPRESS COMPANY
FORM 370•V A
(I ncorpo rated)
RECORD OF NOTICES
To Consion ee _ _______ ___ _ _ __ _ _
To Shipper_ _ _ _ __ ________ ___
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVE R )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRGINI A, ✓
COUNTY OF _ __ _ __ __ __ _
--
... , - - - - - -- - - - - - -- - - - -- - - -, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as speci! ed on other side of thjs form, this day
delivered tome by the Southern Express Company, from_....,.._ _ _ _ _ _ _ __ __ ; ' ihat I am not a
student or minor, and, if a female , I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and 1;hat I have noi, within the thirty days previous
h ereto , received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of ihe quantity allowed by the provisions of ihe Act of 1;he General Assembly of Virginia, approved
March 10, 1916, or conirary to law, and that the ardent spirits so r eceived by me are for my own use, at
my own home , and that the said ardent spirits will ot be used in viol ation of law .
/
Cons icuee.
Sworn t arid sub,s<Jibed before me ,
_ ___,_J , 191 _
Aeent for S outhern Exvress Com pany.
�FORM 370•VA
RECORD OF NOTICES
To Consionee _ _ _ _ _ ___ __________
To Shipper ____ _ _ ______ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OV ER)
�cs • s
!Cl
AFF I DAVIT FO R A RDENT SPIRITS FOR
™
LS?
*-
.c:
z.__
PERSONAL USE
~, -"~-'--"=-=-...._..L-'.-==---'-4------'=---"--+-- -->,----, being duly sworn, depose and say t hat I am
the consignee of a certain shipment of ardent spirits, as :zz;,ed on oth@c side of this form, this day
. delivered tome by t he Southern Express Company, from_~___::-=--z+--"-"'---- --'=-<---" i that I am n ot a
student or minor, and, if a female, I am the head of a family; t
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of t he quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw, and that the ardent spirit.s so received by me are for my own use, at
m y own home, and that the said ardent spirits will not be used in violation of Jaw.
l
Cons i,:nee.
Sworn to and subscribed before me,
t his ~
day o~,d
1'/a 'Ml
,
1911-
A~nt for Southern E-s:pres s Uompauy.
�FORM 370-VA
SOUTHER N EXPRESS COMPANY
(lucorpo rated )
AdTanrea to
Coll ect
A~d
Undercharge
RECORD OF" NOTICES
To Consign ee _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
To Shipper _ _ _ _ _ __ ______ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVl<R)
�AFFID AVIT FO~ ARDE NT SPIRI TS
FOR
I
shi~
PERS ONAL USE
P.t'c?lLt
being duly sworn, depose and say 1ihat I am
ardent spirits , as 8j~1ifi ed on other side o this form,
1ihis day
'/Ah · , ,
k 'T
deliver ed to me by the Southe" Expres s Compa ny,
from
that I am no1i a
studen t or minor, and, if a female , I am the head
of a fam ily; that the ar9,, t spirits so receive d by
me
were brough t into ihe State on my written order, and
that I have not, wt1:hin the thirty days previo us
hereto , receive d any ardent spirits of any kind whatso
e!er, from any person or from any place wh atsoev er,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and that the ardent
spiriis so receive d by me are fo r my own use, at
my own home, and that th e said ardent spirits will
not be used in violati on of law .
;
/
Consienoe.
Ai:ent for Souther n Ex1>ress Comvau y.
�RECOR D OF' NOTICE S
To Consi gn ee _ __ _ _ _ _ _ ._ _ _ _ _ _ _ __
To Sh ipper_·_ _ _ _ _ _ _ _ _ _ __ _ __ _
NAL USE .
AF'F'IDA VIT F'OR ARDEN T SPIRIT S F'OR PERSO
'
( OVE R)
.
�AFFIDAV IT FOR ARDENT SPIRITS FOR
PERSON AL USE
STA'l'E OF VrnalNIA _
1
COUNTY m'--'-....;:__ ___'..~ ~ ~ ~ ~ , ~ - -
i, -----,- ----- ----- ----- ---,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side
of this form, this day
1;
delivered to me by the Southern Express Company, from
that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so rec~ived by m e
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
Aeent for Souther~ Exvress Company.
�SOUTHERN EXPRESS COMPANY
FORM 3TO•VA
( Incorporated}
Advaur e e to
Collect
RECORD OF NOTICES
PREPAID
0
To Consig nee _ _ _ _ _ _ __ _ _ _ _ __ _ __
To Shipper _ _ __ __ __ __ __ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVllR)
�AFFIDAVIT FOR ARDENT SPl"ITS FOR
PERSONAL USE
STATE OF VI
COUNTY OF~--...-~ i
- --
~ ---=.""""
1 ----L-¥---1LL--=-L- ---"'.L~~~'?).~~~:.....:___ , being duly sworn, depose and say that I am
"fled on other side of this form, th· day
delivered to me by the Southern Express Company, from_' _,__~--___,_~_..,.__,__,_----'---=--=--~
' -=
=; th?:1'{_ am
a
student or minor, and, if a female, I am the head of a family;
at the ardent spirits so received
me
were brought into the State on my written order, and that I have not, within the thirty days p evious
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
ftf-r~ \Rtrt ~
Ae-ent for Southern Express Compauy.
/,
c,......
�F"ORM 370-VA
Affidavit No, _ _ _ __ _
Received at
RECORD Or NOTICES
To Consignee ___________ ________
To Shipper _ __________ ______ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( O V ER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
COUNTY OF~rr ----'.r-- ----;-vt- -'--
~, - =~= = ~ - -4 µ:c=--,,-..,='-----: :.-.....!..- ..!-:....,:::"--'/4 - , being duly sworn, depose and say that I am
ardent spirits, as spec· ed on other side of this form, this day
delivere d to me by the Souther n Express Compan y, from
;,;;-;:
,...._.,; that I am not a
student or minor, and, if a female, I am the head ,of a family;
at the ardent spirits so received by m e
were brought into the State on my written order, and fast I
ave not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used
in violatio n of law.
/211
.J.,r ~I
Sworn to and subscrib ed before me ,
this
'Z,../ day o
1/-
�Affidavit No_ _ _ __ _
Adv e.n ce a t o
Collect
RECORD OF NOTICES
To Consionee _ ______ _ ______ _ _ __
To Shipper _ ______ ______ _____
AFFIDAVIT FOR ARDENT SPI RITS FOR PERSONAL USE .
(OV ER)
�delivered to me by the Southern Express Company, from
, that I am not a
student or minor, and, if a femal e, I am the head of a family;
t the ardent spirits so received by me
were brought into the State on my written order, and that I
ve not, within the thirty days previous .
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in } •'·
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approve«t ,, ·
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at',,
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subs
th i s - . -day oL-
A2ent for Southern Exvress Comvauy.
�PRF. P AID
RECORD Or NOTICES
To Consign ee
To Shipper _ _ __ _ _ _ _ _ _ _ _ _ _ __
Arf"IDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE.
( OVER )
�FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
... , --- - -- ~ -- ~- - -- -- - - - -~ ~ - , being duly sworn,
depose and say that I am
the consigne e of a certain sh(pm ent of ardent spirits, as specified on
other side of thi s form, this day
delivered to me by the Southern Express Company , from
· ·
; that I am not a
student or minor, and, if a fem ale , I am the h ead of a family; that ui'e
ard ent spir its so received by me
were brought into the State on my written order, and that I ha
not, within th e thirty days previous
h ereto, received any ardent spirits of any kin d whatsoev er , from any p erson
or from an y place what soever, in
excess of the quantity allowed by the provision s of the Act of the Gener
al Assembl y of V.irginia, approved
March 10, 1916, or contrary to law , and that the ardent spiri1.s so r eceived
by m e are for my own use, at
my own hom e , and that th e said ardent spirits will no be used in viol
ation of law
'
0/ ~G ,
Con · nee.
�------~------~~---~----~--SOUTHERN EXPRESS COMPANY
FOAM 370•VA
(Inco rporated)
Received at
Consignee
Advnur e s to
Collect
Add
s
Undercharge
RECORD Of' NOTICES
To Consign ee ___ _ _ ___ __________
To Shipper_ _________________
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONAL USE.
(OVER)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR PERS ONAL USE
STATE OF VI !j !NIA, ,
COUNT Y OF-''C - ' - - -- -=---' --,1-:._
.,.,l. . ,, -----,
'---- <fl'--- - -'-"\- - -=~--- --, being duly sworn , depose
1
and say ihat I am
the consig nee of a certai n shipm ent of ardent
spirits , as pecifie d on other side of this form,
U;iis day
delive red to me by ihe South ern Expre ss Comp
t.
any, from .,
; that I am not a
studen t or minor , and, if a female , I am the head
of a family · that the ardent spirits so receiv ed
by m e
were broug ht into the State on my writte n order,
and that I have not, within the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind whatso
ever, from any person or from any place whats oever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law, and that the
ardent spirit.s so receiv ed by me are for,,,my own
use, at
my own home, and that the said ardent spirits
il, not be used in violati ou of law,
.. , _
Sworn to and subscr ibed before me,
this_L !.__da y oL-
~1---_ , 191.;z
A~ent for Southe rn Exvres s Compau y.
t/
Consicn ee.
�l'OAM 3TO•V A
SOU THE RN EXP RES S COM
PAN Y
(Incor
porate d)
......
-?__ }: . . __:'-"-
Affidavit No . _ _
Advan res to
Co ll ec t
PREP AID
RECO RD OF NOT ICES
To Consionee ____ __ _____
___
___ __
To Shipp er _ __ __ __ __ __
__ __
___
AFFI DAVI T FOR ARD ENT SPIR
ITS FOR PER SON AL USE .
•
(ov~R )
1
�FOR ARDENT SPIRITS FOR
PERSON AL USE
~
i, -'-d-----"---"-'-_._~_ _,,.....,,.,_ ~-~~--- ~~--,
being duly sworn, depose and say that I am
the oo~ign,e of , oerl,in ,hipm,nl of
"'®' spidts, , ,>~
n othe, oide of lhi, form, thi• d•y
delivered to me by the Southern Express Company, from
.
; that I am no a
student or minor, and, if a femal e, I am the head of a family; that he ardent
spirits so received by m e
were brought into the State on my written order, and that I ha/ not, within
the thirty days previous
here~ _received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
1
excess o'f the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in iolation of law.
r
Sworn to and subscribed before me,
th isL -day oL.. .p..;..;.:..:.;:::......_ , 19l! J
r
Aa-ent for Southern Exvress Compauy.
Consianee.
�FORM 3TO•VA
SOUT HERN EXPR ESS COMP ANY
(Inco rporated)
RECOR D Or NOTIC ES
To Consignee ___ ___ __ ___ ____ __
_
To Shipper_ _ ___ ___ __ _ ___ ___
_
ArrlDA VIT rOR ARDEN T SPIRIT S rOR
PERSO NAL USE .
( OVER)
�_____.___________......,......,_,,...,..~r-~~~=,.-,,,.-•+-.,c~-.. .-,. ,. .- ---....,-------....,.,--~---- -.
Af;FIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
L1
being duly sworn, depose and say that I am
sp c· ed on other side of this form, thi day
--''-''-'-------'---'----"--~ c.___,,-,---,,--"---=--=--- - --==-,
the consignee of a certain shipm~ t of
V
-
-
,6~
delivered to me by the Southern Express Company, from 1--,,--,L--1
; tliat I am ot a
student or minor, and, if a female, I am the head of a family; t hat the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoeve1·, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw .
.n
Sworn to and subscribed before m e,
this /
,t'da
V
ot. -/ t
1Z
1911
Ae-ent for Southern Exvress Company.
C
t
Consiauee.
�RECORD OF NOTICES
To Consianee _ __________ _ __ __ _
To Shipper_ _ _ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OV &R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
STATE
O}'
PERSONAL USE
V1 1;, ' 1 IA ,
COUNTY OF,.
, /, __' -
- --
=--c._--'c...
... , - - - - - -- - - -- - -- - -- - - - - -, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
7'/'
;
delivered to me by the Southern Express Company, from
that I am not a
student or minor, and, if a female; I am the head of a family; that the ard ent spirits so r eceived by m e
were brought into the State on my written order, and that I have not, within th e thirty d ays previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any p erson or from an y place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Gen eral Assembly of V irginia , approved
March 10, 1916, or contrary to law , and that the ardent spirits so received by me ar e fo r my own use, at
my own home, and that the said ardent spirits will not be used in violati on of law.
Sworn to and subscribed before m e,
th is ___day ok
, 191_ /
A£ent fo r S outhern Express Company.
-
Consianee.
�,-OAM 3TO•VA.
SOUTH ERN EXPRES S COMPA NY
(Incorporate d)
Received at.-== f '-flr._.e_:_p.~""---~- ,-----r---:.--- -
Affidavit No
Consianee,,.C:::L .li.-~~~..C Z....!!'.LL .!.£l...ila. ,.cf..,,11!!!1,,- -~ - -......f.--"'= - - - - - - - - - - - - •
Kind of Ardent Spirits,_ ~~ ~a~'.::! !.::::;~1 .:~~ -----.-Way- ~i
. J..-' 2,,,- / c.£
T o f/v b l,
Date
SM~~ ~ - - , . , . , )
RECORD OF' NOTICES
To Consignee
To Shipper
AF'F'IDAV IT F'OR ARDENT SPIRITS F'OR PERSON Ai USE
.
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
8TA'l'I': OF VIRGINIA ,
COU NTY Ot' _ _ _ _ _ __ _ __ _ /,
I, - - - - - - - - - - - - - - - - - - -- - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specifi ed on other _s ide of thi s form, this day
delivered to me by the Southern Express Company , fro~- - -- _ _ _ _ __ _ ; that I am not a
student or minor, and, if a female , I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and faat I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind what soever, from any person or from any place what soever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia , approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are fo r my own use , at
my own home, and that the said ardent spirits will no be used in viol ation of law.
/
Sworn to and subscribed before me,
\his ___day O~-----, 191_ ,
Aaten1i for Soutiheru Ex.;,ress ()omvany .
/
Consi~nee.
�SOUTHERN EXPRESS COMPANY
(I ncorporated}
RECORD
---------"'=---- 2.- "/_ _
Ad•nm e s t o
Coll ect
1917-
Affidavit No.
EXPRESS CHARGES
PREPAI D
~
Add
Uuctercba rge
RECORD OF' NOTICES
To Consign ee _ _ _ _ ____ _____ _ __ __
To Shipper _ _____________ _ _ __
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE .
(OV ER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
COUNTY OF-c.-.,,.=c"---
-=_.:_-
--J:.__L_-=
... , ___,....,,...___~ - ---'--r-H"',,....ll
-'ll.,.•"4.,- ~'---""----';"-----'
.,-~'•"·_ _ __ , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits,
c· ed on ther side of this form, this day
Ji)
deHvered to me by the Southern Express Company, from
•
-; t1iat
not a
student or minor, and, if a female, I am the head of a family;
were brought into the State on my written order, and that I have not, wi in the thirty days previous
hereto, received any ardent spii-its of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly.of Virginia, approved
March 10, 1916, or contrar·y to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, ~• fu•t tho ••id s,dont ,pid1' will ~
~~
t'!ml
IN
{
Cons ii;::uee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(lncorpo raLed
J 71
Affidavit No. , /
Add
Undercharge
RECORD OF NOTICES
To Consignee _ __ __ _ __ ~ - - - - - - - - To Shipper _ _ _ __ _ ___________
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVJCR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
}
STATE OF
Vrn
COUNTY OF _ _ __ _ _ _ _ _ __
i, - - - - - -- - - - - - -- - -------, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
/
.
delivered to me by the Southern Express Company, from _________ _ _ _ ___ ; th · I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirit so eceived by m e
we.re brought into the State on my written order, and that I have not, within the j;hirty days previous
hereto, received any ardent spirits of any kiud whatsoever, from any person or from a ny place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law , and that the ardent spirhs so rec eived by me are fo r my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw.
Sworn o and subscri · ed before me,
this _ _day oL. - -~-,
1911
Aeeut for Southern Express Company.
Consicnee.
�To
Advau rea to
Collect
PREPAID
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR P E RSONAL US E .
(OVER)
�AFF IDAV IT FOR ARD ENT SPIR
ITS FOR PER SON AL USE
STAT E OF VIRG INIA,
COUN TY O F - - - -- ---~-
~, - - - - -- -- -- - - - -- - - - - - - , being duly swor n, depo
se and say 1ihat I am
the consi gnee of a certa in shipm ent
of arden t spirit s, as speci fied on other
side of this form , 1ihis day
deliv ered tome by the Sout hern Expr
ess Comp any, from ___ ___ ___
___ __ ; that I am not a
stude nt or mino r, and, if a fema le, I
am the head of a famil y; that the arden
t spiri ts so recei ved by me
were brou ght into the State on my writt
en order , and that I have not, withi
n the thirty days previ ous
heret o, recei ved any arden t spirit s of any
kind what soeve r, from any perso n or from
any place what soeve r, in
exces s of the quan tity allow ed by the
provi sions of the Act of the Gene ral Asse
mbly of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law,
and that the arden t spiri ts so recei ved
by me are for my own use, at
my own home , and that the said arden
t spiri ts will not be used in viola tion of
law.
Sworn to and subsc ribed befor e m e,
//
this ~da y oL. - - -- , 191 _
A11ent for South ern Expre ss Comp auy.
Consi enee.
�SOUTHERN EXPRESS COMPANY
F'ORM 370•VA
(lncorporatt1d)
Affidavit No.
:;J 1 '2.-.
PREPAID
RECORD ·OF NOTICES
To Consignee___ _ _ _ _ _ ____ _ ____ _
To Shipper _ _________________
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE. ,,.
{OV KR)
�AFFIDAVI T FOR ARDENT SPIRITS FOR
PERSONA L USE
STATE OF VIR <J ~NIA,
COUNTY OF_....f_,!~
= '-------"'-----,l"I-- .,.
_..,-.....,,__
i,
- - - - - --'--"---'--~ -=----=""- ---"--'-"-=~~ , 'l:ieing duly sworn, depose
and say Uiat I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form,
this day
1/ 1,,,.
',
'
"; that I am
delivered to me by the Southern Express Company, from rJ,..I
" ·
! • , •
not a
student or minor, and, if a female, I am the head of a family; that the dent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
{
Sworn to and subscribed before me,
tbi s
t c.L
day
-4-
oJ -..,,,,/,-, , 191.!J'
)
/
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,,,
A~ent for Southern Exvress Compau)·.
u J nsianee.
�FORM 370•VA
SOUTHERN EXPRESS COMPANY
(Incorporated)
Affidavit No
~l/0
{
--1-f_ __ Amount,_
,_;.:=....=--==-----=:. __:_- =---==-,.,,.
_ I_..L.'-.,_,__ _ _ _ __ Weioh .__ _ _ 1bs.
____,__~I_J____ ____ 191 _:_
I
To
~,.,....=,,___ __---.,L-=--"r---- - - -
Advan, e e to
Coll ect
To Consignee _ _ _ _ _ _ __ _ _ _ _ _ _ _ __
Fro ~ _L.,,,· ,,,
; EXPRESS CHARGES
PREPAID
'.J
Add
Unde r cha rge
To Shipper _ _ _ _ __ __ __ _ __ _ _ _ __
AF'F'IOAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE .
{OVER)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
PERS ONAL USE
STATE OF V IRGINI A,
COUNT Y OF _ _ __ _ _ _ _ __ _
... , - - - - -- - - -- - - -- -- - - -- - , being duly sworn , depose and say that
I am
the consig nee of a certai n shipm ent of ardent
spirits , as specifi ed on other side of this form,
this day
delive red to me by l;he South ern Expre ss Comp
any, from _ __ __ _ _ __ _ _ _ __ ; that
I am nol; a
sl;uden t or minor , and, if a fem ale , I am the head
of a family ; that the ard ent spi r its so r eceive
d by m e
were broug ht into \he State on my writte n order,
and thal; I have not, within t he thirty days
previo us
hereto , receiv ed any a rdent spirit s of any kind whatso
ever , from any person or from a ny place whatso
ever , in
excess of the quanti ty allowe d by the provis ions
of th e Act of the Gener al Assem bly of Virgin ia,
approved
March 10, 1916, or conl;ra ry to law, and that
the ardent spiriis so r ec eived by me a re fo r my
own use, at
my own home , and that the said ardent spirits
~ ill not be used in viol ation of l aw.
Sworn to and subscr ibed before me,
thi s ___day oL.- - --
, 191_
A29nt fo r Souther n Expres s Compa ul·•
Consic:nee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
Received at
Consionee
~
>,f(i!.,-.,,,,..i_
!
..+- ·.
I
N .
(Incorporat ed)
. SP¥,~- LIQUOR RECORD
1· _
Date _ _ __ __
191 _
Affidavit No. _ _ _ _ __
'Y A)~~U1,..,,
=-f).-,-=--rr---+-,---- - - - , - - --+,-=:
1
I
--~""'-_!_~ ~v-==
· :..-'£f~·= ~ .L-- e-+--Amount_ _
_c___-+-=----__,'---
RECORD OF NOTICES
To Consionee
To Sh ipper_ ____________ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
' .
( O VKR )
.,,' • ·
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
~, - --==---....z...--=--_ __
.£._..!:._->-
being duly sworn, depose and say that I am
S{lecified on ol_fillr s·de o this form, this day
-'--''--'--F-L-=---.,<----- ,
delivered to me by the Southern Express Company, from_~~-'-----,--~~----=-.,- ----'--- i that I am not a
student or minor, and, if a female, I am the head of a family; tha' the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw , and that the ardent spiri\s so received by me ar for my own use, at
my own home, and that the said ardent spirits will not be s
la~ion of law .
Sworn to and subscribed before me,
";'7 [¼ ,,,71/
Aeent for Southern E:xpress Co.mpau y.
�FORM 370•V A
EXPR ESS COM PAN Y
SOU THE RN (Incorp
o rated)
Affidavit No, _ _ _ __ _
Advt1.n.-ea t o
Collect
RECO RD OF NOTI CES
___
To Consignee ___ ___ ____ _ _
_ __
PREPA ID
_ _ _ __
To Shipper _ ___ ___ ___ ___
ITS FOR PERS ONAL USE.
AFFID AVIT FOR ARDE NT SPIR
(OVER )
�AFFIDA VIT FO R ARDEN T SPIR I TS FOR
PERSO NAL USE
STATE OF VIRG)NI A ,
COUNTY OF - - ~ -- - - - -- _._ , - '--'--"--'-''- ---'---'--'----'---"--"-'='" -'-- - ' -- L----'---'----"--'---'----'- , 'being duly sworn, depose and
say Umt I am
ihe consign ee of a certain shipmen t of ardent spirits, as Jipecifie
d on other side of this form, fois day
delivere d to me by foe Souther n Express Compan y, from _ _,__
__ ,-.,..= ::.__ _ _ _ __ ; that I am n ot a
student or minor, and, if a female , I am the head of a family;
thlit-the ard ent spirits so r eceived by m e
were brought into the State on my written order, and foat I
have not, within th e thirty days previous
h ereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of t he quantity allowed by the provisio ns of th e Act of
t he Gener al Assembl y of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirit.s
so r eceived by me are fo r my own use , at
my own hom e , and t hat the said ardent spirits will not be used
in violati on of l aw .
Consianee .
Ai:ont for Sontb.,fn Express Company.
�FORM 370•VA
Received at
Affidavit No
Consign ee
,, .,,~ ,z
~--' ,
Frqpr:
Weigh .___,__ _ lbs.
·'>t..-:/L, ?-?. •u -t;~
Advan.- e e to
Collect
RECORD OF
To Consign ee ___ _ _ _ _ _ _ _ _ _ _ _ _ __
To Shipper_ ____ ____ ____ _____
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE .
( OV<R)
�AFFID AVIT FOR ARD E NT SPIRI TS
FOR
PERS ONAL USE
STATE 0~' VIRGIN I A ,
COUNT Y OF _ _ __ _ _ __ _ __
i, ---
--- -- -- - - --- --- --- -, being duly sworn, depose and say
t hat I am
the consig nee of a certain shipme nt of ardent spirits
, as specifie d on other side of this form, this day
d elivere d to me by the Southe rn Expres s Compa ny,
from ____ ____ ____ _ __ ; that I am n ot
a
studen t or minor, and , if a femal e , I am the head
of a family ; that the ard ent spirits so receive d by
me
were brough t into the State on my written order, and
that I have not, within the thirty days previous
hereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and that the ardent
spirit.a so r eceived by me are for my own use, at
my own home , and that ihe said ardent spirits / II
not be used in violati on of law.
Sworn to and subscr ibed before me ,
this ___day o1.
- -- - , 191_
A~ent for Souther n Express Company.
<Jonsien ee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Incorporated )
,/
Affidavit No.
~
'
.;,.,, /
L/
.
lbs.
/,11, ,>I , /_/,
/
RECORD OF NOTICES
To Consionee ___ _____ ._ _ _ _ _ _ _ __
To Shipper _ _ __________ ______
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
·-..
(O VER )
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE O~' VJRG!NI A,
COUNTY OF _ _ _ __ __ _ __ _
i, ---- ---- ---- ---- ---- --, being duly sworn, depose and say that
I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
delivere d to me by the Souther n Express Compan y, from ____
_____ ______ ; that I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by m e
were brought into th e State on my writt en order, and that I
have not, within th e thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law , and that the ardent spirhs
so rec eived by me are for my own use, at
my own home, and that the said ardent spirits will not be used
in violation of law.
Sworn to and subscrib ed before m e,
this ___day oL.. - - -- , 191_
Aeent for Southern Exvress Comvauy.
~
/
Consia:nee.
�SOUTHE RN EXPRESS COMPAN Y
FORM 370-VA
(Incorporated )
Advnnree t o
Collect
Add
PREPAID
Ond er cbar gc
Shipper_ ~ ~~ =:..:'.i:·__ __J
\u}cc
''-"'i._....-=::..:1L, _.:,
-l::_,c=-- 1)
\)
RECORD Of" NOTICES
To Consign ee _ _ _ _ _ _ __ _ _ _ _ _ __ _ _
To Shipp er _ _ _ _ _ _ _ _ __ _ _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE .
(OVER)
I
J
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
I
i,
PERS ONAL USE
·
-"=4 .,-L---"''-'-'=c..... .::=---,<-_ J.•-L-"" '--"-"-A
'--'-:::::_-= =---'--- ,
being duly sworn , depose and say ihat I am
as ~j ~ e~ n othe ·de of this fo, ; ~his
ay
delive red to me by the South ern Expre ss Comp
any, from ~ (
; that I am no
studen t or minor , and, if a female , I am the head
of a family ; t t the arden t spirits so receiv ed
by m e
were broug ht into the State on my writte n order,
and that I ha e not, within the thirty days
previo us
hereio , receiv ed any ardent spirits of any kind whatso
ever, from any person or from any place whats oever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916 , or contra ry to law , and that the
ardent spiri1,s so receiv ed by me are for my own
use, at
my own hom e , and that the said ardent spirits
will not be used in violati on of Jaw .
j
Sworn to and subscr ibed before me,
t his-l- --day oL- -- -- - , 1911 -
Consicn ee.
�FoRM 3TO•VA
RECORD OF NOTICES
S COMPA NY
SOUTH ERN EXPRES
rated)
(I ncorpo
To Consignee _ __ _ ______ _ _ _ _ _ _ __
To Shipper _ _ __ ____ ____ _ _ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE.
(OVJt R}
�AFF IDAV IT FOR ARD ENT
SPI RIT S FOR
STAT E OF
}
PER SON AL USE
Vrno J JA,
COUN TY O~' ~_,_
/-'j/ - ""---- '-''-<' -~
i, Y
,
,
bein g duly swor n, depo se and say that
the cons idee of a certa in shipm ent
I am
of arde nt spiri ts, as spr ified on ot
r side of this form , this day
deliv erel o me by the Sout hern Expr
ess Com pany , from
stud ent or mino r, and, if a fema le
that I am not a
, I am the h ead of a fami ly; th,,t the
arde nt spiri ts so r eceiv ed by me
were brou ght into the State on my
writt en orde r, and that I hav1e not,
with in the thirt y days prev ious
here to, recei ved any arde nt spiri ts of
any kind what soev er, from any perso
n or from any place what soev er, in
exce ss of the quan tity allow ed by the
prov ision s of the Act of the Gene r al
Asse mbl y of V irgin ia , appr oved
Marc h 10, 1916, or cont rary to law,
and that the arde nt spiri ts so r eceiv
ed by me are for my own use, at
my own home , and that the said arde
nt spiri ts will not be u sed in viol ation
of l aw.
?v-,tf.,,fl~ M l6
Swo rn to and subs cribe d befo re m·e,
thi s _ _day O~
=-= --,
1911
A2ent fo r South ern Exvre ss Co mvau
y.
Uonsi anee.
�l'OAM 370•VA
SOUT HERN EXPR ESS COM PANY
(I ncorpora ted )
Affidavit No.
Ad vnm·e e to
Co llect
RECO RD OF' NOTIC ES
To Consignee___ ___ __ ___ ___ ___
__
To Shipper _ ___ ___ ___ __ _ _ _
_ __
AF'F'ID AVIT F'OR ARDE NT SPIRI TS
F'OR PERS ONAL USE .
(OV ER )
�AFF IDA VIT FOR AR DE
NT SP IRI TS FOR
PER SO NA L US E
STA TE OF VIRG
COU NTY OF -.--- -~ -...,,.
,,~ - =~ --
~, _(_....,...--'~-'----+--',.-. .,__.,_.. . . ,___ _ _ _ __
+-_ _ , bein g duly swo rn,
as spe/
e
dep ose and say that I am
on othe r side of this form ,
this day
deli vere d to me by the Sou ther
n Exp ress Com pan y, from
stud ent or min or, and , if a
/
; that I am not a
fem al e , I am the head of a fam
ily; that the af den t spir its so
wer e brou ght into the State
r ecei ved by m e
on my wri tten orde r, and that
I h,av e
here to, rece ived any arde nt spir
with in the thir ty day s prev
its of any kind wha tsoe ver, from
ious
any person or from an y plac e
exce ss of the qua ntit y allo wed
wha tsoe ver, in
by the p rovi sion s of the Act
of
the Gen er al Assembl y of Virg
Mar ch 10, 1916, or con trar y
inia , app rove d
to law, and that the arde nt
spir its so r ecei ved by me are
for my own use, at
my
hom e, ~• "" ' th, ,,id a,de
nt , pfri ts will ••: /
t;
M
: ''..11:•:••~: . C:j
•=
I,.
Swo rn to and subs crib ed befo
re me ,
-;- ~I~ ,
1911
---ezt- <Jb tc
\.J--
Cons i
�FORM 370•VA
SOUT HERN EXPRE SS COMP ANY
(Incorpor ated )
7JJ
RECO RD
.1-7
- - ~~ - --'-_..,'--___ _ 191--rTo ___ __:_::=-'---'-'--"''-'-L.::;.,.,..- --'--- - - -
Advanr e s to
Collect
Shipper_J_f~·~'td..,; ~~t-..=__j_~{. ::1~~ ~~-
Affidavit No _ _ _ _ __
191 7
--
From~ ---=-::... :::...=--- ---''---"'" --
EXPREs s CHARGE S
COLLECT
Add
Underchar 1e
RECOR D OF NOTICE S
To Consicne e _ _ _ _ __ ___ ___ ___ ___
To Shipper _ __ _ _ _ ____ _ _ _ __ _ __
· AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE .
(OVIIR)
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
STATE OF VIRGIN IA,
COUNTY
o~•- ---- - -- - - -
i, --- --- ---- --- --- --- --- ,
being duly sworn, depose and say 1;hat I am
the consign ee of a certain shipme nt of ardent spirits,
as specifie d on other side of this form, this day
deliver ed to me by the Southe rn Expres s Compa ny, from
_ _ _ _ _ _ _ _ _ _ _ _ _ ; that I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so receive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisi ons of the Act
of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and that the ardent
spirits so receive d by me are for my own use, at
my own home, and that the said ardent spirits will not be
used in violatio n of law.
Sworn to and subscri bed before me,
"' ,I,
1,,,
,.
191 _
Aeent for Southern Exvress Compauy .
Cousi,;nee.
�FORM 3TO•VA
SOU THER N EXPR ESS COM PAN
Y
(Incorp orated)
COLLECT
RECO RD Of" NOTIC ES
To Consignee _ _ _ _ _ _ ___ ___ ___
__
To Shipp er _ _ _ _ _ _ _ _ _ _ _ _
__ _ _
Af"f"ID AVIT f"OR ARDE NT SPIRI TS
f"OR PERS ONAL USE .
(OV tR)
�AFFIDA VIT
RDENT SPIRIT S FOR
PERSO NAL USE
STATE 0~' VIRGINI A ,
COUNTY O F - - - -- - -- - - r -
,J
~, ______,,;__,___,,___--=---~-- - - - -- - - - --,-bei ng duly
sworn, depose and say that I am
the consign ee of a certain shipmen t of ardent spirits,
Specified on other side of this form, this day
delivere d to me by the Souther n Express Compan y, fro
// I
;
•,, '
J;, Otat I-am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by m e
were brought into the State on my written order, and that I
have not, within the thirty days previou s
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe v·e r, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, allj that the ardent spirits
so received by me are for my own use, at
my own home, and that the said ardent spirits wil! n t be used
in violation of Jaw .
Sworn to and subscrib ed before me ,
this _ _._ day ot.. - -- - ' , 191 __
Aeent fo r Southern Exvress Comp~uy .
Consignee .
�FORM 3TO•V A
SOUT HERN EXPR ESS COMP ANY
(Incorpo rat ed)
Affidavit No, _
P REPAID
_,½
'---- --'7__
Add
Uu de rcba r1e
RECOR D Of" NOTIC ES
To Consion ee ___ _ _ ___ _ _ _ _ __ _ _
_
To Shipper _ ___ ___ ___ ___ __ __ _
Af"f"IDA VIT f"OR ARDEN T SPIRIT S f"OR
PERSO NAL USE .
•
( OVKR)
�AF FID AV IT FOR AR
DE NT SP IRI TS FOR
i, _ __,~,____ _ _.c__
PE RS ON AL US E
-=..,.____,__= --,. ,c_
____ , bein g duly swo rn, dep
the con sign ee of a cert ain
ose and say tha t I am
ship men t of ard ent spir its,
~~ ecifiec_},on othe r side
of this form , this day
deli vere d to me by the Sou
ther n Exp ress Com pan y, fro
~
stud ent or min or, and , if
1,/ ,
tha t I atn not a
a fem al e, I am the hea d of
a fam ily; tha t the ard ent
wer e bro ugh t into the Sta
spir its so rece ived by m e
te on my wri tten ord er, and
tha
t
I
hav e not , with in th e thir
here to, rece ived any arde nt
ty day s prev ious
spir its of any kind wha tsoe
ver, from any p er son or fro_
exc ess of the qua ntit y allo
m any plac e wha tsoe ver, in
wed by the pro visi ons of the
Act
of
the Gen e1·al Ass e mbl y of Vir
Mar ch 10, 1916, or con trar
gini a, app rov ed
y to law , and tha t the ard
ent spir its so rece ived by me
my own hom e, and that the
are for my own use , at
said ard ent spir its will not
e use d in viol a ·on of law .
.ItL
/1
, /j ,
ed befo re me,
~
Co'i1s ic: uee.
,-----,F-- , 191 _2
,ft
Aee nffe r Sout hern E:xvress
Com vauy .
•
�FORM 370-V A
SOU THE RN EXP RES S COM
PAN Y
(l ucorpo
rat e d )
REC ORD
Received atL--1.c= ,:...;,, :~~
Consignee _
""-"- --'-- -
---=--- =-=----
Date._ _,~---4--7_ __
191
J-
Affidavit No
___:,,_L.. Ju.. J.l-;..c..L!!==-==-.;---==-=~ --';;/""-----~•.L/:.__,1'<'---"'"---=-'
=----"'=e._-- ~- - -
-- - - - -
I
REC ORD OF NOT ICES
To Consionee ___ _ __ _ _ _ _
__ _
J
.2 6
__ __
To Shipp er_ __ __ __ __ __
___ _ _ __
AFFI DAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
(OV ll:R)
�i•
•
~
., =:_:::r7 ~ ,
AFFIDAVIT FOR ARDENT SPIRITS FOR
COUNTY
8TATk O>
0~'
-
PERSONAL USE
~
'/~
boing duly ,wom, dopo" ~, "1 lbot l om
foe consignee of a certain shipment of ardent spirits, as -~pacified on otl~er side of this form, this day
f
I
ll
delivered to me by the Southern Express Company, from f. ~ - .
·
.~
t I am not a
student or minor, and, if a female, I am the head of a family; that the ardent SIJ. its so r \) ived by m e
were brought into the State on my written order, and ihai I have not, within
thirt
ays previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law , and that the ardent spirits so received by me are for my own use, at
my own home , and that the said ardent spirits wil not be used in violation of law .
;J.'!
L
Sworn to and subscribed befo re me,
I
A11:ent for Southern 'Exvress Company.
�SOUTHERN EXPRESS COMPANY
(Incorporat ed )
LIQUOR RECORD
Affidavit No.
//0
,
Kind of Ard ent Spirits_ _ _ __ _ _ __ __ ~ -- + - -- Amoun _ ...,...._ _ _ __ _ _ __ Weioh t- _ ___ lbs.
F/-~,,_____
Way-Bill No. _~
From_-"-- - - -~ - - -- -
7
To
Advau< e a to
Coll ec t
E X PRESS CHARGES
PREPAID
Add
Unde r cha rge
RECORD OF NOTICES
To Consign ee _ _______ ____ _ __ _ _ __
To Shipper _ _ __ _ _ _ _ _ _ _ __ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVkR)
�. AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA ,
COUNTY 0 • ' - - --
- - - - -~ -
i, - - - -- -- - - - -·- - -- - =-"""'-- - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
/
delivered tome by the Southern Express Company, from ___ _________ __ ·;
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of -Ia,
Consicuee.
Sworn to and subscribed before me ,
this ___day oL. - - -- , 191 _
A~ent for Southern Express Com:pauy.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Incorporated )
SPECIAL LIQUOR RECORD
Received a,.___ _ __ __ _____ _____ Date, _ __ _ _ ___ 191 _
Affidavit No, ____ _ _
Kind of Ardent Spirits_~ -=-----'----------'-- - -- Amoun.___________ Weioh '--- " - - -lbs.
From, ___ _ ________
1
Way-Bill No...c•c.._ _ _- ' - - -- Advsnrea to
To __ _ _ _"-.!....:c.=-----=-- - - - - - - --
Collect
EXPRESS CHARGES
PREPAID
- - - -- - ! - - - - - -
COLLECT
Arld
Unde r ch arge
RECORD OF NOTICES
To Consignee_________ __________
To Shipper _ _________ __ __ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
{OVE R)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE OF VIRGINI A,
COUNTY OF _ _ _ __ __ _ _ __
i, - - - - - - -- - - - - - - - - - - - - - -, being duly sworn, depo se
and say that I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
delivere d tome by the Souther n Express Compan y, from _ _ _
_ _ _ _ _ _ __ _ _ ; that I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by m e
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spiriis
so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used
in violatio n of law .
Sworn to and subs9-ri 'ed before me ,
£. lf: f~
this ___day ot-, - - - - , 191 _
Al:ent for Southern Express Company.
Consir:nee.
�FORM 370-V A
3--;7
EXPR ESS COM PAN Y
SOU THE RN (lncorpo
rn&ed )
sj\£c1AL
LIQU Om
ORD
----- .6----'~
_ D;ate.__rP/
-;:
___
r-
' ---1. --==-------='---'---+!'.::I---_:-- ~
Affidavit No.
-----r_ ~- --- - - - -- --.--r-- -
:'.:.:'. :__ _ __ _ _
Consignee ...b,,::'.'.~::._::_.::.~ :;....¢~::-Z a.~(_~~~~
P R EPA I D
Add
Unde r ch a rge
- - - -)
Shil'J/J~'- _.,_~ ~::;,:: :-=- ----= --_,_- ' - ~
RECO RD OF NOTI CES
_ _ __
To Consignee _ _ _ _ _ ___ _ _ _ _ _
_ _ __
To Shipper_ _ __ ___ ___ ____
ITS FOR PERS ONAL USE .
AFFID AVIT FOR ARDE NT SPIR
(O YER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
STATE OF
PERSO NAL USE
VrnmNJ A,
CouNTY m · - - - -- -- --
~~
i, ---- -- -- - -- ---- ---- ---, being duly sworn, depose and say that
I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
-rt
delivere d to me by the Souther n Express Compan y, from ,
/
~
, ; th t I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by m e
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to Jaw, and that the ardent spiri1.s
so received by m e are for my own use, at
my own home, and that the said ardent spirits will not be used
i_n violation of law.
.
7r(7
Cousianee .
Sworn to and subsc ! be before me,
thi s/ - -day oU
(
- - - - , 191 /
~
/
A&"ent for Southern Ex.vres s Compauy .
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(Incor
porated )
_~_(p:;__\()_
Affidavit No .
A rld
Unde r charge
RECOR D OF ,NOTIC ES
To Consignee ___ ____ ___ _ __ _ __ _
_
To Shipper _ _ _ _ __ _ ____ __ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
(OVltR)
�AFFI DAV IT FOR ARD ENT SPIR
ITS FOR PER SON AL USE
STAT E OF VIRGI NI A ,
COUN TY OF _ _ __ _ _ _ _ __
_
-;
i, --- --- -- - - - --- - - ~ ~ - --- ,
the consi gnee of
being duly sworn , depos e and say that I
am
a certa in shipm ent of arden t spirit s, as
specif ied on other side of this form, this
day
deliv ered to me by the South ern Expr ess
Comp any, from _ _ _ _ _ _ _ _ _ __
__ ; that I am not a
stude nt or mino r, and, if a femal e , I am
the head of a famil y; that the arden t spi
rits so r eceiv ed by me
were broug ht into the State on my writt
en order , and that I have not, withi n
the thirty days previ ous
heret o, receiv ed any arden t spirit s of any
kind whats oever , from any perso n or from
any place whatsoever , in
exces s of the quan tity allow ed by the provi
sions of the Act of the Gene ral Assem bly
of Virgi nia , appro ved
Marc h 10, 1916, or contr ary to law, and
that the ard ent spiri1. s so r eceiv ed by me
ar e for m y own use, at
my own home , and that the said arden t
spirit s will not be u sed in viola tion of Jaw.
Swor n to and subsc ribed befor e me,
thisL _da y oL- . - - - - , 191 _
Aeen t fo r Southe ru E:x:vre ss Comvl luy.
y J/ l
Consi ,:uee.
�SOUTHERN EXPRESS COMPANY
FOAM 370-VA
(Inco rpo rated )
Ad d
P REPA ID
Und e rc harge
RECORD Of" NOTICES
To Consignee___ _ __ _ _ _ __ __ _ _ __
To Shipper _ _ _ __ _____ _ __ __ _ __
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE .
(O VER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
,
i, "
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered tome byl;he Southern Express Company, from _ _ _ _ _ _ _ _ _ __ _ _ ; i;hai; I am nol; a
studenl; or minor, and, if a female , I am the head of a family; that the ardent spirits so r eceived by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,.approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
j
Consi,:nee.
Sworn to and subscr"bed before me ,
this
'J
/4ay ot.. - - -- , 191 _
Aeent for Southern Express Comvauy.
�FORM 370•V A
SOU THE RN EXP RES S COM
PAN Y
(I ncor
porat e d )
191-. ;!
Advn.n re e t o
Coll ec t
Affidavit
ll
No_ Y,"-· f
PREP A ID
REC ORD OF NOT I CES
To Consignee _ _ __ __ __ __
__ __ __ _
_
To Shipp er_ __ __ __ __ __
_ _ _ _ _ __
AFFI DAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
( OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
i, - - - - -- -- - -- - - -- - - -- ---, being duly sworn, depose and say that I am
the consignee o.f a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by ihe Southern Express Company, from _ _ _ ______ _ __ _ __ ; that I am no1; a
siudent or minor, and, if a femal e , I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoeve1·, in
excess of the quantity allowed by the provisions of the Act of the General Assembl y.of Virginia, approved
March 10, 1916, or contrary to Jaw , and that the ardent spiriis so rec eived by me are for my own use, at
my own home, and that the said ardent spirits will no: be~
inl ;lation of law .
Sworn to and subscribed before me,
tbis ___day oL-
Ai:ent f or Southern Exvress Company.
�FORM 370• VA
SOUTH ERN EXPRE SS COMPA NY
(I ncorpo rated )
Affidavit No
£/ t/
/
Advnu r-e a t o
Collect
EXPRESS CHARGES
PREPA I D
A~d
Uude r cba rgo
RECORD OF' NOTICE S
To Consignee _ __ _ _ _ ____ ____ ___
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ _ __
AF'F'IDA VIT F'OR ARDENT SPIRITS F'OR PERSON
AL USE.
(OV ER )
�AFFID AVIT FOR ARDE l'IT SPIRI TS
FOR
PERS ONAL USE
STATE OF VIRGIN IA ,
COUNT Y OF _ _ _ __ _ _ _ __,'--
i,
~ - --- ---'---- -,
~
being duly sworn, depose and say that I am
the consig nee of a certain shipme nt of ardent spirits
, as s 0,llified on other side of this form, this day
deliver ed to me by the Southe rn Expres s Compa ny,
fro~
ai I am not a
studen t or minor, and, if a female , I am the head
of a family ; that the ardent spirits so receive d by
me
were brough t into the State on my written order, and
that I have not, within the thirty days previo us
hereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Ge!!era l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and that the ardent
spirits so rec eived by me are for my own use, at
my own home, and that the said ardent spirits will
ot be used in violati on of Jaw .
{2, ' '
Sworn to and subscr il~ed before me,
this
1?
day
ot.-.'/
I, 191. J
A&"ent for Souther n Express Compau y.
,
Consiau ee.
�SOUT HERN EXPR ESS COMP ANY
(Incorpo rated )
~ ~ ~IJ!! _~~::_ 191;:7
,
Affidavit No., _ _ _ _---'-
- ~ -CL__e_--'-'---'--'--"--Jl ,7--,':. -- -- Amoun .____ _
::__3.4._; ,.;LL.__:: '--'..!=' -
-"'1
"'.J
Advnu re e to
Coll ec t
PR E PAID
Arld
Ondcrcbn r go
RECOR D Or NOTIC ES
To Consignee _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
To Shi pper_ _ _ _ _ _ _ _ _/ _ _ _ __ _ __
_
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
{OY KR )
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
STATE OF VIRGIN IA,
COUNTY OF--
- --
- -----'~ -'-~
~, - - - - -- - - - - - - '·- - - - - - - - - -- , being
duly sworn, depose and say 1;hat I am
the consign ee of a certain shipme nt of ardent spirits,
as speciiie d on other side of this ·form, this day
~
deliver ed to me by the Southe rn Expres s Compan y, from
_ _ _ _ _ _ _ _ _ _ _ _ _ ; that-I am not a
student or minor, and, if a femal e , I am the head of a family;
that the ardent spirits so receive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisi ons of the Act
of the Genera l Asse mbly of Virgini a, approve d
March 10, 1916, or contrar y to law , and that the ardent
spiril.s so receive d by m e are fo r my own use, at
my own home, and that the said ardent spirits will not be
used in viol ation of law.
I
Sworn to and subscri bed before me,
this ___day oL - -- , 191-l
A~ent fo r Southern Express Cowpau)'.
Consiane e.
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(I n corpor
ated )
RECOR D OF NOTIC ES
To Consion ee ___ _ _ ___ _ _ _ _ _ _ _ __
To Shipper _ ___ ___ _ __ _ _ _ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
'
(OV ER)
-
�- _.,,..,..,,,.,.,,.,,.,..,:s,,,..,...,,_...,e,...,sa....,c.,....,.,,,.,..=.,,,.,,.....,=~w«<"w.....,___,.....,_ __,,,...,,~ - -
AFFIDAV IT FOR ARDENT SPIRITS FOR
PERSON AL USE
STATE 0~' V!RGI
COUNTY OF _ _--'-J'------''--- -"C...,::---=----=-c:._J_
. ., 7 (, {
I
,1
, being duly sworn, depose and say Ulat I am
the consignee of a certain shipment of ardent spirits, as sp cified on other side
of this form, this day
delivered to me by the Southern Express Company, from
/
; that I am not a
student or minor, and, if a female, I am the head of a family; th t (he ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
th e thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any p erson or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March IO, 1916, or contrary to law, and that the ardent spirits so rec eived by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Cons ii;:noe.
Sworn to and subscribed before m e,
this ___day oL-
"
/,
.I
)
/
,,
,
19Ly
,
'7
✓I/£
7 /i"
�-- -·- --- - --- - ------SOUTHERN EXPRESS COMPANY
l'ORM 370•VA
(luco rporated )
•
S f ~ L LIQUOR RECORD
Received at--- ~ ~~ ~ ~ ~ -,,___ _ _ _ _ Date _ _ _ __ ___ 19 J_
•
J
Affidavit No . ~ /~ /_; :_ _
-~
- '--~ - - ' - - - ~ - - -~ - - -- - Amoun ~ _ ______, ____ Weioht_--'_ _ lbs.
Way-Bill No· -- - ~ -
v ~ -- -
To _____ _______________
~ _ _ _ 191_
__
Advnn,ee t o
Collect
From _ __ _ __ _ _ __
EXPRESS CHARGES
COLLECT
~
Arld
Uude rcburgc
RECORD OF NOTICES
To Consign ee ________ ________ __ To Shipper_ _ _ _ _ _ _ _ _ _ _ __ __ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(ov ,a)
�AF FID AV IT FO R AR
DP "!T ~ SP IRI TS
FO R
STA TE OF VIR GIN IA
,
COU NTY m• __ __
I
PE RS ON AL US E
_ _ __ __ _
i, -- -- ---- -'---
-- -- -- -- -- -, bei ng dul y
the con sign ee of a cer tain
swo rn, dep ose anq say tha
shi pm ent of ard ent spi rits
t I am
, as spe cifi ed on oth er side
of this for ~, this day
del ive red to me by the Sou
the rn Exp res s Com pan y,
from~------stu den t or min or, and ,
- - -- -- ; tha t I am not
if a fem ale, I am the hea
a
d of a fam ily; tha t the ard
wer e bro ugh t into t.he Sta
ent spi rits so rec eiv ed by
te on my wri tten ord er, and
me
tha t I hav e not , wit hin
her eto , rec eiv ed any ard ent
the thir ty day s pre vio us
spi rits of any kin d wha tsoe
ver , from any per son or from
exc ess of the qua ntit y allo
apy pla ce wha tsoe ver , in
wed by the pro visi ons of
the Act of the Gen era l Ass
Ma rch 10, 1916, or con trar
emb ly of Vir gin ia, app rov
y to law, and tha t the ard
ed
ent spiri~s so rec eiv ed by
my own hom e, and tha t
me are for my own use ,
the said ard ent spi rits wil
at
l not be use d in vio lati on
of Jaw .
Sw orn to and sub scri bed
bef ore me ,
this __ _day oL-
l Ji
Ai:e nt for S6 uthe rn Exp
ress Com pauy .
.(A_
Con sien ee.
�FORM 370•V A
SOU THE RN EXP RES S COM
PAN Y
( Incor
porate d)
LIQ UO
R.7! ~0
- -- ~'U
~~
_ -- 191
Affidavit No _ _ _ _ _ _
Advan re11 to
Coll ect
REC ORD OF NOT ICES
To Consignee _ __ _ __ __ __
__ __ ___ _ To Shipp er _ __
__ __ __ __ __ __
AFF IDAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
(OV ltR ) ,
___
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
~, - -F-"""'-"--=--'-'--= - - -L-~ --=---- - - - -- - -- - , being duly sworn, depose and say ihat I am
as SP.e Hied on other side of t his form, i is day
;J
)? I
delivered to me by the Southern Express Company, from ,/J
I' •
; that I am not a
student or minor, and, if a female, I am the head of a family; Wat the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw, and that the ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in vi lation of law.
.
Sworn to and subscribed before me ,
this:2..i__day o
. :iu
. . ,.,=-,-=-+-_,
:U J~
_ =-r-i~--=---.:...=---
tl
t
A~ent for Southern Express Compan ~·.
Consienee.
�FORM 370-VA
SOUTHER N EXPRESS COMPANY
(Incorpo rated)
PRE P A ID
Ship
RECORD OF
To Consianee _ _ _____ _ ______ ____
To Shipper _ ____ _____ ______ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OV ER)
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR
PER SON AL USE
STAT E OF VIRG INI A,
CouN TY m ' _ _ __ _ _ _
__ _ _ ' - - - - - ~
i, -- -- --- - -- -
- - -- -- -- - - -, bein g duly swor n, depo
the cons igne e of a certa in ship men
se and say that I am
t of arde nt spiri ts, as spec ified
on othe r side of this form , this
day
deliv ered to me by the Sout hern Exp
ress Com pany , from ___ __ _
__
__
__ __ ; that I am not a
stud ent or mino r, and, if a fem ale
, I am the head of a fami ly; that
the ard ent spiri ts so r eceiv ed by
were brou ght into the State on my
me
writ ten orde r, and that I have
not, with in th e thirt y days prev
here to, rece ived any arde nt spiri ts
ious
of any kind what soev er, from any
p erso n or from any plac e wha tsoev
exce ss of the quan tity allow ed by
er, in
the prov ision s of the Act of the Gene
ral Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
an d that the ard ent spiri is so r eceiv
ed by m e are for my own use, at
my own hom e , and that the said
arde nt spiri ts will not be used in
viola tion of Jaw .
Swo rn to and subs cribe d befo re m
e,
thi s __ _day 01.. - -- - , 191_
A2en t for South ern Exvress Comv
auy.
Cons ienee.
�SOUTH ERN EXPRES S COMPA NY
(I ncorporated )
.. ~
Affidavit No?
Advnnrea to
Collect
r (/
. /y
PREPAID
RECORD OF NOTICES
To Consion ee _ _ _ _ _ __ _____ __ _ __
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE.
( OV ER}
�AFFI DAV IT FOR ARD ENT SPIR
ITS FOR
PER SON AL USE
STAT E OF VIR
COUN TY OP-= - -- - ----
----·<
L' ---- -'=~ --- - -- - - -- - - - - -- - , being duly sworn , depos e and say that
the consi gnee of a certa in shipm ent of
I am
arden t spirit s , as
citied
s
on other side of this form, this day
deliv ered to me by the South ern Expre ss
Comp any, from -'-.-- ' - - - - -·- - - - - - ; that I am not a
stude nt or mino r, and, if a femal e, I am
the head of a famil y; that the ardim t spirit
s so receiv ed by me
were broug ht into the State on my writt
en order , and that I have not, withi n
the thirty days previ ous
heret o, receiv ed any arden t spirit s of any
kind whats oever , from any perso n or from
any place whats oever , in
exces s of the quan tity allow ed by the provi
sions of the Act of the Gene ral Assem bly
of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law, and
that the arden t spirit s so receiv ed by me
are for my own use, at
my own home , and that the said arden t
spirit s will not b used in viola tion of law.
I
Swor n to nd subsc rib d befor e m e,
this/ . ,.., day ot.../ 1
, 191_ !
Ae-ent for Southe rn Ex.pre s s Uompa ny.
Consia nee.
/
�FORM 370•VA
SOUTH ERN EXPRE SS COMPA NY
(lucorpo r&ted)
LIQUO R RECOR D
Z - ,l-1
Received at_~ ~~f:;r'--~ ¼----...~ ~ ~---D ate
7
1911--
Affidavit No.
'f:/()
I
A dvn. nres t o
Co ll ec t
RECORD OF" NOTICE S
To Consion ee _ _ _ _ __ _ _ ____ __ _ _ __
To Shipper _ _ _ _ __ __ __ _ _ _ _ _ __ _
AF"F"IDA VIT F"OR ARDENT SPIRITS F"OR PERSON
AL USE .
{O VER)
�AFFID AVIT FOR ARDE NT _ SPIRI TS FOR
PERS ONAL USE
STATE OF VIR
COUNT Y OF--'- -,-C-~ --'----
-'--,4'-- -
~, - - ~- ---'-.:....CC- ~ - - --,.---- '----'- -'---= ----, being
duly sworn, depose and say ihat I am
ihe consig nee of a certain shipme nt of ardent spirits
, as
.§_j1ified on other side of ihis form, ihis day
deliver ed to me by ihe Southe rn Expres s Compa ny,
from
J .,/ I
; that I am not a
studen t or minor, and, if a female , I am the head
of a family ; that; the ardent spirits so receive d by
me
were brough t into the State on my written order, and
ihat I lfflve not, within the thirty days previo us
hereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and that the ardent
spiri1s so receive d by me are for my own use, at
my own home, and that the said ardent spirits will
not be used in violati on of Jaw.
//1- ..
/I r/(
Consicn ee.
J
�Advan ce s to
Coll ect
RECORD OF" NOTICES
To Consign ee _ _ _ _ _ _ _ _ __ _ __ _ __
~
EXPRESS CHARGES
COLLECT
P RE PA I D
Add
Underchar ge
To Shipper _ _ __ _ _ _ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
/
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
-
PERSONAL USE
STATE OF VJRGINIA ,
COUNTY OF _ _ _ __ _ _ _ __ _
~, - - - - - - -- - - - - -- - - - - - - - -, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as s cified on other side of this form, this day
I"
; that I am not a
✓. l '
delivered to me by the Southern Express Company, from(
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiril.s so received by me are for my own use, at
e'used in violation of law .
my own home, and that the said ardent spirits will_ ~
Consianee.
p
rI
7
A&"ent for Sonther. Express Compauy.
�Affidavit No.~
/ .(/t'
t,t-•4;;==
j
y-
#
RECORD OF
To Consionee _ __ _ __ _ _ _ _ _ _ __ __
To Shipper _ _ _ __ _ _ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE:.
( OV ER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _ _ _ __ _ _ _ __ _
i,
..._.
,
1!,eing duly swqrn, ,J;lepose and say that I am
the consignee of a certain shipment of ardent spirits, as speci:fl_ed on otlier ' side of this form, this day
delivered to me by the Southern Express Company, from _ _____________ ; that '! am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, fr.om any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Consignee.
Aeent fo p'Southern E~vress Comvauy.
�Affidavi~ No; ~
P REPAID
Arl d
Oude rcbo.rge
• RECORD OF
To Consignee _ ____ ____ ___ _ _ _ __
To Shipper _ _____ __ _____ _____
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
( OV ER)
�AFflDAVIT FOR ARDENT SPIRITS FOR
i,
PERSONAL USE
c
(l
being duly sworn, depose and say that I am
s e'cified on other side of this form, this day
./
;
, th t I am not a
"
1
delivered to me by the Southern Express Company, fro
student or minor, and, if a femal e, I am the head of a family ; that the ardent spirits so r eceived by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever , in
excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Virginia , approved
March 10, 1916, or contrary to law, and that the ardent spirHs so r eceived by me are for m y own use, at
my own hom e , and that the said ardent spirits will not be used in violation of law.
---='---= -
---'= :.._--=--'-·--''----'-''--- - - - - - - ,
the consignee of a certain shipment of ardent spirits,
.
Vt~
~
- - -~---- -- - -- -- - -- -- - - -- - Consicnee.
Sworn to and subs
this ___day of-
ibed before me,
- -~ ' - · 191 _
�FORM 370•VA
SOUTHERN EXPRESS COMPANY
(Incorporated)
Affidavit No(
1 j' /
Add
Undercha rg e
RECORD OF' NOTICES
To Consianee _ _ _ _ _ _ _ _ _ _ _ _------''-----
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ _ __
AF'FIDAVIT F'OR ARDENT SPIRITS FOR PERSONAL USE.
(OVXR)
I
�AFFIDAVI T FOR ARDENT SPIRITS FOR
PERSONA L USE
I am
... , - - - - -- -- -- - ·"--- -- - -- -- - - , being duly sworn, depose and say that
day
this
form,
this
of
side
other
on
specified
as
spirits,
ardent
of
shipment
certain
the consignee of a
I am not a
delivered to me by the Southern Express Company, from _ _ _ _ _ _ __ _ __ _ _ ; that
by me
received
so
spirits
student or minor, and, if a female, I am the head of a family; that the ardent
previoUB
days
thirty
the
within
not,
have
I
that
and
order,
written
my
on
were brough1; into the State
in
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
approved
Virginia,
of
Assembly
General
the
of
Act
the
of
provisions
the
by
allowed
excess of the quantity
own use, at
March 10, 1916, or contrary to law, and that the ardent spirils so rec eived, by me are for my
_
_
_
_
_
.
aw
l
of
folati
in
ed
wild
spirits
ardent
my own hom e, and that the said
Sworn
z
•
and subsc:?e ' before me ,
this /
/J
day o1- ,,__ _ _ , 191_ /
/
A2ent for Southern Exvres s Compa.uy.
'
Consi£uee.
�RECORD OF NOTICES
To Consignee
(OVER)
��..,.p
ADAM S EXPR ESS COMP ANY
•
•<
'
.
(OVBB)
�STAT E
ol' Vm"
CoUN TYOP
(_,
fl.
~
? ~6
>
I,
~
the consignee of a ~ rtain ~bigment of arden t spirit
s,
, depose
say that I am
I specifg ieddulyonsworn
other side of this orm, this day
t/vf_
and
·
,
delivered to me byth e~~ Exp ress Company,
t I am not
a stude nt or minor, and, if a ~mal e, I am the bead
of a famil y·
t the arden t spirit s 80 rece1
y me
were broug ht into the State on my writt en order
, and that have not, withi n the thirty days pre
ous
hereto, received any arden t spirit s of any kind whats
oever, from any person or from any place whats
oever, in excess of the quant it allowed b the provi
sions of the Act of the General Assembly of Vir.
ginia, approved March 10,
ary to law, and that the arden t spirit s 80 receiv
ed by me
�D ELIVE RY PORM
eo
ADA MS EXPR ESS COM PAN Y
R&V l allD J UI.Y, 1917
/
_ _ ...__ _ -'--- ,.--' ---~
Reoelved at_L
I'
P.O. Address
RECORD OF NOTIC ES
_
To Shipper _ __ _ _ _ _ __ _ __
T o Conelgnee
(OVIIB)
�S'l'ATE 01' VIRG
COUNTY OF
~
/Z (,
1 /(.
, 1>eing duly sworn, depose and say th11t I am
y==
/:
f:
I,
lfpe · ed on other side of this fVm, this day
as
spirits,
ardent
of
shigment
the consignee of a certain
I
delivered to me by the Adams Express Company, fro _ _...._....__ ................_ __..............._; ·t lt,Am not
the ardent spirits so received by me
a student or minor, and, if a female, I am the head of a family;
within the thirty days previous
not,
have
I
that
and
order,
written
my
on
were brought'into the State
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Vir.
ginia, approved March 10, 16 or contraq; to law, and that the ardent spirits so received by me
l
are to be UBed by me for
•
·
'
(State whether for Sclentlftc, Sacramental, Medicinal or Kechanlcal)
ses.
�P.O. Address
RECORD OF NOTICES
To Consignee
To Shipper
(OVBR)
�STATE OF VI~GINIA,
.,. , being duly sworn, depose and say that I am
I,
the consignee of a certain ahigment of ardent spirits, as specified on other side of this form, this day
' ; ; th' t Him not
·
. ·,
delivered tom~ byth~xpress Company, fro
a student or minor, and, if a female, I am the head of a family ; tha( the ardent spirits eo received by me
were brought into the·-State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 19}6, ortconp:ary to law, and that th~ ardent spirits so received by me
are to be used by me40'-'· .;:-· , •
·
, /
1
,.,._,., \ . . .
'{State whether for Scientific, Sacramental, K e e l ~ ~
l
ieir'O
~ -
purposes.
/
,;ignee)
/
,,
I
�- --------·-------------------- --------ADAMS EXPRESS COMP ANY ·
, ,,
1)1Velgh..._-r:::==!
J>a.
Add
Undercbarire
RECORD OF
To Conalgne
To Shipper _ _ _..________/-'-- - - - - -
(OVIIB)
�•
,,.
the
'-+-----~------~------•
being duly sworn, depose and say that I am
on other side of tbill f~ , this day
signee of a certain ahif?ent of ardent ap· ta, as a
i, ____
not
, a
delivered to me by the~press Compa.ny, fro
a student or minor, and, if a female, I am the head of a fam1 y ; tha e ardent spirits BO received by me
were brought into the State on my written order, and that I have-not"; within the thirty days previous
hereto, rece~ved any ardent spirits of any kind whatsoever, from any person OI' from any place whatsoever, in exceas of the quantity aUowed by the provjsions of the Act of the General Assembly of Vir.
, or co~ ary to law, and that the ardent spirits so received by me
ginia, approved March 10,
�DELIVERY FORM 80
Kind
WaJ-r,J•''Jl-f~~;,111;;;;_;_...ia ---- - ;~ ~ :::::::=
To -...,....,,rc....,4---=-------"'-'b,;,---- - --
To Conslgne
.-------.---------------.----To Shipper
(OVER)
�, • ' I! 1 1 >< , •
I, J
the consignee of a certain ahigment
f
, ".' \
l)eing duly swom, depose and say that I am
r-roent spirita, aa S{Je~ifted on other ~ide of.~ form, this day
ot
, tti
{
delivered to me by the ~ p r ess Company, from
me
by
received
so
spirit&
ardent
thaJthe
a student or minor, and, if a female, I am the head of a family;
days previous
were brought into the State on my written order, and that I have not, within the thirty
place whatso· hereto, received any ardent spirits of any kind whataoever, from any person or from any
of Virever, in excess of the qq.antity allowed by the provisions of the Act of the General Assembly
by me
received
so
spirita
ardent
the
that
ginia, approved March 10, 1916, or contrary to law, and
are to be used by me for
l
l
L
purposes.
(State whether for Scientltlc, Sacramenta l, Medicinal or llechanleal)
(Conelpee)
'
�P.O. Add_ress
RECORD OF NOTICES
To Consignee
To Shipper'_ _ _ _ __ _ __ _ __ _ _
(OVE R )
�I
, being duly swom, depose and say that I am
,
Y <
I, • ~ (
the consignee of a certain 1higment of ardent spirite, as specifted on other side of f;hls.t'orm, this day
/_/_
.
uf
;t
.
1t!ha.t
I am not
1: .. ; >
delivered to me by the ~ ~ r e s s Company, frmrr:'.'.: //(...
lne
the ardent spirits so rece~
a student or minor, and, if a female, I am the head of a family
were brought into the State on my written order, and that I hava not, within the thirty days previous
hereto, received any ardent spirite of any kind whatsoever, fronr any person or from any place whatsoever, in exceBB of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved .March 10, 916, or contpu"Y to law, and that the ardent spirits so received by.me
are to be used by Die for
l
£·
'-
(State whether for Scientific, Saeramental, ~ or
l
this ,;)
~
purposes._
~ cf~ .' ✓
_/,.
�To Shipper
(OVER)
�STATE O l ' V ~
COUN'rY
OF-------------
----
1,----- ::,'I'=,,:,,-+-- - - - - ' - ' - - - - - - - - - . tieing duly sworn, depose
and say that I am
the consign«¥! of a certain shigmen t of ardent spirits, as specified on otheJ side
of this form, this day
~livered to me by tb~x pres a Company
,~ ,
, at I am not
astudent or minor, and, if a female, I am the head ,offrora
a family ; that the ardent spirits 110 received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
beret.a, received any ardent.spirits of any kind whatsoever, from any person or
from any place whaaioever, in excess of the quantity allowed by the provisions o:l:theAct"'of the General
Assemb lyofVir•
. ginia, approved March 10, 1&16, or contrary t.o law, and tbat the ·ardent-s
pirits- so received by me
are to be JlSed by me for
·
·.
- _ -. - ~ ~urpos e_s.
(State whether for Sclentille. 13aeraiont al, Medicinal or Mee&inl
Sworn t.o and ~ before me,
this
day of. , ,
:/ , 191
(Cone~ )
•
·
�DELIVERY PORM
eo
ADAMS EXPRESS COMPANY
RECORD OF NOTICES
To Conalgne
/
To Shipper _ _ _ __ _ _ _ _ _ __ _
(o ~)
�- ~~--- ~-
-~ ---·.. .------....______________________,
�1- ..~ ~~-
- -_ ,=___,.___
-:-::-:-=:
___:-:-:-:
___:-:-::
___:-:-:-:
___::::=
___ _,..,,.,..,
...
2....-::-,4'
_ ..
..,._=- -........ ,._______::-:;-_
Kind of Arden t Spirite.~ •~1,,1 111_ ,.~rc. .-.-J----AI
w/,Lt ~-:
,Way-Bill No
Dat..,_,._t..To _ _ __ _ _ _ __ __ _ _ _
~++_,,_-
~
RECOR D OF NOTIC ES
To Consignee
To Shipp er
.,
(OVER)
�ti
�To Shippe r
(ovu)
�-------
=-:~~ C---:STATE-~~-V~
•
-
'
homg duly ,wom, depo,e and ,ay that 1 am
the consignee of a certain shigment of ardent spirit&, as s
·
on other side of
is form, this day
- - - - i that I am not
_~
,.,....
=.....:.
-=:.-..rdelivered to me by th~ ~~xpress Company, fro1p;,f1C...~::;;_.q.._L
a student or minor, and, if a female, I am the head of a family; th _the ardent spirits so received ~y ~e
were broupt into the State 9n my written order, and that I have not, within the thirty daysl)reviQus
hereto, received any ardent spirits of any kind whatsoever, from ,any person or from any place wha~
ever, in excea:s of the quantity allowed by the provisions oftheAct of the General Assembly of Virginia, approved March 10, 1916, or- eontr,ry to law, and that the .ardent spirits so received by me
(U'e to be used by me fo~
Sworn to and BUbs~
.
purposes.
1(/1.;,. tf • «.. .,....,...,_
,...,.w...,_ ,~~-.....~ ~
ore m~,
"'· '70 ~tfJ
£ ¥ ~--
(Con• lpiee)
�DELIVE RY P'ORM
To
(OVEB)
�- --- ---~~ ---- ---- ~~-~~- -- -- -- -- -- -- -- -- ---- -~
STA TE 01' VIR~
CouNTY
· f='2 :'~- ::-7"
.
I,
the consignee of a cert ain ahigmen
t of iu4lent spirits,
,
being duly sworn, depose and say
that I am
ass~
on o~ side of this fqrm, this day
/:}
/.
delivered to me by the Adams Exp •
l~tL
ress Company, frnm ~ • /fL,/_ / 1 '"t I
I
"
_;t, •
a stud ent or minor, and, if a female,
, that I am
not
I am the head of a family ; that the
arde
wer e brou ght into the Stat e on my
nt spir its so received by me
writ ten order, and that I have not,
with
hereto, received any arde nt spir its of
any kind whatsoever, from any pers in the thir ty days previous
on or from any place whatsoever, in excess of the qua ntity allow
ed by the provisions of the Act of
the General Assembly of Vir.
ginia, approved March l_Q, 191~, or
con tr8" to law, .and that the arde
nt spir its so received by me
�DELIVERY P'ORM 60
ADAMS EXPRESS COMPANY
Received at.- -..1""""-.;--,-.,....,~~~- - Conelgnee,_--;-r-r- =--~q,,.,:+..,.._ ~---"'""'--I
Kind of Arden
RECORD OF NO
To Consignee
To S~lpper
(ovn)
�STAT E OF VIRGl MIA,
I,
✓
being duly swoni, depose and say that I am
the consign" of a certa in shigmen\ of arden t spirit
s, as specified on other aide of this form, this day
delivered to .me by the Adams Expre ss Company,
'
~
!' ; thaf hm not
ttstud entor mino r, and, if a female, I am the head
of a ~mil y ;..that_t}ie_ard1m t spirit s so received byme
were broug ht into the State on my writt en order
, and that I have not, within the thirty days previo
us
hereto, received any arden t spirit s of any kind whats
oever, -from any person or from any place whats
oever, in excess of the quant ity allowed by the
provisions of the Act of the General Asse mbly
ofVir .
ginia, approved March 10, 1916, or contr'1')' to
law, and that the arden t spirit s so received by
me
hoia,·•·
Swor_,;.to_a nd Sllbscril)e4 before me, __
· this r
}- d"Y ot:
,, · , 191 )
'
�DELIVERY P'ORM
eo
ADAMS EXPRESS COMPANY
Affidavit No, _ _ __
To Shipper _ _ _ __ _ _ _ _ _ _ __
(OVER)
�'
I
•
,,
\) ,(
,
,,
r(
-, :
· , t~/
/
0
I .'
:~~th~
being auty sworn, depose and say that I am
the consignee of a certain ahigment of ardent spirits, as r r i1ied_OD otqer sjde of th~
day
1:2:'
,,
,
I/& / - · / " ., \ ';
'1~t1: not
delivered to me by the Adams Express Company, fro
a student or minor, and, if a female, I am the head of a family ; tifot the ardent spirits so recei
by me
wei:e brought into the State on my written order, and that l ~ve not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess Qf the quantity allowed by the provisions of the Act of the General AssemblyofVir.
ginia, approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me
II
,
,
,
are to be used by me for
L.(,,{ -1- I Cl:.- '--purposes.
/ ,/c. ,(, t i
(State whether for Scientlfie, Sacramental, Medicinal or Mechanical)
/
.~
,,.
' (Coialpee)
I
�DELIVERY FORM 60
ADAMS EXPRESS COMPANY
Affidavit No, _ __ _
RECORD OF NOTICES
To Shipper _ _ _ _ __ _ __ _ _ __ _
To Consignee
.
•
(OVE R )
�I , - - - ' ' - - - - - - - - - - - - - - - - - - - , being duly sworn, depose and say that I am .
the consignee of a certain shigment !)f ardent spirits, as specip ed on other side of this form, this day
~
".11
_;
~
-
r
----.
delivered to me by the Adams Express Company, f r o ~ ~ - - - - - - - - - - - - ; that I am not .
a studentorminor, and, if a female, !'am the head of a family; that the ardent spirits so received byme
were brought into the State on my ~itten order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me
~
-~
are to be used by me for
.
·
purposes.
.
.
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
•
Sworn . to and subscribed J,efore me,
• • .?
this /
; day of · /~
, 191
_;
t/
Agent for ,Adamo Expn,oo Company.
,:,·
�D ELIVERY PORM
eo
To Ship per _ _ _ _ _ _ _ _ _
__
,
(o vn)
_ _
��Affidavit No, _ _ __
P.O. Address
RECORD OF NOTICES
To Conalgn_ee
To Shipper
(OVER)
~ -- .
�STATE OP VIRGINIA,
I,._.:- ~~--- --~--- ------ , being duly sworn, depose and say that I am
the consignee of a certain shigment of ardent spirits, as specified on other side of this form, this day
Adams
delivered to me by the
Express Company, from ; that I am ~ot
a student or minor, and, if a female, I am the bead of a family; that the ardent spirits so received by me
were b~ught into the State on my written order, and that I hJ'Ve not, within the thirty days previous
hereto, received any _a rdent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ardent spirits so "received by me
are to be used by me for
·
·
(State whether for Scientific, Sacramental, :Medicinal or :Mechanical)
purposes.
...
Sworn to l!nd subscril,)ed before me,
.,,, I
•
tbis._ _....,...~day qf
, 191 ,
... ,.
(Conalgnee)
•
,i
Agent f o ~ Expre88 Company.
,
•
�DELIVERY l"ORM ISO
RECORD OF NO
To Consignee
ADAMS EXPRESS COMP ANY
To Shipper
(OVBB)
�STATE OF VIRGINJA,
-,-
CoUNTY OP;_
· _- (_
/
/
:..o:...,.;;..'-"-- - -
/
1:
l.being duly sworn, depose and· say that I am
the consignee of a certain shigment of ardent spirits, as. Sl)El i!J.ed on other side of thls form, this day
S ,..-
,
-
, I\
.. '
delivered to me by the .Aeem& Express Compaily, froto / ;., ...
•- •
.: · ·, ;'tDat ani not
a student or minor, and, if a female, I am the ~ead of a family ; piat the arden_t sptrits so received by~~
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in e~cess of the quantity allowed by the provisions of the Act of the General Assembly of Vir.
ginia, approved March 10, 1916, o~ contrary to law, and that the ardent spirits so .received by me
,
are to be used by me ifor:
1
-1 • •
L
,· ~
purposes.
(State whether for Scientiftc, Sacramental, kedichial or llechanlcat)
Swo~ to-411d subecri",d bef~re me, .
l- I
,
~
•
./
this Y
day of
, 191 •· 1
~
I
Aaent for,....._ ~ Crmpany•
..4~~
, ~ R~
.
.
..
,.
�DELIVER Y FORM 80
RKVl • ED JUI.Y, 1817
,,-
ADAMS EXPRE SS COMP ANY
SPECIAL LIQUOR RECORD
Received at.- -1._...:;..:;.c:_..c....:-l'-==------ ,~--Conalgne e._ ,,,.~,,,_,'----1,,...------'i:,a,-","-:>!!t--cr-,;.:-::f-:,:::-,:: - - - -
Kind of Ardent Spl rlts,_ .:-;-,...,_.,"""""_ _ --z-r-~ --"'---- ""
Way-Blff No. --,.,,..._______
To-..,,._;___,,L.,;~c:,..,.--h' -='----- - - P .O. Address
RECORD OF NOTICES
To Consignee
~To Shlppu
t.
(OVBR)
..
-
�STAT EOFV IR~
delivered to me bythe
xpress Company, frnro / / / · ,'i't 1-'L- ✓; • i,
, .._,..;..t1i
_a..f •t'"'a_m_ n_o·t
a stude~i or minor, and,. if a female, I am the head of a f~ily; that the
ardent.s piri~ so receiyed by rpe
were brough t into the State on my written order, and that I have not,
within the thirty days previous
hereto, received· any ardent spirits of any kind whatsoever, from-an y
person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act
of the General Assembly of Virginia, approved March 10, 1916, or contrar y to law, and that the
ardent spirits. so received by me
JI
are to be used by me for
L
< < _.I': ~
• r
purposes.
• .
· (State whether f~ Scientific , Sacramen tal. llledlclnal or
-//
4
.
/
)
L , ·
Mechanic al)
·-~
--:;-._, ,..
�DELIVE RY P'ORM 60
RIIVISIED JULY, It
ADAM S EXPR ESS COMPANY
7c;;;c .,t~~;;;;;;:--.- .."
liiiii., -~
-=-= --lbs.
To Shippe r
(ovza)
�STATE OF VIBGDIIIA,
!, _ _ ___ ___ ___ ___ ____, being
duly swom, depose and say that I am
the ~naign ee of a certa ,.~ e n t of ardent spirits, as specifie
d on other side of this fo~, this day
delivered to me by the .
Expres s Company, frnm
,
; ~ t'~
not
a studen t or minor, and, if a female, I am the head of a fakily ; that
the ardent spirits so received by me
were brough t into the State on my written order, and that I have
not, within thi thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from
any person or from any place whatsoever, in exceu of the quantit y allowed by the provisions of the
Act of the General Assem blyofV ir.
ginia, approved March 10, 1916, or contrar y ~ law, and
that the ardent spirits so received by me
are to be used by me for
-
(State whether for Sclentlftc, Sacnme ntal, Kedlclna l or llechanl
Swom tq ~and subscrilfed before me,
'
1 /
eal)
purposes.
�DELIVERY FORM 60
ADAMS EXPRESS COMPANY
To Shipper
It
•
(OVBB)
�STA.TB 01'
V,,.'fNIA,
CoUNTY 01'.:.,
I# ....
( ------'-'-~.......- ~
' , being duly sworn, depose and say that I am
e consignee of a certain shigment of ardent spirits, as specified on other side of this form, this day
·vered to me by the,..__. Express Company, fro..,._ _______ _~ - - - - i tliilrl am not
· tudent orinihor, and, if a female, I am the head of a family ; that the ardent spirits BO recf ived by me
re brought into the State on my written order, and that I have not, within the thirty days previous
ereto,-received any ardent spirits of any kind whatsoever, from any person or from any place whateo' ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, li16, or conq,uy to law, and tha! the ardent spirits BO received by me
1-; •/1
are to be used by me for
'
.
:
'
-
(State whether for Scientific, Sacramental, llediclnal or Mecbanical)
purposes.
/
..
Swom)o,Pfd subs~ e~ -~o..re me,
this j,, · day of'-' '_
· , 191
(Conalsnee) ·
/
I
•
�DELIV ERY P'ORM
eo
R llVIBIED JUI.Y, 11117
Reoelved a
RECO RD OF NOTI CES
To Consignee
To Shipp er _ _ _ __ _ _ _ _ _
_ __
•
(o VBB)
�STATE OF VIRGINIA,
-·---
"
COUNTY OF _ _ _ _ __' _ _ _ _/
1 , - - - - - - - - - - - - ~ ~ - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shigmer{t of ardent spirits, as specified on o~her side of this form, this day
s~
~
V
delivered to me by the ~ Express Company, fro ' .
; that I 'aJn not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by-qie
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess ofJ he quantity allowed by the provisions of the Act of the General Assembly of Virginia, apJ,>roved March 10, 1916, :or contrary to law, and that the ardent spirits so received by me
are to be used by me for
'
.{
·
,
~
..._-
purposes.
(State whether for Scientific, Sacramental, Medicinal or Mechani~ I)
v:..1 I'
I
Sworn to and subscr~ ed before me,
1
this /t--r d~y_()f t -~ .,?"" , l9l'J. .
;;r
7
/
j
,
\
i' -
,, ,
Agent for
/4
"
r:::::!..
!I'
/::1
Express Company.
(Consignee)
.,,/
�DELI VERY P'ORM ISO
•
•
RIIVl IED JUI.Y, 1 17
Affidavit No, _ _ __
RECORD OF NOT ICES
To Conelgne
.
·
To Ship per
,
(OVBB)
�STATE OP
V~
,
•
CoUNTY OF ~ - { / ( /
,
'-7J1,
v _ ,
I,
t -?J -:- ~
1. I
being duly swom, depose and say that I am
the consignee of a certain abigment of ardent spirita, aa s~ified on other side of this form, thill day
1
d~livered to me by the Adame Express Company, -frorp- ' f .1'.t1,
, that I am not
a student or minor, and, if a female, I am the bead of a fam · · at the ardent spirita so received by me
were brought into the State on my written order, and tha have not, within the thirty days previous
, hereto, received any ardent spirits of any kind whataoever, from any person or from any place whataoever, in excess of the·quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or contraey ~ law, and that the ardent spirita so received by me
are to be used by me for
/z~
J! 41.,<Z -L
(State whetherforclentlfic, Sacramental, llediclnal or lllechanlcal)
purposes. ·
ztt . r _c.c..t
(Comipee)
1.-
�DELIVER Y l'ORM
eo
RIIVl81ED JUI.Y, 1817
ADAMS EXPRE SS COMPANY
Affidavit No, _ _ __
Add
Uadereharire
S!llp~r _......&'-',...................._~"'""",...,.._'-""-....__
P.O. Address
RECORD OF NOTICES
To Consignee
To Shipper _ _ _ _ _ _ _ _ __ __ _
(OVBR)
•
�STATE OF VIRGINIA,
I, ,
,
., ing duly swom, depose and say that I am
the consignee of a certain abigment of ardent spirits, as specified on other side
of this form, this day
6 ~ _. Express Company
·,' delivered to me by the....
, from
( _. ,
;,.. ; ,t!mt. I am not
a student or minor, and, if a female, I am the bead of a family ; that the ardent spirit
• so received by me
were brought .iJlto the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whataoever, from any penon or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the G~neral
Assembly of Virginia, approved March 10, 1916, or contraey to law, and that the ardent spirits
so received by me
• j
I l
are t<t be used by me for
(
·
purposes.
(State whether for Scientific,
j
Sacrament al, Kedlc:lnal or M:echanlcal)
)
Sworn
and subs~t
~ b~fore me,
this._·-- --day of ' '
f , 191
7
,
"(¢"',:I t <
�DELIVERY FORM 60
Received
EXPRESS
at__.._.~~r-...c-=,4t~-=----='----=--
Conalgnee_ --¥4t,L,t.~~L•l!!£11!!!1!!~--A1--___:_-
To Consignee
To Shipper
(OVBB)
�-..,
----- __·---------~
being duly sworn, depose and say that I am
,
I,
the conalgnee of· a dllrtain shigment f ardent spirit., as Sl)!3Cified on other side.of this form, this day
deliverecl to me by the ~xpress Company,.Jrotb-"-_ _ _ _ _.....__""-__:;-t1iat I am d"ot
a student or minor, and, if a female, I~ .the.head of a family ;_that the ardent spirits so recei-!ed by JJl~
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General AssemblyofVir.
ginia, approved -March _10, 1916, or contrary to law, and that the ,.ardent spirits JIO received by me
are to be used by me for
_
:
" _
.
_
11~es. ,
(State whether for SclentUic, Sacramental; ilecllclnal or '.Meclulnlcal)
Sworn to and subscribed before me,
day of_____,, 191 • ,
this •
·
(Cona~)
�DELIVER Y FORM 60
ADAMS EXPRE SS COMP ANY
Rl:V18ED JUI.Y, 1917
SPECIAL LIQUOR RECORD
........-;. ---191 -!: Affidavit No, _ _ __
.......~---._ _ __
- ~-h.e.-- -;;,:..+*---:~... :=-\=_ .----P , 0. Addres,___ _ _ _ _
RECORD OF tio¥fcEs
To Consignee
To Shipper
(OVJIB)
�f'
I
~
. . . ,__
,
I, ,t
being duly sworn, depose and say that I am
the corlignee of a certa in shigm ent of arden t spirit
s, aa specided on other side of tbi, form, this day
.
delive
red "to me by the ,S(N.V~
d-,"' .,_..-z,.
lMlem' s Expre ss Compaµy, from r
, ---....:::-m not
a stude nt or minor, and, if a .female, I api the head
of a f!m_iIJ ithat 'the art!~nt spirit s so received oy
were broug ht into the State on my writt en order
l!l-e
, and that I have not, within the thirty days previo
us
hereto, received any ardea t spirit s of any kind whats
oever, from any person or-from any place whats
o.
ever, in excess of the quant ity allowed by tl:ae provi
sions of the Act of the General Assembly of Virginia, approved March 10, 19]i6, or cony,ary to
law, and that the ard~ s"Ji¥ts so .received by
me
(l?'e to be used by me for . ·
JC;::
·
- _ purposes.
-·
(State wheth er for Scientl ~ Sacramental, Jle,i
i)a1
/J \;.
. .
or"Kec hanlca l)
#
�REC ORD OF NOT ICES
To Conslgne
To Shlp per. ::=:= ::=:: =::;= :::::: =::= ::=:=
=== =
(OVER)
�STATE OP
V1¥INIA,
I,
,
~
/
, being duly swom, depose and say that I am
the consignee of a
shigment of ardent spirits, as specified on other side of this -(orm, this day
.S,-J
! ,
delivered to me by t h e ~ E;press ~ompany, from ·
,
..
; Uiat I am not
a student or minor, and, if a female, I am the head of a family ; that the ardent spirit.a
so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia, approved March 10, 19~, or contrf'Y to law, and that the ardent spirits
so received by me
are to be used by me for
·
purposes.
(State whether for Scientific,
----
Sacram en~clna l or lllechanlca l)
,
,,,.-
,-
,,
�To Shippe r
I
(OVEB)
�STATE OF
COUNTY
v-,y,w., ,
O✓-k:t._Clf.
_..:;.!---"'--r'-"--''-""
I, • ),
the consignee of a certain
~
, being duly sworn, depose and say that I am
igment of ardent s rits, ass
ed on ot~er side of_ · form,~ day
.
/-
delivered to me by the ~ Express Company, f
1
1
'.t1
.i.,
, &t I am not
a student or minor, and, if a female, I am the bead of a family ; at the ardent spirits so received
by me
were brought into the State on my written order, and that I have !}Ot, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assemply
of Vll'ginia, approved March 10, 1916, or contrary to law, and that the ardent sptrlts so
received by me
are to be used by me for ·
'.tl;. .
. . ._ "
urposes.
(State whether for Scientific, Saeramenta l.
Swo~ to
this /
~
subsc ·
da.y of .,,.-,L...,.._,-
icinal or Mechanical)
�DELIVER Y FORM
eo
RKVl• IED JUL,Y, 11117
ADAMS EXPRE SS COMPA NY
SPECIAL LIQUOR RECORD
--\,of!lj~ ~~IC:.. ~.J-~::: ___ Date
~3
191 "7: Affidavit No, _ _ __
_ L~~ ~~~ ~~-- ...,,= ---- P, 0. Address ~~
'"7't"T.ltt ""~.;;,,J~ ,... eigh~__ ,.-lbs.
RECORD OF NOTICES
To Consignee
To Shipper
(ovu)
�STATE OP VIRGINIA ,
1,---- ------ ---- ---- ---'- ---- being duly swom, depose and say that I am
the consignee of a certain ahigment of ardent spirita, as specified on other side
of this form, this day
I
delivered to me by the Adams Express Company, fro
· ;·that I am not
a student or minof, and, if a female, I am the head of a family ; that the ardent spirita
so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spitjta of any<li:ind whatsoever, from any person or
from any place whatsoever, in excesa of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ardent
spirits so received by me
are to be used by mefor
,
·
{5tate whether for Scientific, Sacrament al, lledlelnal or Keehanleal) purposes.
Sworn
and subscril)ed before me,
thi-s._.. ,_,,..____.day of
, 191 _.
(
•
Airent fo,
I
(Cclllaipee)
J
A.ijJiii El<pnaa CompanJ".
I
.
�DELIVERY PORM
eo
P.O. Address
RECORD OF NOTICES
To Consign
To Shipper _ _ _ _ _ _ _ _ _ _ _ __
(OVBB)
�l.~="-J ll.:.._-= ~._.....,.....,;:::.....~....1:__.,i:::..t~1<,&,,""'-c;..,:.., IM!flng
duly swom, depose and say that I am
t spirits, as s~c· ed on other side of th·
, this day
Asent for A(Jama Expnae Coa,pan y.
�CIAL LIQUOR RECORD
~ ;p/J__ 1_9_1~~-- - ·- 1
Received at_~"""'-~~~~- ..._--,1~-Date
Conalgnee-7'4~~,c.q. ,µ':#---::a1~~"'-----= --- -- -
To Shipper
(OVBB)
�STATB 01' VIBGUW..
I;
, · - 1
·
, oetng duly sworn, depose and say that I am
the consignee of·a certaiL shigment of ardent spirits, asspe~iftedonot herside of-th» form, this day
delivered to me by the Adams .Express. Company, frnm ·
_, · -- ·-
; th~t I am not
astudent or minor, and, if a female, I am the head of a family ; that _the ardent _spi~ts so receive~ by :r,ne
were brought into the State on DiJ writtel'l order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Vir.
ginia, approved March 10, 1916, or contrary to law, and that the ardent spirits -co received by me
are to be used by me for _
~
·
'
.
· .
-- purposes.
(State whether for Sclenililc, Sacramental, M:ec1lclnal or lllechanicil)
Swo~
this l
I
!'° and s u ~ d before· me,
day of .
I
l~l / ;
,
(Couipee)
�DELIVERY PORM 60
ADAMS EXPRESS COMP ANY
SPECIAL LIQ"
UECORD
§!
~,.,,.L4-~~=.:::s....-1._
_
_ _ oate
19
P. 0. A dress _ _ _ ____,t--s_--'.,.._
~...::......._&.-~<.J,,,l~"""'4t.4"=~""""-- -
Advancee t.o
Collect
Shipper, ___._,,._,,..____,....,...._.,......~- - -
P.O. Address
,
1
RECORD OF J.io;ICES
ToConalgne
To Shipper
. (OVBB)
'J
�I
I,---- -~-'-- - - - - - ~ - - - - 1 - - - - , being dwy ·sworn,
depose
the consignee of a certain shigment of ardent spirits,
ana say that I am
8f specified on other side .of thf8
form, this day
delivered to me by.the Adame Expree s Company, b-q m~
---- ---- --; ~ at;J am not
"stude nt or minor, and, if a female, I am the head of a fauµly ;
~at th~ ardenU pirits 80 received by pie
brough t into the State on niy written order, and that I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from
any pereon<>r from any place whatso;.
ever, in excess of the quantit y allowed by the provisions of the
Act of the_General Assembly of Vir.
ginia, approved ,March 10, 1916, or contra ry to law, and
that the ardent -s~ta 80 received by me
>
are to be used by me for
· _
·
_ • _ . _ _ _ _ - purposes.
(State whether for Sclentlftc, SacramenfaL M'.edlelnal or llechanl
cal)
~ere
Sworn, to and subscribed before m~,
this :
day of
- 191
�DELIVERY PORM
eo
To Shipper
(ovn)
�STA.TB OP VIRGIN IA,
I, ·
being duly sworn, depose and say that I am
the consignee of a certain llhig_!Dent of ardent spirits, as specifie
d on other aide of this form, this day
delivered to me by the Adams Expres s Company, fro,.. .._--a studen t or minor, and, if a female, I am the head of a family ; that''--.;. _---- ----; that I am not
the ardent spirit.a so received by me
were brough t into the State on my written order, and that fhave
not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from
any person or from any place whatsoever, in excess of the quantit y allowed by the provisions of the
Act of the General Assembly of Virginia, approved March 10, 1916, or contra.ry to law, and that
the ardent spirits so received by me
are to be used by me for ·
'
·
~
,
parpoeea.
(State whether for Sclentlft c, Sacrame ntal, Kedlclna l or :Mechani
cal) •
Sworn to and eubscrjhed before me
this / '
day o.f._ -'---....,....-
: (Ccmafirn6e)
·
�Way
T0---11t"#--------,----"l;-.,_:-;,_,j>~--~-r7W~~..
t
P.O. Address
To Shipper
.
(OVEB)
"
�STA.TB OP VIR(}JNIA.,
I,,----'-'.......- -""'- - - - - - - - - , . . . - - - - - - - - being duly
sworn, depose and say that I am
•the consignee of a certain 11higment of ardent spirits, as specifie
d on other side of this f~, this day
delivered to me by the Adams Expres s Company, from ~,
{
·
; 6ia
not
a studen t or minor, and, if a.fema le, I am the head of a family
; that the ardent spirits so received by
were brough t into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits oJ any kind whatso ever, from
any person or from any place whatso ever, in excess of the quanti ty allowed by the provisions of
the Act of the Genera l Assembly of Virginia, approv ed March 10, 1916, or contrar y t.o law, and that
the ardent ~pirits so received by me
,.
are to be used by me for
·
'
·
purpose,/.
(State whether for Scientlftc, Sacrame
. -
.
Sworn to j&Dd subscribed before me,
this f , d•y of /
~ • 191
ntal, /'-r11cln al or Kechanl cal)
. /f
I
/
I/
�DELIVE RY FORM 60
ADAM S EXPR ESS COMP ANY
Received at
Oonalgnee
To OonalgoAe
To Shippe r
(OVBB)
�STATE OF VIRGIN IA,
I,--- -;-- "'-'- ~-~ ~--- ~--- ---, being duly
the consignee of a certain-'Bhigment of ardent spirits, as specifie sworn, depose and say that I am
d on other side -of this form, t!iis day
delivered to me by the Adams Expres s Company, fro
· ; that 1 am not
a studen t or minor, and, if a female, ~ am the head of~ f~ily
; ~ the _ardent s11irit.11._so receive4 by
ijtJ!
were brough t into the-Sta te on my written order, and that I have
not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, fr-0m
any·person OI' &om any place whatsoever, in exceBB of the quantit y allowed by the provisions of the
Act of the General Assembly of Vi~~
ginia, approved March 10, 1916, er contra ry to law, and that
the ardent spirits. so received by Dl;!t
..
tbis \
\
I
~
I
�DELIVERY l'ORM 60
ADAMS EXPRESS COMP ANY
Way-
To_h ~ ~ ~ ~ ---.---...----:-----Shipper _µ~,V..#YY.li+-JP.-..,&,,:1!:J!'.___ _.!,~
P.O. Addr&ss
RECORD OF NOTICES
To Consignee
To Shipper
(OVER)
�STATE OF VIRG~
I,
7
'I
· being duly sworn, depose and say that I am
the consignee of a certain shigmen t of ardent spirits, as spee.itied on other side
of this form, this day
. ~delivered to me by the Adams Express Company, from _ _
_ _ _ _ _ _ _~ _ ; that lam not
a student or minor, and, If a female, I am the head of a fai_nily ; that th~ ardent spirits
so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or
from &11y place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ,ardent
spirits so received by me
are-to be U!led by me for
-
· • ·
•-
.
(State whether for Scientific, Sac1'111D8ntal, lledlclnal or M:echanlcal) purposes.
/
Sworn to and subscribed before me,
-J
this !
day o(
, 191. •
(Comfirnee )
�-
DELIVERY FORM 80
Received at~--~~#1..!o:-I-+~~ -~
Conalgnee-4~L~~~~flei'~+ ---'-4~~t;,,l,,IM~
WayTo r
/
(OVER)
�STATE
of
VIRGINIA,
j, _____ _____ _____ ____, being duly sworn, depose·and say that I am
the conaignee of a certain Bhigment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, .fro
1
,.
•
;
that I am not
astudent or minor, and, if a femaie, I am t.hebeadof :a family; that the ardent spirits so recetved by ,me
were brought into the State on my written order, and that I have not, within 1;,be thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from -any person 01' from any pl\ ce whatsoever, in -excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or cqn~ary to law, and thal the ardent spirits .so received by me
are to_be used by me for
•
· .
.
_ _
_purposes.
{State whether for Selentiftc, Saerainental, llecilelnal or M:ecbanfcal)
Sworn to and subscribed before me,
this '
day of ·
, 191 ;
(Con• ipee)
�DELIVE RY P'ORM 60
ADAM S EXPR ESS COMP ANY
I
RECOR D OF NOTICE S
I
To Conalgne
To Shippe r
•
(OVBR)
�STATII OF VIRGINIA,
I,
·
being duly sworn, depose and say that
the consiguee-of a cert ain ahigment
I am
of arde nt spirits, as specified on othe
r side of this form, this day
delivered to me by the Adams Exp ress
Company, fro
a stud ent or minor, and, if a female, I
· ; that I am not
am the head of a fam ily; that the.arde
nt spir its so received by me
wer e brou ght into the Stat e on my writ
ten order, and that I have not, within
the thirt y days previous
hereto, received any arde nt spirits of
any kind whatsoever, from any person
or from any place whatsoever, in excess of the quan tity allow
ed by the provisions of the Act of the
General Assembly of Vir.
gini a, approved March 10, 1916, or
cont rary to law, and that the arde nt
spir its so received by me
/'
, ..
.
are to be used by me for ~
/
• ~
purposes.
(Stat e whet her for Scientific, Sacra
ment al. Jllediclnal
or Kechantcal)
Sworn to and subscribed before me,
. tbis /
day of , 191 ";/
.,
/JI /, /~
r
\
, Apn t fo,: Adams Expn111a Comp
anJ".
(Conalsnee)
•
•
�To Shipper
(ovim)
�I
STAT E 01' VtaGI NIA,
I, __......._ __._ _ _ _ _~ ' - - - - - - - - - • being duly sworn, depose and Bay that I am
the consignee of a certa in ahigment af arden t
spirit s, as specified on other side of this form, this
day
.
delivered to me by the Adam s Expre ss
'
Company, fro
• · : that I am not
a stude nt or mino\', and, if & female, I am the h~ of
e fam_ily ; tha,t th!! ardent_ ~i!it s so received
by lllf!
,vere broug ht into the State on my writt en order
, and
hereto, received any arden t spirit s of any kind whats that I have not, withi n the thirty days previous
oever , from any person or from any place whats
oever, in excess of the quant ity allowed by the
provisions of the Act of the General Assembly
of Vir.
ginia, approved March 10, 1916, or contr ary to
law, and that the arden t·a~ ts so received by
me
are to be used by ~ fol'. · ·
.
~ _ ' ·
.
· pll!'pO
(State wheth er for Scientific, Sacram ental,
llledlclnal or 'Mechanlcaf)
Sworn to end s~)1 ea' befor e me,
, '
this : ·
day of •
k
, 191 1
1
Bes:
-
(Couf pee)
�DELIVERY FORM 60
RECORD OF NOTICES
To Conslgne
To Shipper
(OVER)
�--------------~----~----~.......
.....
.................-:_.,,.......-..........---- ~
~ ...-.
I,~~:.£.....t. !!:~- A.;z:.::ll:~3::-::..J.:_L!.. ....;~q_...l.., being duly sworn, depose and say that I am
the consignee of a certain abigment of ardent sp· ts, ass cified on other side of this form, ·s day
.
-;:;1/t
delivered to me by the Adams Expreas Company, fro?AUL.i~ u.2:i:M: ~ci~~~; that I am not
a student or minor, and, if a female, I am the bead of a famil
at the ardent spirits BO received by me
were brought into the State on my written order, and tha have not, within the thirty days previous
hereto, received eny ardent spirits of any kind whatsoever, from any penon or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ardent spirits BO received by me
are to be used by me for
,.
/,
(State whether for Scientific, Sacramental, lledlclnal or Mechanical)
S~~
th1
ands~
day
•
Agent for Adama Expnea
Campany.
purposes.
�RECORD OF NOTI
To Consignee
(OVER)
�ST.A.TE OF VIRGINIA,
l, ___ _ ....;...,..._~~----...;._--'-- ----being duly sworn,' depose·arid say that I am
the consignee of a certain ehigment of ardent epirita,. as specified on other side r,f this form, this day
; ttiat l am not
delivered t.o me by the Adams Express Company, from astudeat o:rminor, and, if a female, I am thehead of pl fam_ily; tlult t}ie ~ent e11iri!;!I ~ .received by file
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from-any place whatsoever, in excess of the quantity allowed by .the provisions of the ~ct of the General Assembly of Virginia, approved March 10, 19~6, er contrary -to law, and tnaf the ardent .spirits.so ~eceived by me
are to be used by me fol'.
· ·
. .
·
.
_.
.
. ·... __ . .
~es.
(State whether for Sclentfftc, Sacramental. lladiclnal or Mechanh;al}
Swom ~ and sube~d before me_,
, l91 ·
this \ , · day of ·.,
·'
�~--~-
----..,.......---,---,--- --- -~- --- --- ~-- --- --- ~-,
RECORD OF NOTICES
To Conslgl"!ee
To Shi pper
(oVBB)
�r ,
delivered to me by tile .Adams EJi:press Company, from , A/
ardent spirits so rece1
the
that
family;
a
of
head
the
am
I
female;
a
if
and,
minor,
astudent or
were brought inter the State on my written order, and that I have not, within·the thirty days prev1
hereto, received any ardent spirits of any kind whatsoever, from any person ol'from any place wba~
ever, in excess of the quantity allowed by the provisions ot the Act of the General Assembly of Vir.
ginia, approved March 10, 1916, or contrary to law, and that ·the ardent spirits so received by me
I
are to b_e used by me for
·
__ I
.
,
0
'-=::::-
J.,
purposes.
Medicinal or Mechanical)
(Sta&i whether for'scientl~c, Sacramenj
I
I
I'
•
i f i,1, f ;
I
,
-
(Coiwlrnee)
.
•·
J
�ADAMS EXPRESS
,-
S PECIAL LIQU
-rReoelved at-,F-l----..-+--F-4'--,_v _______ Dat,..:::::c.,c;__
, vi_,
P,O, Address
RECORD OF NOTICES
To Conslgoee
(ovn)
_ _ __
�STATE 01' VIRGINIA,
CotJNTY OJ'_.....;;.....:.;;._ ___;;___ _.;_
I,
•
,
, being duly sworn, depose and say that I am
the consignee of a certain lhigment ;/ ardent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, fro,iu.. _ _ _ _ _ _ _ _ _ _ _ ; tbat"f--am not
a student or minor, and, if a female, I am the head of a family; that the ardent spi:rits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Vir.
ginia, approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are to be used by me for
...-
,.
(State whether for Scientific, Sacnmen~ Kedlclnal or Mechanical)
Sworn to and su'-'ribed before me,
/
-r , I
this ._." I
dav
, 191
" 6f , ;
purposes.
. (Conafpee)
!
�Affidavit No, _ _ __
P.O. Address
RECORD OF NOTICES
To Consignee
To Shipper
(OVEB)
�delivered to me by the Adams Express Company, frQ11~l..:~~ ::..!!~:::: !~~~_:....::., at I am not
a student or minor, and, if a female, I am the bead of a fami}y
at the ardent spirits so received by me
were brought into the State on my written order, and th
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever,·from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Vir.
ginia, approved March 10, 1916
contr,ary to law, and that th ".ardent spirits so received by me
are to be used by me for
/2
C.
.
/'
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
A:lrent for Adanu Expreaa Company.
purposes.
�DELIVER Y FORM
eo
ADAMS EXPRE SS COMPA NY
P.O. Address
RECORD OF NOTICES
To Consignee
To Shipper _ __ __ __ __ _ _ __ _
(o vu)
...
�I,..,,,
the consignee of a certain • bigment of ardent s
, being duly swom, depose and say that I am
cified on other side of this form, ·s day
ta, ass
delivered to me_bythe Adams Express Company, f
; at I am not
a student or minor, and, if a female, I am the bead o a f
, that the ardent spirits so received by me
were brought into the State on my written order, and
I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatso- ,
ever, in ex.cess of the quantity allowed by the provisions of the Act of the Genf ral Assembly of Virginia, approved March 10, 1916, or contrlll"Y._ to law, amd that the ardent spirits so received by me
are to be used by me for .
~t .
~ '--<le
(State whether for Scientlftc,. Sacramental, Kedlcinal o :Mechanical)
Swoi'iP and sub, r br
this
day crf
J/k
purposes.
me,
, 191
Agent for Adama ExpN&• Company.
f
�FORM 370-V A
Ad•anre a to
Collect
.Md
Unde rc harge
RECORD
To Consian ee _ _______ ____ __ _ _ __
To Shi pper _ _ _ _ _ _ __ _____ _ _ _ __
AF'f"IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(OVER)
�AFFIDAVI T FOR ARDENT SPIRITS FOR
PERSONA L USE
STATE OF VIRGINI A,
COUNTY O F - --
-
- - - - - --
~
... , - - - - - -- - -- - -- - - - - - - -- - , being duly sworn, depose and say that
I am
the consignee of a certain shipment of ardent spirits , as specified on other side of this form,
this day
delivered to me by the Southern Express Company, from _ _ _ _ _ _ _~ - -- - - ; that
I am not a
student or minor, and, if a female , I am the head of a family; that the a; dent spirits so received
by me
were brought into the State on my written order, and that I have not, within th e thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Vi rginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirhs so rec eived by me are fo r my
own use, at
my own hom e , and that the said ardent spirits will not be used in violation of law.
l
- --+--c~~
Sworn to and subscribed before m e,
this ___day ot.. .
,I
.A2ent1 for Southern Exvress Compauy.
.L~ ~ ~Y~~~,..:==-.--:,t..,f--:;-,--- +~
onsiauee.
•
�FORM 370•VA
SOUTHERN EXPRESS COMPANY
(Inco r po rated)
Affidavit No
Adv o.n re e t o
Coll ect
To Consianee_ _ _ _ __ _ ______ ____
To Shipper _ ______ ______ ____
Af"f"IDAVIT FOR ARDENT SPIRITS f"OR PERSONAL USE .
( OVER)
�AFFI DAVI T FOR ARD ENT SPIR
ITS FOR
PERS ONA L USE
STATE OF VIRGI NIA,
COUN TY OF _ _ _✓----~-~--+--
... , - ~ - - -- -- - - - - - -- - - - -- - , being duly sworn , depos e and say
that I am
the consig nee of a certai n shipm ent of arden
t spirit s, as specif ied on other side of this
form, this day
delive red to me by 1.he South ern Express Comp
any, from ___ ___ ___ _ _ ___ ;
1.hat I am nofi
stude nt or minor , and, if a femal e, I am the
head of a family ; that the arden t spirit s so
r eceive d by me
were broug ht into the State on my writte n
order, and 1.ha1. I have no1., within th e thirty
days previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
whats oever , in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgin
ia, appro ved
March IO, 1916, or con1.rary to law, and that
the arden t spii:il.s so receiv ed by me are for
my own use, at
my own home , and that the said arden t spirit
s will not be used in violat ion of law.
/
Sworn to and subsc ribed before me,
this ___day ot...
- -- ~ , 191 ~
I
A29ut for S outher n Expres s Conipauy.
Consh:nee.
�FORM 370•V A
SOU THE RN EXPR ESS COM PAN
Y
(Incorp
orated )
Affidavit No.
RECO RD OF NOTI CES
To Consignee ___ _ _ _ __ __ _ _
_ _ _ _ __
To Shipper _ ___ ___ _ __ _ _
____
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE .
( 6 VER)
__
�~,,,.-- -- -=--- =--oa!t!
t:: m
2£1
:a: c::
Ls m
AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERS ONAL USE
....,,_ .....;._ _ +'---''- -+= - -_.:;._ ..:_~= ~=~ - - - , being
duly sworn, depose and say 1;hat I am
as specifi ed on ot her side of this fo rm, this day
deliver ed to me by the Southe rn Expres s Comp9 9· ,
from
that I am not a
studen t or minor, and, if a female , I am the head
of a family ; tlilt the ardent spirits so receive d by
me
were brough t into the State on my written order, and
that I have not, within the t hirty days previous
hereto , receive d any ardent spirits of any kind whatso
ever, fro m any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assf;lm bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to law, and that the ardent
spirits so receive d by me are for my own use , at
my own home, and that the said ardent spirits will
no be used in violat i~
w.
~M '
v.
Sworn to and subscr ibed before me,
this
v,._{~ t-, 1911--
·
;
~
,14
�FOAM 370-VA
SOUT HERN EXPR ESS COM PANY
(Incorpo rated)
...{ _,,,.
Affidavit No .
Advnnre a t o
Collect
PREPA ID
_.__
J __
j </-'-----
Arld
Uudercb a rge
RECO RD OF NOTIC ES
To Consignee _ _ _ _ _ ___ ._ _ _ _ _ _ __
_
To Shipper _ _ __ _ __ ___ ___ ___ _
_
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERSO NAL USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINI A ,
COUNTY
~,
m•-- -- - - - ---"--
L
~-- ~-~~--~-,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on othe side of thi s form, this day
delivered to me by the Southern Express Company, from~~- -~-~ - - ~ ~- - - i \hat I am not a
student or minor, and, if a female, I am the head of a family ;
at the ard ent s pirits so r eceived by m e
were brought into the State on my written order, and that I have 1;1ot, within th e thirty days previous
hereto, received any ardent spirits of ariy kind what soever, from any person or from any place whatsoeve1·, in
excess of the quantity allowed by the provisions"of the Act of the Gener al Assembly of Vi rg inia , approved
March 10, 1916, or contrary to law, and that the ardent spiri1s so rec eived by me a re fo r my own use, at
my own hom e, and that the said a rdent spirits will not be used in viol ation of law.
J,
Consianee.
Sworn to and subscr ibed before me,
191_
J
A2ent for S outhern Exvress Comvany.
�- - - - - --
.,., - ..:r:--: - - - - - - -- ~~-.-~~~ -----'
.-"t
Affidavit No,~_
• __ _
/.-.
_
_ _ _ __ _ _ _ _,,__ _ __ __ Amount,_
~ __
6_- /
1
7
Advan,es to
Collect
_:__
1--4-_ __
,_,_-1-_
191_
COLLECT
Add
Undercharge
RECORD OF NOTICES
To Consignee _ _ _ _ _ _ _____ _ _ _ _ __
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVltR)
�AFF IDA VIT FOR AR DE
NT SP IRI TS FOR
~ . : . __
_____:__:__;__ :;._< ..=•-
L'
PER SO NA L US E
-·"?i; /
r
.I
C.
, bein g duly swo rn, dep ose
the con sign ee of a cert ain ship
and say that I am
men t of arde nt spir its, as spec
ified n othe r sidil of this
form , this daY,
deli vere d to me by the Sou ther
I I\/),
.
n Exp ress Com pan y, from ~
Z
stud ent or min or, and , if a
,_
t; thll am not a
fem ale , I am the hea d of a fam
ily; that the ard e t spir its
wer e brou ght into the Stat e
so rece ived by m e
on my writt en orde r, and that
I hav e not, wit in the thir
here to, rece ived any arde nt spir
ty day s prev ious
its of any kind wha tsoe ver, from
any pers on or from any plac e
exce ss of the qua ntit y allo wed
wha tsoe ver, in
by the prov isio ns of the Act
of the Gen eral Ass emb ly of
Mar ch 10, 1916, or con trar y
Virg inia , app rove d
to law, and that the arde nt
spiri1.s so rece ived by me a1·e
my own hom e, and that the
for my own use, at
said arde nt spir it s will not be
used in viol atio n of law.
I
Swo rn to and sub scri bed befo
re me ,
th is. Lday oL:.
,- ,
Zu_ 1
1911
A~en t for Sout hern Expr ess
Com pa ~y.
~Cons ianee .
�AFFIX
STAMP
HERE
I depose and say that
(Artiolea)
uantity)
,__.......,..,._,-.....::.:...:.,_,.,.1,C--i,..__,,
"
which
under the laws of the State of Virgin ia I am permi tted to receiv
e, and-9f
which I now desire to take deliv,e ry from \ \
~
.
Railw ay Comp any; that I am a manuf acture r dul'y licens ed
1;mde~ Act of
Virgin ia, approv ed Ma rch 10, 1916; that the conten ts of said
shipm ent
are to be sold, dispen sed or u sed in ac , d
Act.
//-C--
�,
�SOUTHERN .EXPRESS COMPANY
FORM 3TO-V A
(Incorporated}
Affidavit No. _ _ _ __ _
COLLECT
RECORD OF NOTICES
To Consign ee _ _ _ _ _ _ ___________
To Sh ipper _ _ _ _ _ __ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(O VER)
�AF FID AV IT FOR AR
DE NT SP IRI TS FOR
PE RS ON AL US E
--', __- ~~ "--_.___ _...,'- ----'--=-+-- -- == "---,
bein g d ly swo rn, dep ose and
say 1;hat I am
as / f f~ ified n othe r side
of this form , this day
deli vere d to me by the Sou
ther n Exp ress Com pan y, from
stud ent or min or, and , if
7 ( I I,
, ha - am not a
a fem ale, I am the hea d of
a fam ily; tha t the a Ient spir
wer e bro ugM into the Sta te
its so rece ived by me
on my wri tten ord er, and
that I hav e no{ with in
here to, rece ived any ard ent
the thir ty day s prev ious
spir its of any kind wha tsoe ver,
from any pers on or from any
exc ess of the qua ntit y allo wed
plac e wha tsoe ver, in
by the pro visi ons of the Act
of the Gen eral Ass emb ly of
Mar ch 10, 1916, or con trar
Vir gini a, app rov ed
y to law , and tha t the ard
ent spir its so rece ived by me
my own hom e, and tha t the
are for my own use , at
said arde nt spir its will not
be use d in viol atio n of law .
W/
Swo rn to and sub scri bed befo
re me,
this ..J.7.--. ay
,
I
01.-i"~ ,1911
Con shtnee.
/
A11:ent tor Sout hern Exp
ress Com pauy .
'
~
�FORM 370•VA
Received at
EXPRESS CHARGES
PRF.PAID
COLLECT
Add
Unde r charge
RECORD OF NOTICES·
To Consignee _ _ _ _____ _______ __ _
To Shipper _ _ __ _ _ __ __ _ __ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER}
�-- -- -- -- -- -- - -- --
-- --- -'- -- -- - - - - --- -
AFF IDA VIT FOR AR
DE NT SP IRI TS FOR
STA TE OF VIJ;W INI A,
COU NTY OF
i, -
PE RS ON AL US E
✓
L ._:,
i!t: /3...<
, b ing duly swo rn, depose
1.he con sign ee of a cert ain
and say 1.ha1. I am
ship men t of arde nt spir its
, as s ci1ie d on othe r side of
this form , 1.his
day
deli vere d to me by the Sou
~
ther n Exp ress Com pan y, fro
/
• ,,,.
stud ent or min or, and , if
'
tha t 'r:-aiu._not a
a fem al e , I am the hea d of
fam ily; that the ard ent spir
wer e bro ugh t into ihe Sta te
its so r ece ived bym e
on my wri tten ord er, and 1.ha
t I hav e not, wit hin th e
here to, r ecei ved any ard ent
thir ty day s prev ious
spir its of any kind wha tsoe ver,
from any pers on or from any
exc ess of the qua ntit y allo wed
plac e wha tsoe ver, in
by the pro visi ons of the Act
of the Gen er al Ass emb ly of
Mar ch 10, 1916, or con trar
Vir gini a, app rov ed
y to law, and tha t the ard
ent spiri1.s so r ecei ved by me
my own hom e , and tha t the
are for my own use , at
said arde n1. spir its will not
be use d in viol atio n of law.
,,
,;
Swo r
o and sub -{ibed befo re me,
this,?' l day oL-..
_, 191 _
I
~
/
/
Ae-ent for ?out heru Exp ress
Com pa uy.
(
Con s h:ne e.
�FORM 370•VA
Affidavit
No. V L
IL
11/IJ.-,,/' ./ ; ✓ u ,; /,, ,,.~
' I
Weiah .__ _ _ lbs.
.
RECORD OF NOTICES
To Consignee_ _ _ _ _ __ __________
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVl< R )
�AFFIDAVIT FORr ARD!;:NT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OJ<' _ _ _ __ _ __ __ _
~, - - - - -- -- - -- - -- - - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specifi'ed on other side of this form, this day
.
/j
delivered to me by the Southern Express Company, from _ _ _ _ _ _ _ _ _ __ _ _ ; that I am not a
student or minor, and, if a female, I am the head of a family; that ~he ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use,
my own home, and that the said ardent spirits will not be used in violation of Jaw.
at
,
Sworn to and subscribed before me,
this ___day oL- _ _ __ , 191_
Ai:ent for Southern Express Compan y.
Consit?nee.
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(Inco rpora t ed
}
j/t
"--~
Affidavit No~ _ _
Wat Bill No._ ~ "-=-- '----- --To - -""'-'-4'='--'-- -~-- '·c ._~,- ----,,,-
Ad vt1.ure a to
Co ll ec t
Add
Onderch a rge
RECOR D OF NOTIC ES
To Consignee_ ___ ___ ___ ___ ___
_
To Shipper _ _ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
( OV E R)
_ _ _ _ _ _ _ __
�AFF IDA VIT FOR AR DEN
T SPI RIT S FOR
PER SON AL USE
STA TE OF VIRG IN 'J,.,
COU NTY OF _---,-,., /-"-":=:-<
'---==-~"
7
'-+'-"
... , .....c..
c .1.
1 .:.):......._,_
, --''---'=-- =--- .-,." --""--
-"'---':......._" --= ~=" "--"--'~ -• bein
g duly swo rn, depo se and say
the cons igne e of a cert ain ship
ihat I am
men t of arde nt spir its, as spec
ified on othe r sicle o tl!iil ;.orm
, this day
deli vere d to me by the Sou ther
n Exp ress Com pany , from
stud ent or min or, and, if a fem
; that I am not a
al e, I am the head of a fam ily;
that the arde spir its so rece
were brou ght into the Stat e on
ived by me
my writ ten orde r, and that I
have not, wi hin t he thir ty
here to, rece ived any arde nt spir
day s prev ious
its of any kind wha tsoe ver, from
any pers on or from any place wha
exce ss of the qua ntity allow ed
tsoe ver, in
by the prov ision s of the Act of
the Gen eraf Asse mbl y of Virg
Mar ch 10, 1916, or con trar y to
inia , appr oved
law, and that the arde nt spir iis
so rece ived by me are for my
my own hom e, and that the said
own use, at
arde nt spir its will not be used
in viol atio n of law .
~
Sworn to and subs crib ed befo
re m e,
this __ _day o
r
\
A26n t for Sont hern Express
Com vauy .
Cons ianee .
II
�FORM 370•V A
SOUTH ERN EXPRES S COMPA NY
(lnco rpo r a&;ed)
,,,......__SPECIA
__- ~
LIQ~UR
RD
E
.!-e'.1~ ~~~4~•1---· _ _ _ _ __ _
_I.,~L-._
'
:,,,,...--,1'-Cc,,·= I-/_:·=-- /?-
Date
.
191 _
..
·~,
P R EPAID
COLLECT
A dd
Unde r ch arge
RECORD OF' NOTICES ' ·
To Consion ee _ __ _ _ ___ ,_ _ _ _ _ _ _ __
To Shipper _ _ __ ____ ___ __ __ __ _
AF'F'IDAV IT F'OR ARDENT SPIRITS F'OR PERSON AL
USE .
(ov xa)
�. .
AF FID AV IT FO R AR
DE NT SP IRI TS FO
R
STA TE OF VIR GIN IA,
COU NTY O ~ ' - - -- - i1 - - - - -
PE RS ON AL US E
- -~ -
-- - -
- - - -- - - -- the con sign ee of a cer tain
- , bei ng dul
y swo rn, dep ose and say
shi pm ent of ard ent spir
1.ha t I am
its, as spe cifi ed on oth er
side of this form , \his day
del ive red tom e by the Sou
the rn Exp ress Com pan y,
from _ _ _ _ _ _ _ _
stu den t or min or, and ,
_ __ _ _ ; tha t I am
if a fem al e, I am _the hea
not a
d of a fam ily; tha t the ard
wer e bro ugh t into the Sta
ent spi rits so rec eiv ed by
te on my wri tten ord er, and
me
that
" I hav e not , wit hin the
her eto , rec eiv ed any ard ent
thir ty day s pre vio us
spi rits of any kin d wha tsoe
ver , from any per son or from
exc ess of the qua ntit y allo
any pla ce wha tsoe ver , in
wed by the pro visi ons of
the Act of the Gen era l Ass
Ma rch 10, 191 6, or con trar
emb ly of Vir gin ia, app rov
y to law , and tha t the ard
ed
ent spi rits so rec eiv ed by
my own hom e, and th at
me are for my own use ,
the said ard ent spi rits wil
at
l not be use d in vio lati on
of law .
Sw orn to and sub scri bed
bef ore me ,
thi s __ _day ot...
- - -- , 191 _
A29 nt for Sou ther n Exv
ress Com vauy .
Con s iane e.
�l'oRM 3T0•VA
SOUTH ERN EXPRE SS COMP ANY
(Inco rporated)
,m,m,,, ~
Advan r ea to
Collect
RECOR D Of' NOTICE S
To Consign ee _ _ _ _ __ _ _ _ _ _ _ _ _ __
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ _ __
Af"f"IDA VIT f'OR ARDEN T SPIRIT S f"OR PERSO
NAL USE .
( OV ER)
�AFFIDA VIT FOR ARDE~ T - SPIRIT S FOR PERSO
NAL USE
STATE OF VIRGIN!
COUNTY
m'----,r-r1.t_ _ ~
;-...c~
'-----i'F-I-~
i, _..,f'-N
--',= --'-,,-=....1...-----"'='--"L...:"-=---- ===- ,
being duly sworn, depose and say that I am
specified on other sid
thi&..form, this day
delivere to me by the Souther n Express Compan y, from v
; that I am not a
stud~nt or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by m e
were brought into the State on my written order, and ihat I
have not, within the thirty days previons
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March IO, 1916, or contrary to law, and that the ardent spirit.a
so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used
in violation of law .
Sworn to and subscrib ed before me,
thi
_.L_day o'--v,__,,_,__, 1911
r
A2ent for Southern Exvress Comvany.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
( Inco rpo rated )
_ _ __
Advau, e 11 to
Colle ct
191
Add .
PREPAI D
Onde r cha rge
RECORD Or NOTICES
To Consign ee _ _ _ _________ ___ ____
To Shipp er _ _ __ ______ _ __ _ __ _ _
Arf"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE .
( OVER)
'
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
~, _ _J~L-4-L__,__ __.2_~£,L_f:~ ::::::::::~ =~- - - ,
being duly sworn, depose and say that I am
the consign ee of a certain shipme nt of ardent spirits,
as sp cified on other side Qf this form thi day
'-X/J
J
deliver ed to me by the Southe rn Expres s Compa ny, from
H£
-(,,I
; tliat I am not
student or minor, and, if a female, I am the head of a
family; tp{t the ardent spirits so receive d by m e
were brough t into the State on my written order, and
1;hat I have not, within the 1;hirty days previou s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisio ns of the
Act of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and 1;hat the ardent
spiriis so receive d by me are for my own use, at
my own homo, ond th•I tho soid "doot spirits will : ; , :•
I"'~
-r. ,
.
•~ 7: I
Sworn to and subscri bed before me,
this -
day ot..
/
-i'i.(,,.
_,
m
y-
A2ent for South9r £ Express Compauy .
Consiane e.
�Affidavit No
Way-Bil
To
Advnn,es t o
Collec t
RECOR D OF
To Consigne e
To Shipp er _ _ __ ___ _ ._ _ __ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL US£.
'
(OVlt R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF V!RGlNIA,
COUNTY O F - - - ----::---:r.-'---- -:---
~, - - - - - -- - -- - - - -- - - - - - -- , being •duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered tome by1;he Southern Express Company, fron, _ _ _ _ _ _ _ _ _ __ __ ; thatj am no1; a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into foe State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March · 10, 1916, or contrary to Jaw, and that the ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me ,
,
this ___day o .
A2ent f r Southern Expres s Compauy.
Consh:nee.
�SOUTHERN EXPRESS COMPANY
F'ORM 3TO•V A
(Incorporated)
Advances to
Collect
A~d
Unde r cha rge
RECORD Or NOTICES
To Consign ee ______ __ ______ __ _ _
To Shipper_ _ _ _ _ ___ ______ ____
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
-
i' - - - - ~ ~=~=~ ~,,_~~~=-- =-- -, being duly sworn,
dep~se and say that I am
the consign ee of a certain shipmen t of ardent spirits, as sye;Ified
on other
side of this form, this day
delivere d to me by the Souther n Express Compan y, from J(.
~
; that I am no a
student or minor, and, if a female, I am the head of a family;
t ~ the ardent spirits so received by m e
were brought into lhe State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so rec eived by me are for my own use, at
my own home, and that the said ardent spirits will not be used
in violation of law.
Sworn to and subscrib ed before me,
this-"- '-day
ot...J;,{
, 191 ~
Consicnee .
�FORM 370-VA
Affidavit No.
f f-•
Aclvn.u re s to
Collect
RECORD OF' NOTICES
To Consign ee _ _ _ _ _ ___ ___ _ _ _ _ __
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ _ __
AF'F'IDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(o v1rn)
�AFFID AVIT FOR ARDE NT SPIRI TS
FOR
PERS ONAL USE
STATE OF VIRGIN I A ,
COUNT Y OF~[½--~= --=-.c...-- =-- -----'--"
... , - - , - - - - -- - - - - - ----;, '--- - - - -, being duly sworn, depose and say ihat I am
the consig nee of a certain shipme nt of ardent spirits
, as- s ecified on other side of this form, this day
deliver ed tome by the Southe rn Expres s Compa ny,
from .
'; that I am not a
studen t or minor, and, if a female , I am the head
of a family ; that the ardent spirits so receive d by
me
were brough t into the State on my written order, and
that I have not, within the thirty days previo us
hereto, receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Gener al Assem bly of Virgin ia, approv
ed
March IO, 1916, or contra ry to law, and that the ardent
spiriis so r eceived by me are for my own use, at
my own home, and that the said ardent spirits will
not be used in viol ation of law .
Sworn to and subscr ibed before m e,
,
day oL-7
/ C
(, -
, 191:;l
Ae-ent for Souther n Express Comv.auy.
Cons icnee.
�·- -----------~~..,.----~.~~- -------.,....-------- FORM 3TO•VA
~7
Advaure a to
Collec t
PREPAI D
A dd
Unde rcha rge
RECO RD Of' NOTIC ES
To Consign ee_ ___ ___ ___ ___ ___
_
To Shipper _ _ _ _ _ _ _ _ _ _ __ _
_ __
Af'f'ID AVIT f'OR ARDE NT SPIRI TS
f'OR PERS ONAL USE.
(OV KR )
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR
PER SON AL USE
STAT E OF VIRG INI A,
COUN TY OF _ _ _ __ _.:...____:_
::.,__:.,__.:_
__
.... , - - - - - -- - -- - ·- -- - - - - -- -, bein g duly swor
n, depo se and say that I am
the cons ignee of a cer1tain shipm ent
of arde nt spiri ts, as speci fied on othe
r side of this form , this day
deliv ered to me by the Sout hern Expr
I
ess Com pany , from __ __ __ __
__ __ __ ; tliat I am not a
· stud ent or mino r, and, if a fema le
, I am the head of a fami ly; that the
arde nt spiri ts so recei ved by me
were brou ght into the State on my
writt en orde r, and that I have not,
with i~ the thirt y days prev ious
here to, recei ved any arde nt spiri ts of
any kind what soev er, from any perso
n or from any place what soev er, in
exce ss of the quan tity allow ed by the
prov ision s of the Act of the Gene ral
Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
and that the arde nt spiri1.s so recei
ved by me are for my own use, at
my own home , and that the said arde
nt spiri ts will not be used in viola tion
of Jaw.
Sworn to and subs crib! d befo re me,
this
I day ot...
1 ,
191 _
Aceut for South ern Exvre ss Comv
auy.
.•
Cons icuee.
�SOUTHERN EXPRESS COMPANY
FORM 370-VA
(Inco rpora ted)
Advnnre a to
Collec t
Arld
Undercha r ge
RECORD OF" NOTICES
To Consianee _ _ _ _ _ _ _ _ _ _ _ __ ~ - - To Shipper_ _ _ _ _ _ _ _ _ _ _ _ _ _ __
AF"F"IDAVIT F"OR ARDENT SPIRITS F"OR PERSONAL USE .
{OV KR)
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PER SON AL
USE
STAT E OF VJRG IN/,i, ,
COU NTY O F - - - ' - -- - ----
- - '-
i, -~ -- --- - - -- - - - -- -- -- -, bein g duly swor n, depose and
the cons igne e of a
say that I am
certa in ship men t of arde nt spiri
ts, as spec ified on othe r side of
this form , this day
deliv ered tom e by the Sout hern Expr
ess Com pany , from _ _ _ _ _ _
_ _ _ _ _ _ _ ; that I am not
stud ent or mino r, and, if a fema
a
le, I am the head of a fami ly; that
the ard ent spiri ts so rece ived by
were brou ght into ihe State on my
me
writ ten orde r, and that I have
not, with in the thirt y days prev
here to, rece ived any arde nt spiri ts
ious
of any kind what soev er, from any
pers on or from any plac e wha tsoe ver,
exce ss of the quan tity allow ed by
in
the prov ision s of the Act of the Gene
ral Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
and that the arde nt spirit.s so rece
ived by me are for my own use, at
my own hom e, and that the said
arde nt spiri ts will not be used in
viola tion of law.
I
Swor n to and subs cribe d befo re
me,
this __ _day ot....
- - -- · , 191_
Aeen t f or South ern Exvr ess Comp
any.
(
Consiz:nee.
�=
FORM 370•VA
SOUTHER N EXPRESS COMPANY
(I ncorporate d)
Advan rea t o
Collect
P REPA ID
RECORD OF NOTICES -
To Consian ee _ _ _ _ __ ____ _ __ _ __ _ _
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
..,.
(OV ER )
�-
AF FID AV IT FO R AR
DE NT SP IRI TS FO
R
PE RS ON AL US E
i, --- ,-- --' ------'~--- --'·-
- - - -- --- - -, bein g dul y swo
the con sign ee of a cer tain
rn, dep ose and say tha t I
ship men t of ard ent spir its
am
, as spe cifie d on oth er side
of this form , this day
· deli ver ed to me by the Sou
the rn Exp ress Com pan y,
from
stud ent or min or, and , if
,
; tha t I am not a
a fem ale , I am the hea d of
a fam ily; tha t Che ard ent
wer e bro ugh t into the Sta
spir its so rece ived by m
te on my wri tten. ord er, and
e
tha
t I hav e ot, wit hin th
her eto, rece ived any ard ent
e thir ty d a ys pre vio us
spir its of any kin d wha tsoe
ver , from any per son or from
exc ess of the qua ntit y allo
a n y pla ce wha tsoe ve1·, in
wed by the pro visi ons of
the Act of the Gen era l Ass
Ma rch 10, 1916, or con trar
emb ly of Vir gin ia , app rov
y to law , and tha t the ard
ed
ent spir ils so r ece ived by
my own hom e , and tha t th
me a re for my own use , at
e said ard ent spir its will
n ot be u sed in viol atio n of
law .
Swo rn to and sub scri bed
bef ore m e,
th is __ _day oL
- -=-- , 191
7
Con sicn ee,
e:£! -
\
�F'ORM 370•VA
SOUTHERN EXPRESS COMPANY
(I ncorpo rated )
.,r
.........~ =:_ lb~
i-:11{'4J )
.
A rl d / \
Underc harge
RECORD OF' NOTICES
To Consionee
To Shipper_ _ __ _____________
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE .
(OVE R)
l
1
�AFFI DAVI T FOR ARD ENT SPIR
ITS FOR
PERS ONA L USE
STATE 0~' VJRGI NIA ,
COUN TY OF _ _ _ __ _ __ _
__
~, - - - - -- -- -- - - -- -- - - - - -, being duly sworn , depos e and say
that I am
the consig nee of a certai n shipm ent of arden
t spirit s, as specif ied on other side of this
form, this day
delive red to me by the South ern Expre ss Comp
any, from ___ ___ ___ ___ __ ;
that I am not a
stude nt or minor , and, if a femal e, I am the
head of a famil y; that the ard ent spirit s so
receiv ed by me
were broug ht into the State on my writte n
order, and that I have not, within th e thirty
d ays previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any p erson or from any place
whats oever , in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgi
nia , appro ved
March 10, 1916, or contra ry to law , and that
the ard ent spirh s so r eceive d by me are for
my own use, at
my own hom e, and that the said arden t spirit
s will not be used in violat ion of law.
dLL
Sworn to and subsc ribed before me,
th is
/j day oL.
(j
~ --
,
191-1
A2e nt fo r Southe rn Exvres s Co mvauy.
.
'faj-1J·1A--Consia nee.
~
�SOUT HER N EXPR ESS COM PANY
( Incorpo
rated )
Affidavit No.
I./ JI
AdYanr ea t o
Collect
,RECO RD
To Consignee _ _ _ _ __ __ _ _ _ _ __
_ __
To Shipper_ _ _ _ __ ___ ___ _ _ _
_ _ _
AF'F'ID AVIT F'OR ARDE NT SPIRI TS
F'OR PERS ONAL USE .
(OV ltR )
�AFFI DAVI T FOR ARD ENT _ SPIR
ITS FOR PERS ONA L USE
STATE m' VIRGI NIA,
COUN TY OF~!_ _ __ __ __ _
_
~, - - - - - -- - -- - - -- - - - - - - - , being duly sworn , depos e and say
that I am
the consig nee of a certai n shipm ent of arden
t spirits , as specif ied on other side of this
form, this day
delive red to me by the South ern Expre ss Comp
any, from _ _ __ _ _ _ _ __ _ _ _ ;
that I am not a
stude nt or minor , and, if a femal e, I am the
head of a family ; that the arden t spirit s so
receiv ed by me
were broug ht into the State on my writte n
order, and that I have not, within the thirty
days previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
whats oever , in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgi
nia, appro ved
March 10, 1916, or contra ry to Jaw, and that
the arden t spirit s so r,eceived by me are for
my own use, at
my own home, and that the said arden t
spirit s will not be u sed in violat ion of law.
Sworn to and subsc ribed before me,
this _ _,_day o
191_
A11ont for Southe rn Expres s Com'l)a uy.
Consii: nee.
�/J .r , ,! ,
'l
(0 :-UGI NAL)
AFFIX
STAMP
HER£
· - ~ -'- •
,
Railw ay Com pany
5 NOTICE TO DELIVERJ'IG AG£ NT : , Thia form
la to be -c1 when mald,.._clell•el'lea of ardent apirila under the Prohibi
tion Act of the State of Viralal a to CONSI
OTHER T HAN HOTELS, DRUG
GNEES ,
SUPi,.P 1 NT ENDEN S OF HOSPITALS,
CHa:.MICALLABORATORIES ANDGISTS,
OR
MANU FACl ' -RERS OF FLAVORJNC EX , RACTS
Etc . Bo h the o tlainal ancl clupUca~
,
hee mual
atampe d oriarinal muat be r .. talnecl bi, Ji
prop~r. i, cancele d. See circula r of
~
b e ai11nocl bi, the couian oo ancl thi•
a pel'IIIRllent .._rc1, The atamp
• - be
/ /
b•ermaa,
v--- -- _- , Virginia
l depo se and say that I am the cons ignee
of /
i /,
<< l .
1
~ V-
/ (Quant ity)
of...:...-"'- • · / of whic h I now desir e to take deliv ery
from
.I •-.-'-_,__(girull
--L
-I-=-...c.
....,____~""·'-·=· ___ /_ __ Railw ay Com pany ; that
I am a male
(or if a fema le, that I am the h~ad of a tami
at a univ ersit y, colle ge or any othe r scho ol ly); that I am not a stud ent
in this State ,.nor a mino r;
that said shipm ent was orde red by me and
brou ght into this State
upon my writt en orde r; that I have not
ot any kind what ever , inclu ding said shipmrecei ved ariy arde nt s pirits
ent as if alrea dy recei ved,
from any perso n or fro·m any place what ever
in exce ss of the quan tity
allow ed by Act of Virg inia of Mar~ h 10, 1916,
or othe rwis e cont rary
to said Act, with in thirt y days prece ding
the date of this affid avit ;
that the arde nt spiri ts cont ained in said shipm
ent are for my own use
at my own hom e and w,ll not be used in
viola tion of said Act.
��l'ORM 370•VA
Affidavit
No._h..;1-----'/J
/'----=--
To - - ~~~-_:._+-- =--•- - - -------,A - Shipper4'C...!.~~ ...p~= .!?-~ ~ =--.L-~ ~ r
~
RECORD Of"
To Consign ee _ __ _ ______ _ _ _ _ _ __ _
To Sh ipp er_ _ _ _ _ ___ ._ _ _ _ _ _ _ __
Af"f"IOAVIT f"OR ARDENT SPI RITS f"OR PERSONAL USE .
( OVER )
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERS ONAL USE
STATE OF VIRGIN IA,
COUNT Y O F - - - --
- --
-
--
... , - - - - - -- - - - - - - - - - - - - -- , being duly sworn, depose and say that I am
the consig nee of a certain shipme nt of ardent spirits
, as specifi ed on other side of this form, this day
deliver ed tome by the Southe rn Expres s Compa ny,
from _ _ _ _ _ _ _ _ _ _ _ __ ; that I am not
a
studen t or minor, and, if a female , I am the head
of a family ; that the ardent spirits so r~ceive d by
m
e
were brough t into the State on my written order, and
that I have not, within the thirty days previo us
hereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provisi ons of
the Act of the Genera l Assem bly of Virgin ia, approv
ed
March 10, 1916, or contra ry to Jaw, and that the ardent
spirits so receive d by me are for my own use, at
my own home, and that the said ardent spirits will
not be used in violati on of law .
Sworn to and subscr ibed before me ,
this_F
_ _day ot
- -- - , 191 _
A1:ent for Souther n Express Compau y.
Cons ianee.
�FORM 3TO•VA
Affidavit No ?
6 l----
NOTICES
To Consigne e _ _ _ __ _ ___________
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OV ER)
�AFF IDAV IT FOR ARD ENT
SPIR ITS FOR
PER SON AL USE
L
_._
·
;J
J~ ng duly
the con~ ignee of a certa i: ihip men_t
_ o_f_a-rd_e_n_t_ s_p_i-r i_t_s_,_a_s_p,,e.·cti.fie d on swor n, depo se and say that I am
other side of thi s form , this day
deliv ered to me by the Sout hern Expr
ess Com pany , from ~~- - - - - -- - -/__ · that I am not a
stud ent or mino r, and, if a fema le
, I am the head of a fami ly; that the
ard ent sp irits s r eceiv ed by m e
were brou ght into the State ·on my
writt en orde r, and that I have not,
with in th e tliirt y days prev ious
heret o, recei ved any arde nt spiri ts of
any kind what soev er, from any perso
n or from any place what soev er, in
exce ss of the quan tity allowe.d by the
prov ision s of the Act of the Gene ral
Asse mbly of Virg inia , appr oved
Marc h 10, 1916 , or cont rary to law,
and that the arde nt spiri \ so received
by m e are for my own use, at
my own home , and th at the said arde
nt spiri ts will not be s d i viol ation
of law
./
Swor n to and subs cr"lfu d befo re me,
thi s_) _jda y o
J , 191 _
A~en t for South ern Expre s s Comp
u.uy.
Consi auee.
�SOUT HERN EXPR ESS COMP ANY
(Incorpo rated )
Advnnr e s to
Collect
PREPAI D
RECOR D OF NOT.IC ES
To Consignee _ ___ ___ _ _ _ _ _ _ _ _ _
_
To Shipper _ _ _ ___ ___ ___ __ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE.
(OYKR)
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
... , ~-~~......~~~ ----\'+'. _~- - ~ ~ ~ - - ~ , being duly sworn, depose and say 1ihat I am
1ihe consign ee of a certain shipme nt
spirits, as specifie d on othet side o his form, 1ihis day
deliver ed to me by 1ihe Southe rn Expres s Compan y, from
that I am not a
student or minor, and, if a female, I am the head of a family;
that e ardent ,spirits so receive d by m e
were brougM into the State on my written order, and 1ihat
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from any pla~e whatso ever, in
excess of the quantit y allowed by the provisio ns of the Act
of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to Jaw, and that the ardent
spiriis so receive d by me are for my own use, at
my own home, and that the said•ard ent 'spirits will not be
used in violatio n of law,
"J../4
L,
Sworn to and subscri bed before me,
this_L _day
oL-f=
""-(~"---, 19f
Aeent for Southern /Expres s Compa_uy.
,
. ~
I'
Consiaue e.
�-~----.-,s-----~---------------
FORM 370•V A
SOU THE RN EXP RESS COM PAN
Y
(lucorp o rated
)
t-
L I Q ~ R~C ORD
Receiv ed at--,::;a1F - ----'-----'-"'"---:al- - --'--- ,:5..
-- - - Dat ~
c·onsian ee ~ L-'::::. ._,~=----""'-1--]f--- ~ -"--'
u
=----.,=. ,V
,c;_=-
/I
1,.,""¥'- ----- - - - - --
Advour ee to
Collect
Shipper____ _ _ _ __ _ __ _
_ __ __
Affidavit.No _ _ _ __ _
- -- -- - ~~ -
....- --
PREPA ID
RECO RD Of" NOTI CES
To Consign ee ___ _ _ ___ ,_ _ _
_ _ _ _ __
To Shipp er _ ___ ___ ___ __
_ _ __ _ _
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE .
( O V KR)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE OF VIRGINIA ,
COUNTY O F - - , - - --
i,
-'--"=-=-=--= ~
,/
, being duly sworn, depose and say that I am
the consigne e of a certain shipment of ardent spirits, as specified on
other side of this form, this day
delivered to me by the Southern Express Company , from ,
(; that I am not a
student or minor, and, if a female, I am the head of a family; th11.t the
ardent spirits so received by m e
were brought into the State on my written order, and that I have not,
within t he thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so rec
eived by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation
of law .
Consicnee.
Sworn to and subscribe d befo1•e m e,
.. .A£8nt for Southern E'xvress Compauy.
I
�FOFIM 370•VA
SOUTH ERN EXPRE SS COMPA NY
(Incorpora ted )
Consianee
Way-Bill No.~,F-~ ::Y,;ii: !~;:;--
To ---<11" -~flf i,~~ ~~- - - --
Advn.n r-e a to
Collect
RECORD OF NOTICE S
To Consignee _ ____ ____ ____ _____
To Shipper_ _ _ _ _ _ ____ __ __ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL US£.
{OVER)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
PERS ONAL USE
- - - ~ ~ - -- - ~~ -- - - - - - - - -- , being duly sworn , depose and say that I am
the consig nee of a certai n shipm ent of arden t
spirits , as specj.fied
ther side of this form, this day
delive red to me by the South ern Expre ss Co~
any, from
/
; that I am not a
studen t or minor , and, if a femal e , I am the head
of a family ;e,t liat the ard ent sp irits so receiv ed
by m e
were broug ht into the State on my writte n order,
and that I have not , within th e thirty days
previo us
hereto , receiv ed any ardent spirits of any kind what
soever , from any person or from any place whats
oever , in
excess of the quanti ty allowe d by the p rovisio ns
of the Act of the Gener al Assem bly of Virgin ia
, approv ed
March IO, 1916, or _c ontrar y to law, and that the
arden t spiri\s o r eceive d by me a re for my own
use, at
my own home , and that the said ardent spirits
wil ~
sed in violat ion of la ' .
,,
c;.,
Sworn to and subscr ibed befor e me,
Aeent fo r Souther n Exvras s Compa uy.
.
�FORM 370•V A
SOUTH ERN EXPRE SS COMP ANY
(l u corpotat e d)
Arld
Under c ha rge
RECOR D OF NOTICE S
To Consion ee
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE .
(O VK R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
,, - - - - -- -'----'--- - - - - -- -- - - -- , being duly sworn, depose and say ihat I am
ihe consignee of a certain shipment of ardent spirits, as specified on other side of this form, ibis day
delivered to me by ihe Southern Express Company, from ______ __ ______ ; ,tha1; I am noi a
student or minor, and, if a femal e , I am the head of a family; that the ard eni spirits so received by m e
were brought into the State on my writt en order, and that I have noi, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place wh atsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so rec eived by me are for my own use, at
my own hom e, and that the said ardeni spirits will not be used in violat io of law .
Sworn to and subscrHSed before me,
th is /
day
o:.I , ,
191
~
Aeen~for Southern EX.press Compau y.
Consienee.
�FORM 370•VA
SOUT HERN EXPR ESS COM PANY
(I ncorpo ra t ed )
Affidavi t
No, _,,.✓,
_~
-~--/
RECO RD Of" NOTIC ES
To Consign ee ___ _ _ _ _ _ __ __ _
__
__
To Shipper _ ___ ___ ___ ___ ___
__
Af"f"ID AVIT f"OR ARDE NT SPIRI TS
f"OR PERSO NAL
(OV KR)
use .
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _ _ _ __ _ __ _ __
i, - - - - - -- - -- - - - -- -- - - - - -, being duly sworn, depose and say \hat I am
the consignee of a certain shipment of ardent spirits, as specified on other side of- this form, this day
delivered to me by the Southern Express Company, from __________ __ __ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, fro~ any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law , and that the ardent spirit.s so received by me are for my own use, at
my own. hom e , and that the said ardent spirits will ot be used in violation of law .
Sworn to and sub~cri ed before me,
,
this
day ot- - -- - , 191_
Aalent for ,Southern Exvross Compauy.
Consicnee.
�FORM 370•VA
1
~J._,'_./'
_ ...z/---1-_
Affidavit No •.
AdvntH e a to
Collect
And
Unde rcharge
RECORD OF
To Consion ee _ __ _ _ __ ______ ____
To Sh ipper _ _ __ _ _ _ _ _ _ _ _ _ _ __
AFFIDAVIT FDR ARDENT SPIRITS FDR PERSONAL USE .
( OV ER)
�AF FID AV IT FO R AR
DE NT SP IRI TS FO
R
PE RS ON AL US E
STA TE OF VI RG
/ . !NIA ,
Co~ NTY OF -~- ~-
--;;--
- - ----:----:z~,F
i, __. .,.____,, __ __ __ __ __ __
__ __
-?
_ , bein g dul y swo rn , depose and say tha
the con sign ee of a cer tain
ship men t of ard eut spir its
t I am
, as spe cifie d on oth er side
of this form , this day
deli vered to me by the Sou
the rn Exp ress Com pan y, fro
m_ ~ - - - - - - - - -stud ent or mii lor, and , if
- -- i tha t I am not a
a fem al e, I am the hea d
of a fam ily; tha t the ard ent
wer e bro ugh t into the Sta
spi rits so r ece ived by m e
te on my wri tten ord er, and
tha t I hav e not , wit hin
her eto, rece ived any ard ent
the thir ty day s pre vio us
spir its of any kin d wha tsoe
ver , from any p erso n or from
exc ess of the qua ntit y allo
any plac e wha tsoe ver , in
wed by the pro visi ons of the
Act of the Gen er al Ass emb
Ma rch 10, 191 6, or con trar
ly of Vir gin ia , app rov ed
y to law, and tha t the ard
.e nt spir its so r ece ived by
my own hom e , and tha t the
me are fo r my own use , at
said ard ent spir its ';ily not
be u sed in viol atio n of aw.
.
V
_
Sworn to and sub scri bed
bef ore me,
C
°7/
__;:: c___ !:.__ : _=c
;I /
,, I
thi s_, _ _day ot.. - -- , 191 _
A,re nt foy So uthe rn Exp
res s Com vau y.
I
,,,
I ~L_' _::..:C..c....=c_
_:-= ---._
_...:..::c....:._
_
_
_e__ _ __
Con sie nee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Incorporated)
-~.L- +f~'
-~,,____."--""""--"'---'=----c,C,_
· -""-'1~---'~,.___Amount,_
t
I
y,,__l""'·--"
·f'-'
·')_,.,"'-'
. -~
' /)-'!--"
1
- - -- ' -.......;L ___.__ __ _ 191 ~
Advom es to
Collec; t
•
I
Add
PREPAID
Uurlercborge
COLLECT
; ,,..
,,,
'?
J
RECORD OF NOTICES
To Consionee
To Shipper_ ____________ __:__ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
{OVE R)
�AFFIDAV IT FOR ARDENT SPIRITS FOR
PERSON AL USE
STATE OF VJRGINIA,
COUNTY OF _ _ _ __ _ __ _ _ __
~, _____ __ __,__ __ ____ _____ __ , being duly sworn, depose
and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side
of this form, this day
delivered tome by the Southern Express Company, f r o m ~ - - - - - - - - - - - - i that I am not a
student or minor, and, if a female, I am the bead of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law
.
,I I
Sworn to and subscribed before me,
this ___day oL
Ae-en, for Southern Exvress Compauy.
Uonsianee.
�P'ORM 3TO• VA.
SOU TH ER N EXP RES S
CO MP AN Y
(luco rpora
lied)
REC ORD OF" NOT ICE S
To Consignee, ___ _ _ _
_ __ _ _
_ _ _ _ __
To Shipper ____ __ __
__
AF"F "IDA VIT F"OR ARD ENT
SPI RIT S F"OR PER SON
Ai USE .
(on: BI
__ _ _ _ _ __
�AFFI DAVI T FOR ARD ENT SPIR
ITS FOR
PERS ONA L USE
8TA'l'~ OF VIROIN LA ,
COUN TY
or _ _ _ ___.=--=-==-=--
I, - - - - - - - - - - ~- - -- - - --- - , being duly sworn , depos e and say
the consig nee of a certai n shipm ent of arden
that I am
t spirits , as specifi ed on other side of this
form, this day
delive red to me by the South ern Expre ss Comp
any, from _ ___ ___ ___ ___ _ ;
that I am not a
stude nt or minor , and, if a femal e, I am the
head of a family ; that the arden t spirit s so
receiv ed by me
were broug ht into the State on my writte n
order, and that I have not, within the thirty
days previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
whats oever , in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgi
nia, appro ved
March 10, 1916, or contra ry to law, and that
the arden t spiril. s so receiv ed by me are for
my own use, at
my own hom~ , and that the said arden t spirit
s will not be used in viol ation of law.
Sworn to and subsc ribed before me ,
this ___day o ~ - - ~ - - , 191_
Consie nee.
.
A~nt for Southe rn Exvres s ()omv1111y .
�FORM 370•VA
A.dvan<e1 to
Co ll ec t
RECORD Or
To Consignee _ _ _ __ ___ _ _ _ _ _ _ _ __
To Shipper _ _____ _____ _____ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFFI DAVI T FOR ARD ENT S~IR
ITS FOR
PERS ONA L USE
STATE OF VJRGl NIA
1
COUNT Y OF _ _ _ __ _ _ _ __
_
... , - - - - - -- - - -- ·-"--== -- - -- -- - , being duly sworn , depos e and
say that I am
the consig nee of a certai n shipm ent of arden
t spirit s, as specif ied on other side of this
form, this day
delive red to me by the South ern Expre ss Comp
any, from .
; that I am not a
stude nt or minor , and, if a femal e, I am the
head of a family ; that the arden t spirit s so
receiv ed by me
were broug ht into the State on my writte n
order, and that I have not, within the thirty
days previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
whats oever , in
exces s of the quant ity allow ed by the provis
ions of the Act of the Gener al Assem bly of Virgi
nia, appro ved
March 10, 1916, or contra ry to law, and that
the arden t spiri\ s so receiv ed by me are for
my owil use, at
my own home , and that the said arden t spirit
s will not be used in violat ion of law.
Sworn to and subsc ribed before me ,
this ___day oL. - --
, 191_
Aeent for Southe rn Expres s Compa uy.
Co nsicuee .
�FORM 3TO•VA
SOUT HER N EXPR ESS COM PANY
(Incorp
o rated)
COLLECT
RECO RD OF NOTIC ES
To Consign ee _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ __
To Shipper _ ___ ___ ___ __ _ _ _
_ __
AFFID AVIT FOR ARDE NT SPIRI TS
FOR .PERS ONAL USE .
( OV ER)
�AFF IDAV IT FOR ARD ENT
SPIR ITS FOR
i, ~. . . .~= ~~- -,e;--~_.,_--.,_-¼ --~~~~-
PER SON AL USE
- -- , being duly swor n, depo se and say
that I am
as speci fied on other s~ of this form
, this day
1
deliv ered to me by the Sout hern Expr
ess Comp any, from
,
i
I
; tliat I am not a
stude nt or mino r, and, if a fema le, I
am the head of a famil y;
nt spiri ts so recei ved by m e
were brou ght into the State on my writt
en order , and that I have not, wi in
the thirty days previ ous
heret o, recei ved any arden t spiri ts of any
kind what soeve r, from any perso n or from
any place what soeve r, in
exces s of the quan tity allow ed by the
provi sions of the Act of the Gene r al Asse
mbly of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law,
and that the arden t spiri \s so rec eived
by me are for my own use, at
my own home , and that the said arden
t spiri ts will not be used in viola tion of
law.
1tt~e 1_ 2 -a ± I,
V
Swor n to and subsc ribed befor e me ,
this ,, (/_ day oL--
1.-f- /7
;/ 0
/
/ ,./ , 191!_ /
">
/
,
Ae-ent f or South ern Expre ss Compau
y.
'-"'
C onsii:noe,
�FORM 3TO•VA
. ,_.
1/4
/.c
~
Affidavit No.,~ -~- - --
,
-'
Advau <' ea to
Coll ect
P REPAID
A ad
Unde r char ge
RECO RD OF NOTIC ES
To Consign ee _ ___ ___ ____ _ _
_ _ _ __
To Shipper _ _ __ __ _ ___ _ _ _
_ _ _ __
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERS ONAL USE .
(OV ER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR
i, _ _(J~d,~f.dC'.'!,¢11..,...:__ _~~~~~~~ ~- - ,
PERSONAL USE
being duly sworn, depose and say that I am
ecified o other side of t~form, this day
that I am not a
student or minor, and, if a female, I am the head of a family; hat the ardent spirits so r eived by m e
were brought into the State on my written order, and that I have not, within the thirty clays previous
hereto, received any ardent spirits of any kind whatsoever, from· any person or from a ny place whatsoeve1·, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
(Pitt
Consiauee.
�.,,
- ~ ':+- ---'="------19 1L
Advan1 e s to
Coll ec t
Shipper _ __ __ _ _ __ _ _ _ _ _ _ _ __
From,_c....__ ~,.__ __ _ __
COLLECT
A~d
Uudercbnrge
RECORD OF NOTICES
To Consignee _ __ _ ____ ._ _ _ _ _ _ _ __
To Shipper________ __ _ __ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( O VER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
STATE m' Vrn?lNIA,
CouNTY m·---•- - - -- -----'-~
i, ------- ------ ------ ---, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, f r o m _ ~ - - - - - - - - -- - ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the· thirty· days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before me,
this
2..-v day oL -7_
,_ , 19lr-,
I
A2ent for Southern Express Comr,au)',
Consienee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(Incorporated )
Affidavit No, _ _ _ __ _
P R EPAI D
RECORD OF NOTICES
To Consign ee ___ _____ _ _ _ __ _ __ _
To Shipper ____ ______ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL US£ .
( OV·KR)
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR
_., --'- ---" ----...L,cc----'-
PER SON AL USE
-'-_.::
_---"- -'=--- - -----""=-- - ,
bein g duly swor n, depo se and say
the cons igne e of a certa in ship men
that I am
t of arde nt spiri ts, as spec ified
on othe r srne of this form , this
day
deliv ered to me by the S~ut hern Expr
ess Com pany , from
f
stud ent or mino r, and, if a fema
; that I am not a
le, I am the head of a fami ly· that
the arde nt spiri ts so rece ived by
were brou ght into the Stat e on my
me
writ ten orde r, and that
have not, with in the thirt y days
here to, rece ived any arde nt spiri ts
prev ious
of any kind what soev er, from any
pers on or from any plac e wha tsoe ver,
exce ss of the quan tity allow ed by
in
the prov ision s of the Act of the Gene
ral Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
and that the arde nt spiri 1s so rec
eive d by me are for my own use,
my own hom e, and that the said
at
arde nt spiri ts will ot be used in
viola tion of law.
ff
~ _j_
Swo rn to and subs cribe d befo re me
,
this
',I
- -- ,
· Cous i2nee .
1917
L
Aeen t for South ern Ex.press Com
=
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(I ncorporat ed )
LIQU ~EC ORD
Received at~m! !!~~"" "'LJq~ ~ :,!-9-- - - + Da t e p { ,
Consignee ......t-.z.... .c:__-=.L_!=+--~l!"J.~f".'.'!i::'.'.~~~~~""'~""'~
""'".:"_ _,,_..,_____ ~ ~--
To
RECOR D OF NOTIC ES
To Consignee _ __ _ _ ___ _ _ _ _ _ _ _
__
To Shipper ______ ___ ___ ___ __
~
AFF"ID AVIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE .
/
( O VKR)
�AFFIDA VI,: FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STATE OF VIR G INI A,
COUNTY OF _ _ __ _ __ _ _ _
_._, - - - - -- - -- - - -- - - -- - - - - -, being duly
sworn, depose and say that I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
delivere d to me by ihe Southern Express Company, from
·'
; that I am ntn a
student or minor, and, if a female , I am the head of a family;
that the ard eµ t spirits so r eceived by m e
were brought into the State on my written order, and that I
have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, fr(!m
any person or from any place whatsoe ver , in
excess of the quantity allowed by the provisio ns of the Act of
the General Asse mbly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so received by me a re for my own use, at
my own hom e , and that the said ardent spirits will not be used
in viol ation of law.
Sworn to and subscrib ed before m e,
this ___day oL - -- - ,
191 _
Aeent fo r Sonthern Exvress Comvauy.
Consi,::u ee.
�FORM 370-VA
"? '/J J~
Rec.eived at
SOU THER N EXPR ESS COM PANY
(;.,/t.,r{lt/l..r.,
Consianee
~ : . , ,_ , ~
~1 '
~
Kind of Arden Sp~s
Date ~ -/ ' ? .
fl,~ ~ ~
U/ •~~:
•
~
'"' !:!::.._ - 9 ?'
.i&
~
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(:;;
P-
w.,.,m , ·
To
S~· ~::~;:> RECORD
Amount
Advam ea to
Shipper_ _ __ _ _ _ _ _ _ _ _ _ _
___
Coll ect
/
"
1917
,;;.;&-- ,.f>1
F,om
Affidavit
~o.3 6 3
/
Wei~L ~
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LU (Jr..l,,v'-'6
EXPRE SS CHARG ES
PREPA I ~
ll-c
_o_L_L_E_
c_-r_, _ _
YI
___ ,
RECO RD OF' NOTIC ES
To Consignee_ __ _ __ _ _ _ _ _
___
__
To Shipper _ _ _ _ _ _ _ _ _ __ _
_ _ __
AF'F'ID AVIT F'OR ARDE NT SPIRI TS
F'OR PERS ONAL USE ,
{OVER)
�AFF IDAV IT FOR ARD ENT
SPI RIT S FOR
PER SON AL USE
STAT E OF V I RGIN IA
COUN TY OF·~ ~ = - ~~~ -:_::
~~:Q '.~ 1
i,
0
''-".
l
, bein g duly swor n, depo se and say that I am
' the cons ignee of a certa in shipm!;lnt
of arde nt spiri ts, as speci fied on othe
r side of this form , this day
deliv ered to me by the Sout hern Expr
ess Com pany , from /
•
• •
stud ent or mino r, and, if a fema le,
that f am not a
I am the head of a fami ly; that the
arde nt spiri ts so recei ved by m e
were brou ght into the State on my
writt en orde r, and that I have not,
with in the thirt y days prev ious
here to, recei ved any arde nt spiri ts of
any kind whai soev er, from any perso
n or from any place what soev er, in
exce ss of the quan tity allow ed by the
prov ision s of the Act of the Gene ral
Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to Jaw,
and that the arde nt spirh s so recei
ved by me are for my own use, at
my own home , and that the said arde
nt spiri ts wil .31ot be used in viola tion
of law.
1
A2en t for South ern Express Comp
auy.
�..,...,---~----~- ----~,--~~---,- ------------~------- ------ ----SOUTHERN EXPRESS COMPANY
FORM 3TO•VA
(Incorporated)
Affidavit No . _ _ _ __ _
Advnn re e to
Collect
EXPRESS CHARGES
PUE PAID
COLLECT
Arld
Undercharge
RECORD OF NOTICES
To Consianee_ __ _ _ __
_ _ _ _ _ _ _ __
To Shipper _ _ _ __ _ _ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVER)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
PERS ONAL USE
STATE OF VIRG), Nl
COUNT Y OF_-' -+
/ _ _ __ __
_
i, --- --~~- --~ --- --- --~ --,
being duly sworn , depose and say 1.hat I am
1.he consig nee of a certai n shipm ent of ardent
spirits , as specifi ed on other side of 1.his form,
1.his day
delive red tome by1.he South ern Expre ss Comp
any, from --"--- -"--_ ._--- ----- -- i -that
I am not a
studen t or minor , and, if a female , I am the head
of a family ; that the ard ent spirits so receiv ed
by m e
were broug ht into the State on my writte n order,
and that I have not, within the thirty days
previo us
hereto , receiv ed any arden t spirits of any kind whatso
ever, from any person or from any place whats oever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law, and that the
ardent spiri\s so rec eived by me are for my own
use, at
my own home , and that the said ardent spirits
will not be u sed in violati on of law .
S~orn to and subscr ibed before me ,
I
this__ .___da y of- --'--"--' ----, 191~
Jll:,
c7
,
A~ent for Souther n Exvres s Comva.uy.
Consicn eo,
�FORM 370•VA.
SOUTHE RN EXPRESS COMPAN Y
S
Received at ~
' -.
Consignee ,.,,-
-r~
~ctJ~(~u(:;~i~~/>~c /
~
llMe
,
<='- ' /l"t/Z; /~,,.., /1!-7' , ,,,_ "C??-,r"'-,' 7~;
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K;odolA ,deo,S~/
Way-Bill No ~
.-L------4::;.__ _
TO
/,
, -,;
~
, . . ~m"""'
Shipper _ _ _ _ _ _ _ _ _ _,/_'_ _ __ _
/ /
.,,.
4:-
7
191 .::'.:__
-
... - ~
191 _
Advnnr:ee t o
Coll en
6
Affidavit f~o. _ _ _ __
~
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,
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--.._..-.,
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4
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I
EXPRESS
---'---~
"""..:.ii!=- -
PREPAI D
Add
Uude rcha rge
---~----.1----4i:. '-- - - -
RECORD OF' NOTICES
To Consign ee .
t.~
To Shipper _ _ _ _ _ __
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONA i USE.
�- - - - - - - - ----~ - - _,. - - - - - - - - - - - AFFID AVIT FOR ARDE NT SPIR ITS FOR
PERS ONAL USE
- . -..-- ---~ ~--- -,,..~- ----_ _,____
-~
_ , being duly sworn , depose and say that I am
p ified on other si
of this form, this day
delive red to me by the South ern Expre ss Company,
from .L.....-"-""'--="-"'--1- •- ~ ' - "--'-"" -- student or minor , and, if a female , I am the head
of a family ; :h
were broug ht into the State on my writte n order,
and that I
hereto, receiv ed any arden t spirits of any kind whatso
ever, from
person or from any place whatso ever, in
excess of the quanti ty allowed by the provis ions
of the Act of the Gener al Assem bly of Virgin ia, approv
ed
.March 10, 1916, or contra ry to law, and that 1.he
arden t spiriis so received by me a.re for my own
use, at
my own home, and that the said ardent spirits will
not be used in violati on of law .
Consl11nee.
c:;:;7'/,
A1111n• t or Southe rn Express Compan y.
�RECORD OF NOTICE S
To Consign ee _ __ _ __ ____ ____ ___
To Shipper _ _ _ _ _ _ _ _ _ __ _ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL US£.
( OV KR)
�AFF IDA VIT fOR ARD ENT
SPI RIT S FOR
STAT E OF VIRG 1NIA ,
COU NTY OF _ _ _ __ _
__ _ _,__
PER SON AL USE
--
i, -- -- -- -- -- -- --- -- -- --, bein g duly swor n,
the cons igne e of a certa
depo se and say that I am
in ship men t of arde nt spiri ts, as
sp.,ecified on othe r side of this form
, this day
deliv ered to me by ihe Sout hern Expr
ess Com pany , f r o m - - ~ - - - - - - -- - ; that; I am not
stud ent or mino r, and, if a fema
a
le, I am the head of a fami ly; that
the arde nt spiri ts so rece ived by
were brou ght into the Stat e on my
me
writ ten orde r, and that I have
not, with in the thirt y days prev
here to, rece ived any arde nt spiri ts
ious
of any kind what soev er, from any
pers on or from any plac e wha tsoe ver,
exce ss of the quan tity allow ed by
in
the prov ision s of the Act of the Gen
eral Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
and that the arde nt spiri ts so rece
ived
by me are for my own use, at
my own hom e, and that the said
arde nt spiri ts will not be used in
viola tion of law.
Swo rn to and subs cribe d befo re me,
.,,.
,
this __ _day ot..-
Aeen t for South ern Expr ess Comv
auy.
Cousia;:nee.
�FORM 370•VA
R,ooi,ed "
Consignee
'~:,~fJ
SOUTHER N EXPRESS COMPANY
ttL';~A--~~ IAL
0
,, ; -
,m,..11 ,.. f?/,I
- - -~- ~'-,,,..--~~_
h
..c:~~-=-L---~~:::..:c:==--'-='==----- --·- - - - -- - --'- -
Advnure 11 t o
Co ll ec t
Arld
Uu de rc hnrge
RECORD OF NOTICES
To Consign ee _ _ _ _ _ _ _ _ _ _ _ __ _ _ _
To Shipper _ __ _ _ _ _ _ _ _ __ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
{OV KR )
�AFFI DAV IT FOR ARD ENT SPIR
ITS FOR
STAT E OF VIRG INI A,
COUN TY OF _ _ _ __ _ _ _
i
PER SON AL USE
__ _
1 - - - -- - -- - - - - - --
- - - - - - - , being
duly sworn , depos e and say 1;hat I am
the consi gnee of a certa in shipm ent of
arden t spirit s, as spllcified on other side
of this form, 1;his day
deliv ered tome by the South ern Expr ess
Comp any, from ___ ___ ___ ___
_ _ ; tliat I am not a
stude nt or mino r, and, if a femal e, I am
the head of a famil y ; · .t hat the ard ent spirit
s so receiv ed by m e
were broug ht into the State on my writt
en order , and that I h ave not, withi n
th e thirty days previ ous
heret o, receiv ed any arden t spirit s of any
kind whats oever , from any p erson or from
any plac e whats oever , in
exces s of the quan tity allowed by the provi
sions of the Act of the Gene r al Asse mbly
of Virgi nia, appro ved
Marc h 10, 1916 1 or contr ary to law, and
that the arden t spirit s so r eceiv ed by me
are for my own use, at
my own home , and that the said arden t
spirit s will not be used in violat ion of law.
Swor n to and subsc rib ed befor e me,
th i _~_ _day ot..
/(
-
--,
1911
f
~
Aeent fo r S o uthern Ex vress Compa uy.
Cousia nee.
�FOAM 3T0•V A
SOUT HERN EXPRE SS COMP ANY
( lucor
porated)
Affidavit No,~ - - -- -
Advnu ce 11 to
Co ll ec t
RECOR D Of" NOTICE S
To Consion ee ___ ___ ___ ___ ___ __ _
To Sh ipper ___ ___ ___ ___ ___ ___
Af"f"IDA VIT f"OR ARDEN T SPIRIT S f"OR PERSO
NAL USE .
( OVER)
�AF FID AV IT FO R
AR DE NT SP IR ITS
FO R
STA TE OF V1 J!i? ,
u ,
CO UN TYO F
/
'
PE RS ON AL US E
t
YI ~ ~ ~ -
~, ?JtMULL
•
~
~I
the con sig nee of a cer
, bei ng dul y sw orn , dep ose
tain shi pm ent of ard ent
and say tha t I am
spi rits , as s
ified on oth~
d eliv ere d to me by ~he
thi
s for m,
s day
Sou the rn Ex pre ss Co mp
any , fro m
stu den t or min or, and
_
, if a fem al e, I am the
,
t!~
~
I
a
hea
',1't a
d of a fam ily ;
we re bro ugh t int o the
t the ard ent spi rits so
Sta te on my wr itte n ord
rec eiv ed by m e
er, and that I hav e
her eto , rec eiv ed any ard
not , wit hin the thi rty
ent spi rits of any kin d
day s pre vio us
wh ats oev er, fro m any
exc ess of the qua nti ty
per son or fro m any pla
allo we d by the pro vis ion
ce wh ats oev el', in
s of the Ac t of the Ge ner
Ma rch 10, 1916, or con
al Ass em bly of Vir gin
tra ry to law, and tha
ia, app rov ed
t the ard ent spirit.a so
my ow n hom e, and tha
rec eiv ed by m e are for
t the sai d ard ent spi rits
my ow n use , at
wil l not be use d in vio
lation of Jaw.
.
Sw orn to and sub scr ibe
d bef ore me ,
th; s~
d'7 o<
1:Jt./ ,1911 .~ /
/
h
A2ent; for So utjl ern
Exp ress Com vau y.
. )J:,J
I
Con sian ee.
�.------ -~ -- -- -- -- -~- ~ -- -- -- --~--
-- -- -- -- ---------- -
.&
/4 ~
;?,. ~ _ _ _ __<~•.:~;;;~CORD
FORM 3TO• VA
SO UTH ER N EXP RES
S CO MP AN Y
SPE CIA L
Received at
Consignee
Kind of Ard e/1 pirit:
Way- /G, o.
To ( ,..
..l
/L
t
""" .I_
r .,7
Shii}i!h
~
2, yJ l
1
r ~
';if
Date
),....._
Amount /
?)t 7
. ...
~
Adva nn! s t o
Coll ect
1,-•"-; ......_
.
q' f
Affidavit No/
-- - -- - - - - -- - - - -- - ..... ,.--
JfoT;.9 ; • j ;,,_ _ u ~,_, , .______
°(, I/
17
LJ_l
'I' / ~
Date
,
,,--...
~ ~-==
= ---- - -- -
i
~J_/' . •~ ·;· ;
7
Weioh t,---,,£,____
Fro~ _ f:l_
'7.----1f.'Y'---,, .,-.;.,_
· _
-
_;____:____;
E XPR E SS CHA RGE S
PR E PAID
COL LECT
Ad d
Unde r ch a rge
REC ORD OF NOT ICE
S
To Consionee _ _ _ _ _ _ __
__ _ _ _ _ __ __
To Shipper_ _ _ _ __ __
__ __ _ _ _ _
AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PER SON
AL USE .
( OV ER )
__
�AFFI DAVI T FOR ARD ENT SPIR
ITS FOR
PERS ONA L USE
STATE OF VIRGI NIA,
COUN TY OF _ _ _ __ _ _ _ __
_
L, - - - - --
-- -- - - - -- - - -- --- , being duly sworn , depos
e and say that I am
the consig nee of a certai n shipm ent of arden
t spirits , as specif ied on other side of this
form, this day
delive red to me by the South ern Expre ss Comp
any, from ___ ___ ___ ______ ;
that I am not a
stude nt or minor , and, if a femal e, I am the
head of a family ; that the arden t spirit s so
receiv ed by m e
were broug ht into foe State on my writte n
order, and that I have not, within the thirty
days previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
whats oever , in
exces s of the quant ity allow ed by the provis
ions of the Act of the Gener al Assem bly of Virgi
nia, appro ved
March 10, 1916, or contra ry to law, and that
the arden t spirii s so receiv ed by me are for
my own use, at
my own home , and that the said arden t spirit
s will not be used in violat ion of law .
Sworn to and subsc ribed before me,
this ___day oL- - -- , 191 _
A&'ent for Southe rn Exvres s Compa ny.
Cons i~nee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(I nco rporated)
Alfid_avit No, --=)'--(
:__-='-/
Advnnres to
Co11ect
- ,;
RECORD OF NOTICES
To Consian ee _ _ _ _ _ _ _______ _____
To Shipper _ _ _ _ _ ___ __ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
'
'
(OVER)
�AFF IDAV IT FOR ARD ENT
SPIR ITS FOR
fl
PER SON AL USE
STAT E OF y 1
COUN TY OF _ __ ~ ,_,_' ------'--
i,
§
,
being duly swor n, depo se and say that
the consi gnee of a certa in shipm ent
I am
of arden t spiri ts , as speci fied on other
side of this form , this day
deliv ered to me by foe Sout hern Expr
ess Com pany , from / / / , /
,
; ,ihat I am not a
stude nt or mino r, and, if a fema le, I
am the head of a famil y; that the arden
t spiri ts so recei ved by me
were brou ght into the State on my writt
en order , and that I have not, withi
n the thirty days previ ous
heret o, recei ved any arden t spiri ts of any
kind what soeve r, from any perso n or from
a ny place what soeve r, in
exces s of the quan tity allow ed by the
provi sions of the Act of the Gene ral Asse
mbly of Virgi nia, appro ved
Marc h 10, 1916, or contr ary to law,
and that the arden t spiril.s so recei ved
by me are for my own use, at
my own hom e; and that the said arden
t spiri ts will not be us in viola tion of
la~
Swor n o and subsc ribed befor e me ,
this ___day oL. ,/
, 191 _
A&ent for S outher n Exvre ss Comva
uy.
) :/LA-..
/Z--l
Consiauee.
�SOUTHER N EXPRESS COMPANY
FOAM 370•VA
( Incorpo ra t ed)
Affidavit No
'3 7
2
Advna r ee to
Colle ct
Shipper _ _ _ __ _ _ _ _ _ _ _ _ _ _ __
PREPAID
RECORD OF NOTICES
To Consion ee _ _ _____ _____ _____
To Shipper _ _____ _____ ____ _ _
AFFIDAVIT F;OR ARDENT SPIRITS FOR PERSONAL USE .
(OV E R)
�... , A_....,_.._..._........_~- =~"-the co
. nee of a cerlain shipmen t of ard
I
~
' being duly sworn, d epose and say that I am
spirits, as. ~PJ<lified on other side of this form, this day
-~?t,. . .
~
_.
delivere d to me by the Souther n Express Compan y, from
)-I ; that I am not a
student or minor, and, if a female , I am the head of a
~hat the ard ent spirits so received by m e
were brought into the State on my written order, and that I
h ave not, within t he thirty days previous
hereto, r eceived any a rdent spirits of any kind whatsoe ver , from
any p er son or from a ny place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assem bly of Virginia , approve d
March 10, 1916, or contrary to law, and that the a rdent spiri\s
so rec eived by me are fo r my own use, at
my own hom e , and that the said a rdent spirits will not be used
in violation of law.
"
family,
Sworn t '.!.!nd subsc1b ed Jefore me,
th is j.:[_da y
oJ ,,,,l,//'-"--~- ,
1917
r ~ ~,4.G
/
A"ent fo r Southern Exprei:;s Compan y.
Consh:uee.
�Advan ree to
Collect
PREPAI D
RECO RD OF NOTIC ES
To Consign ee _ ___ ___ ___ ___
___
_
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ _
_ __
AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERSO NAL USE .
(OVI<R}
�AFFIDAVI T FOR ARDENT SPIRITS FOR
PERSONA L USE
i,
---"----"'- '----'"'-+--=~ ~ ~ - -~ - -- - - - -, being duly sworn, depose and say that
I am
the consignee of a cerlain shipment of ardent spirits , as specified on other side of this form,
this day
/ ~
delivered to me by the Southern Express Company, from
,
; that I am not a
student or minor, and, if a femal e, I am the head of a family; that the ard.fnt spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Vi rginia,
approved
March 10, 1916, or contrary to law, and that the ardent spiras so r eceived by me a re for my
own use, at
my own hom e , and that the said ardent spirits will not e used in violation of law.
Sworn to and subscribed before me,
this
day
0 1.-,,- ...:=--
t
,.
-,
191 T
Aeeut for Southern Exvress Compauy.
Consii:nee.
�FORM
SOUTHERN EXPRESS COMPANY
3T0•VA
(Incorporated)
Way- Bill No,,,_ _,_..,---"--.,.----'----"-- -
To
- - -- -~ .,_=---.,c_L__ _ _ _ _ __ _ __
Advanc e s to
Collect
EXPRESS CHARGES
PREPAID
COL1'ECT
Add
Unde r cha rge
RECORD OF NOTICES
To Consignee _ _ _ _ _ _ _______ __ _ __
To Ship per_ _ __ ______ _ __ __ _ __
AFFI DAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�;
AFFI DAV IT FOR ARD ENT SPIR
ITS FOR PER SON AL USE
STAT E OF
COUNTr
t. __ /4-
£ ~ ;J,~
Vrn
Nt ,
, being duly sworn , depos e and say that
I am
the consi gnee of a certa in shipme t of
arden t spirit s, as spec· ed on other side of
this form, this day
f
deliv ered to me by the South ern xpres s
Comp any, from
I
; that I am not a
·s tuden t or mino r, and, if a femal e, I am
1
the head of a famil y;
he arden t spirit s so receiv ed by me
were broug ht into the State on my writt
en order , and that I have not, withi n
the thirty days previ ous
heret o, recei ved any arden t spirit s of any
kind whats oever , from any perso n or from
any place whats oever , in
exces s of the quan tity allow ed by the provi
sions of the Act of the Gene ral Assem bly
of Virgi nia , appro ved
Marc h 10, 1916, or contr ary to law, and
that the arden t spirit s so receiv ed by me
are for my own use, at
my own home , and that the said arden t
spirit s will not be used in viola tion of law.
- ct,~ Z-o-.t. ~~
-
"">--<" ~
Swor n to and subsc ribed befor e me,
this _ _day
oL-7~ ,
/
(
'
1911 .
--: -.1/. '"
Ai:ent for Sout~ fuJ:,{ press Compa ny.
�FORM 370•VA
SOUT HERN EXPR ESS COMP ANY
(Incorpo
rated)
RECOR D OF" NOTIC ES
,I
To Consign ee _ __ _ _ _ _---'- - - - - - - --
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ _ _ _
AF"F"ID AVIT F"OR ARDEN T SPIRIT S F"OR
PERSO NAL USE .
·,
- ~
, _,...'
..t
...
.
'I. IIU .
.
I
-~
''· '
(o v1rn )
�,
AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PER SON AL
USE
STAT E OF VIRG INI A
COUN TY OF_..:::.._
' _ _ _ ::_1,..~ !_'_c_ .!':::-- 1<"=-t
i, -- -- -- -- ------- - --- - -- ,
bein g duly swor n, depo se and say
the cons igne e of a certa in ship men
that I am
t of arde nt spiri ts, as specified
on othe r sid of this form , this
1
day
I '
deliv ered to me by the Sout hern Expr
i I
ess Com pany , from
/ J /l
,/
stud ent or mino r, and, if a fema
;
that
I
a_
m
not
a
le , I am the head of a fami ly; that
the ar~e nt spiri ts so rece ived by
were brou ght into the State on my
me
writ ten orde r, and that I have
not, with in the thirt y days prev
here to, rece ived any arde nt spiri ts
ious
of any kind wha tsoev er, from any
person or from any plac e what soev
exce ss of the quan tity allow ed by
er, in
the prov ision s of the Act of the Gen
eral Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to law,
and that the arde nt spiri~s so rec
eive d by me a re for my own use,
my own hom e , and that the said
at
arde nt spiri ts will not be used in
viol ation of Jaw.
Swo rn to and subs c ibed befo re m
e,
this_ l__day o~
- -~ -,
191_!}__
I
Aa-ent fo r S outhe rn Exvr ess Comv
au y.
Cons i~nee .
�SOUTHER N EXPRESS COMPANY
(Incorporated )
Add
Undercharge
RECORD OF NOTICES
To Consignee___ _ _ __ _____ _____
To Sh ipper _ __ _ __ _ _ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
{ o vn)
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR
PER SON AL USE
~, - - - - ~ - -- - -- ~-- - -- - -- - , bein g duly
the cons igne e of a cert ain ship
swo rn, depo se and say that I am
men t of arde nt spiri ts, as spec
ified on othe r side of this form
, this day
deliv ered to me by the Sou ther n
Exp ress Com pany , f r o m ~
~ - - - - - - - - - - - ; that I
stud ent or mino r, and, if a fema
am not a
le, I am the head of a fami ly; that
the arde nt spir its so rece ived by
were brou ght into the Stat e on
me
my writ ten orde r, and that I have
not, with in the thirt y days prev
here to, rece ived any arde nt spir
ious
its of any kind wha tsoe ver, from
any
pers
on or from any place wha tsoe ver,
exce ss of the quan tity allow ed
in
by the prov ision s of the Act of
the Gen eral Asse mbly of Virg inia,
Mar ch 10, 1916, or cont rary to
appr oved
law, and that the arde nt spir i\s
so
rece
ived by me are for my own use,
my own hom e, and that the said
at
arde nt spir its will not be used in
viol ation of law.
Swo rn to and subs crib ed befo re
me,
this __ _day oL.
Aa-ent for S outhe rn Exvr ass Com
vva ny.
�F'ORM 3TO•VA
,
"""'
- ~- ..._- lbs.
) ~.
E,
Adve.n r ea t o
Col lect
v ··-
I,
'• ,,
I
,,,,,_.
Arld
Unde r ch a rge
I
RECORD OF NOTICES
To Consian ee _ _________ _ _ _ __ __ _
To Shipper _ _______ __ _ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
I
!
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRGINIA, .
COUNTY O F - - - -- -- - -- ~
~, - - - - -- - - - - - - - - ' -- - -- - -- -, being duly sworn, depose and say 1ihat I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from _ _ _ __ _______ __ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by ~ e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any k ind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
t1
Sworn to and subscribed before me,
this ___day oL.. - - - - , 191_
l
7' }
Cousiane8.
�FORM
370•V A
Affidavit No.
Advnur-e a to
Collec ti,
;J f :J
Add
Unde rcharge
RECORD Of" NOT ICES
To Consign ee _ __ _ __ _ __________
To Shipp er_ _ _ _ ______ __ _ _ _ __
AF"f"IDAVIT f"OR ARDENT SPIRITS f"OR P E RSONAL USE .
( O VER)
�AFFIDAV IT FOR ARDENT SPIRITS FOR
I.
STATE OF V!~RGI/.i
'IJ,,
COUNTY O F -.,._._(IV{...,,
~~
~ ~ ~~~ - ~ ~ ~ -
i,
,
/vi/
PERSON AL USE
/
II
7:'J,W .,(,/ I
'
, being duly sworn, depose and say that I am
the consignee of a cert i,n shipment of ardent spirits, at,.specifie d on other sirui..
of this form, this day
delivered to me by the outhern Express Company, from
~ ; that I-am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by-me
were brought into the State on my written order, and that I li{ ve not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so rec eived by me
are for my own use, at
my own home, end th•I lh• " " a,denl epi,it, ~ =•d in vloJ,lion,er l•w
_;.
.
~ti&#u&!Mu.
this
Aa:en, for Southern Express Compaus.
Consicnee.
�___________ _____
_ .......,...__..
..,
,
__,
/
f• ·'
/t
.
I
Affidavit No,,__:1_' _ _
• __
Advam e11 to
Collec t
Aad
Under charg e
REC ORD OF' NOT ICES
To Consianee_ _ _ _ __ _
__ __ ___ _ _
To Shipper _ _ _ _ _ _ _ _
_ _ __
AF'F 'IDAV IT F'OR ARD ENT
SPIR ITS F'OR PER SON AL
USE .
(OVK R)
_ __
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PER SON AL
USE
STAT E OF VIRG INI-A ,
COUN TY OF _ _ __ _ __
____ ,
... , - - - - - - -,--- -- - - - - - - - - - - , bein g duly swor
n, depo se and say that I am
the cons ignee of a certa in shipm ent
of arde nt spiri ts , as speci fied on othe
r side of this form , this day
deliv ered to me by the Sout hern Expr
ess Com pany , from _ _ _ _ _ _ _
_ _ __ _ _ ; that I am not a
stud ent or mino r, and, if a fema le,
I am the head of a fami ly; that the
arde nt spiri ts so recei ved by me
were brou ght into \he State on my
writt en orde r, and that I have not,
with in the thirt y days prev ious
here to, recei ved any arde nt spiri ts of
any kind what soev er, from any perso
n or from any place what soev er , in
exce ss of the quan tity allow ed by the
prov ision s of the Act of the Gene ral
Asse mbly of Virg inia, appr oved
Marc h 10, 1916, or cont rary to Jaw
, and that the arde nt spiri \s so recei
ved by me are for my own use, at
my own home , and that the said arde
nt spiri ts will not be used iu viola tion
of law.
- I
Swo rn to and subs cribe d befo re me,
this __ _day ot..
\
191,- -
A2"ent for Sonth ern Expre ss Comp
auy.
✓
Consi auee.
�RECORD OF' NOTICE S
To Consign ee _ ____ _____ _ _ _ _ _ _ __
To Shipper _ ____ ____ ____ _ _ _ __
AF'F'IDA VIT F'OR ARDENT SPIRITS F'OR PERSON
AL USE .
(OVER)
�AF FID AV IT FO R
AR DE NT SP IRI TS
FO R
STA TE OF VIR GIN
IA,
CO UNT Y OF _ __
I
_ _~6 ~_ _1
PE RS ON AL US E
.~ -~
., - - - - - -- - -- - -- - - - - the con sig nee of a cer
- - ~ , bei ng dul y swo
tain shi pm ent of ard ent
rn, dep ose and say tha
spi rits , as spe cifi ed on
t I am
oth er sid e of thi s for m,
del ive red to me by the
thi s day
Sou the rn Ex pre ss Co mp
any , fro m __ __ __
stu den t or min or, and
__ ____ __ ; tha
, if a fem ale , I am the
t I am not a
hea d of a fam ily; tha t
we re bro ugh t int o the
the ard ent spi rits so r ece
Sta te on my wri tten ord
ive d by me
er,
and
her eto , rec eiv ed any ard
that I hav e not , wit hin
ent spi rits of any kin d wh
the thi rty day s pre vio
ats oev er, fro m any per son
us
exc ess of the qua nti ty
or fro m any pla ce wh ats
allo wed by the pro vis ion
oev er, in
s of the Ac t of the Gene1·a
Ma rch 10, 1916, or con
l
Ass em bly of Vir gin ia,
trar y to law , and tha t
app rov ed
the ard ent spi rits so rec
my ow n hom e , and tha
eiv ed by me are for my
t the sai d ard ent spi rits
ow n use , at
wil l not be_use d in vio
lati on of law .
Sw orn to and sub scr ibe
d bef ore me,
thi s __ _day oL..
- - -- , 191 _
A2e nt for Sou ther n Exv
ress Com pau y.
Uon sian ee.
�SOUTHERN EXPRESS COMPANY
FORM 3TO•VA
(l u co rpo rated)
Affidavit No~•- --------'-- :
- lJ
..J-_
·~ - -'--=--'---'...c._== ~ --- -- - -- - AmountL_,...
/_-'-,.r.~,,. ,;_~f..__-_
Way-Bill No. cc,.,,...._,_~
.,
I
To
I
Shipper :
, _, ,_=-_:.__c_--
~ ~ - -- -~
3.______
Advnn re a t o
Coll ect
-*
_ ..,__
,,,_,
7,
191.Z Fro m_ __ _ __ _,___---'---EXPRES S CHARGES
PR E PAID
.,,
Arl d
Unde r charge
RECORD OF NOTICES
To Consignee ________ ________ _ _
To Shipper_ _ _ _ ____ ___ __ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
{OV ER)
�STA TE OF VIR
AF FID AV IT FO R AR
DE NT SP IRI TS FO
R PE RS ON AL US
E
COU NTY OF -~ -- - -~ - -
~
~, - - ' - - - - -~ -=- - ·--- '-- - ' - - -=--=--- -, bei ng dul y swo rn, dep
ship men t of arden1i spi rits
ose and say 1ihat I am
, as specifi ed on oth er side
of this · form , 1ihis day
del ive red to me by 1.he Sou
the rn Exp ress Com pan y,
fro m-- - - - - - s1iudent or min or, and ,
- ---=-"'--- i 1iha1i 14ffii
if a fem al e, I am the hea
o1i a
d of a fam ily; tha 1i the ard
wer e bro ugh t into ihe Sta
ent spi rits so rec eiv ed by
te on my wri tten ord er, and
me
1iha1i I hav e . no1i, wit hin
her eto , r ece ive d any ard ent
th e thir ty day s pre vio ua
spi rits of any kin d wha1isoe
ver , from any per son or from
exc ess of the qua ntit y allo
any pla ce wh atso eve r, in
wed by the pro visi ons of
the Act of the Gen era l Ass
Ma rch 10, 1916, or con trar
emb ly of Vir gin ia, app rov
y to law, and tha t the ard
ed
ent spiri1.s so r ece ived by
my own hom e, and tha t
me are ·fo r my own use ,
the said ard ent spi rits wil
at
l not be use d in vio l ati on
of law .
Con si1:u ee.
�{(13
',
Ad van r-e a to
Collect
Add
Underc harge
RECORD Of" NOTICES
To Consignee _ _ _ _ __ ____ ____ ___
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Af"f"IDAV IT f"OR ARDENT SPIRITS f"OR PERSON AL USE
.
( OVltR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
STATE OF VIRGINIA,
PERSONAL USE
//
COUNTY O F - - - ---'-'- "
l(/4:.__::___
,
_::;_
~, - - - - - -- ~-'-- --,L----- - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipi:ient of ardent spirits, as specified on other side of this form, this day
delivered tome by the Southern Express Company, from ______ _______ _•; that I am not a
student or minor, and, if a female, I am the head of a family; tha1; the ardent spirits so received by m e
were brought into the State on my written order, and tha1; I have not, within the thirty days previous
hereto, received any ardent spirit s of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law , and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
/'
Sworn to and subscril'>ed before me,
l
,
J
th i ___day oL..c - - -- , 19L .....!
I
A21')nt for Southern Express Comvauy.
/ f
Consii:nee.
�TO BE FILED.
WITH CLERK
OF COURT
antity)
::::e".at~
ini a~ =rp >te d
un~ er the law s o~ the Sta te o . irg
=c=.=froOM~~~•lil·l!!!~!!'JHll!ll!lol!l~t,!~!....-~~~of
Act
er
whi ch I now des tre to take delia very
und
d
nse
lice
iy
nu fa~ d;i
men t
R ailw ay Com pan y; tha t I am ma
ship
said
of
s
tent
con
the
t
tha
6;
Virg inia , app rov ed M arch 10, .191in a
da ce · said ct.
are to be s old, disp ens ed o
��J. T. WA LL AC E
DR UG GIS T
DRU GS A N D DRU GGI S T SUPP LIES , PAIN T
S , VAR NIS H ES A ND OILS
CUT GLASS , STATI ONER Y, SCHO OL SUPPL IES,
GARD EN SE E DS
ELKTON, VA.,
3/1/1 7
Mr . '8' .F . Blac kbur n
Cl erk of Coun ty Cour t ,
Harr i s or_bu rg , f' ockin gha m Co., 1.Ta .
~,i r: _r.:.'he f ol _ow i r.t.:, is a s t a t e rr,en t o f r;.y a lc c :·,01
a c_co un t r o .. e,ll ,~
1. 0 1, l,lt of Feb . 191 7 •
Amou nt of a l coho l on ha nd Feb . lst , 1917
3ga l , O p t , 1 2oz .
Amou nt of alco hol bo ught in mon h Fob . 19 ....,I
1t:.a 1 ' El pt , ,Q_ oz .
Amo unt of alcoh ol used duri ng f eb . 19 17
4£.,al , 6 p t, 10 o z .
Amou n t of alco hol on hand Mch . ls t , 1917
3e;a l, 0 pt , 2o z .
Yo urs very truly ,
1) / / J/
v' .
'
//
·
..
..
a-u :,,c'Z:--~
.. ... .
.
~
..
·..
~
#
•• • •
�•
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 04
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Elkton in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
elkton
virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
1918
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box10-040
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Elkton, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/80843db71ebf97a215b212f800d0efdb.pdf
796d75819810a57f153d67470654b071
PDF Text
Text
FORM 370 - VA.
R evised June, 1017
COMP ANY
SOUT HERN EXPR ESS
)
(In co r porate
P'ECIA L
./ I
~Q/'nt,ty
I
191_ .
Advan ces to
Co ll ect
v
I,,.
Weigh ~
/2
To Shipper
/
"'(OVER)
From
EXP RESS CHARGES
CO L LECT
PREPAID
l
P. 0. Add ress ~ - - - - - I
Affidavit No . _ _ __ __
]
Shi pper ~ - ~,---- - ---.,_ _-----; ;..-+-- ~-
To Consig nee
191_
P. 0. Address
/
Date
RECORD OF NOTIC,E S
I
)
_ - - 4 -_ _ _ _ _
(
I,
Add
Undercha rge
�--->.,,;£...-~-
-""<--+--=" - - - - ' - c - - - - - - - - - - - -, being duly sworn,
depose and say that I am
a certain shipment of ardent spirits , as specified on oth er side of this form,
this day
delivered to me by the Southern Express Company, from ____ _ _________
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the !IUantity allowed by the provisions of the Act or' the General Assembly
of Virginia, approved
March 10, 1916, or c.)ntrary t~ law, and that the ardent spirits so received by
me are to be used by me
✓ 1/ (
L
Sworn to and subscribed before me,
e ~,c
,
·~~
�FORM 370-VA .
Revi sed June, 1917
SOUTHERN EXPRESS COMPANY
(Inco rporate d :
Advonces to
Coll ect
I
Shippers""?\
,----,·, --~~:.....-==----=:__:,~--:='-------=:~ = P. 0. Address - ~ - ~ - ~ -- ~ ~ ~ - To Consignee
To Shipper
(OVER)
PREPAID
�STATE OF
t
7v1::.t
\
r
I$-;,-,,,µ ' ~ V-,~-«:....t{_,,(,.A..,-t_..
; ' - , , ' VT-✓V y
couNTY OF,
CJ!!
,,:f ~/L-- tl·r
.f'
.J .
l-V , being duly sworn, depose and say that I am
,
1
the consi ~ ,e'e of a certain shipment of ardent spirits, as specified on olher side of this form, this day
delivered to me by the Southern Express Company, from
that I am not a
1~
student or minor, and, if a female, I am the bead of a family; that
ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or co~ 1,ary to lawl and that the ardent spirits so received by me are to be used by me
I\Y~\\"~ 'a,
ti:
/•// l( p ·--- <
for
·
(StatEe
w
p>":; S,•;•;;
S,e,om••"'•
-; ( .
>
i ,r__f
- purposes.
Me<He;,., oe M••>sc
;e,Df t
/ L/.,£_-1.((,.....,~_ f!t~~~
f-~(..,. . ~4=.-____
{J
Sworn to and subscribed before me,
,,,,,.;,-
Consignee.
/
Ii
' 'd :7~"(c·
;
t
t \.
Aa:ent for South e'1·n Express Company.
�F"ORM 370-VA.
Revised June, 1917
SOUTHERN EXPRESS COMPANY
(I nco rporated)
SPECIAL LIQUOR RECORD
•
Received at _ _ _ _~ - ~ ~ - - - - - - ate _ _ _ _ __ _
Consig nce _ _--'---'---'----___:::__ __
_:____c__ _ _ _
191 _
p. O. Address
Aff idavit No. _ _ __ __
-
Urottocs l Va.
I
Kind of Arde nt' Spirits _ _ _ _ _ _ _ _ _ _ _ _ _ _Quantity _ _ __ _ _ _ ___ We ight __'/ --_lbs.
Way-Bill No·- - - - - - '' - - - Advan ces to
Collect
EXPRESS CHARGES
. PREPAID
Shipper - - -- - - - ' ~ - ~ - - - - - - - ' - -
I
P. 0. Address - - - - - - - ~ - ~ - - ~ ~ ~
To Consignee
To Sh ipper
(OVER)
I
COL L ECT
'\)
Add
Undercharge
.
I
�STATE OF
t_-/
I, --'---'- '--__,'---- ------'==--=----='------ - -- - , being duly sworn, depose
and say that I am
the consignee of a certain shipment of ardent spirits , as specified on olher side
of this form, this day
Gl'llttnCB, Va.
delivered to me by the Southern Express Company, from
that I am not a
student or minor, and, if a fem ale, I am the head of a fam ily ; th at the ardent
spirits so received by me
were brought into the State on my written order, and th at I have not , within
t he thirty days previous
hereto , received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of th e quantity allowed by th\l provisions of the Act of the General Assembly
of Virginia, approved
March 10, 191 ,
to w, and th at th~ ardent
"rits so r eceived by me are to be used by me
for
t/
'/; tA
;
es
A
'-"'
(State whet her for Scientific, Sacramental , Medicinal or Mechanical)
purposes.
Cons igneo:t.
this ___ day of _
- - -
, 191-
.
Agent for Southern Express Company.
�Kind of Ard ent Spirits _ _.,,._=----- ---+----'-- -=----'-- Ouantity, _ _ _ _ _ _ _~ _
· Wei ght+ ...J bs, ,{
- - - ~- - - - - - 191_.
Adv ances to
· C'o llect
From,_ , _ _____ _ __ _ ~
KXPRESS CH AI\GES
PREPAID
Add
COL L ECT
I
(
U nde rch arge
P. 0. Address ------''---'---------=:__--=-__:_------''------''------== -- ' ,___ _.__ ____._ _.......__ _.__ _,._,,;.........:....._
......._ __,
RECORD OF' NOTICES( " /
To Consign ee
/ -
I
To Ship pe r
(OVER)
�.,.
,,.,,, '
' L_
~
t(;...J.,r
A..A..- L-
_..-l
.
- - - -, ~---~:,.)u5lti},7{_A
1 ..,
";-tleing duly sworn, depose and say that I am
·
/
on olh, side of this form, this day
specified
as
spirits,
ardent
of
shipment
certain
a
of
th e consignee
(\_"f-1\\\i~• \ '
delivered to me by the Southern Express Company, from _ _ __ \1-1}~\l________ _ ; that I am not a
student or minor, and, if a female, I am the head of a family ; th at the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any pl ace whatsoever, in
th e pruvisions of the Act of the General Assembly of Virginia, approved
excess of the quantity allowe:iib
March 10, 1916, i~Jftrary to law, and that th e ardent spirits so received by me are to be used by me
/{.__f__
CA/:
,
J
,
for
·
~
.
purposes.
(State whe ther for Scien tific, Sacramental, Medicinal or Mechanical)
<-
({
AKent for Southern Etx'vress Company.
f
Consigneo.
�F'ORM 370-VA.
SOUTHERN EXPRESS COMPANY
Revised June, 1917
"
..
(In co rporate d)
PECIAL LIQUOR- RECORD
,
Kind of Ardent Spirits_ --"'=-- - - - - - - -- --='-'---
~
I
)
Ou antity,_ _ _ _ _ _ ___:'-----
Way•Bill No._ __ _ __ __
Advances to
Collect
Shipper - - - - - - -- - ~ ' - - - - - - - - - - - ''-----.C....
P. 0. Address - - - - -- - - ·- - - - - - To Con signee
To Shipper
(OVE R )
EXPRESS CHARGES
PREPAID
COLLECT
Add
Undercharge
�//
STATE OF Vf RGI,:tj'IA,
// ~'
~~-
. _/4
COUNT Y itJF~ ~~·- - - , - - - - - - - , - - -
.
. fJ,,
&
'/J··'
.,
I
4 ,.·
I,
· / , being duly sworn, depose and say that I am
the consig nee of a certain shipm ent of ardent spirits
, as specifi ed on other side of this form, this day
' I
deliver ed to me by the Southe rn Expres s Compa ny,
from ___ ______ ___ __ ; that I am not
a
studen t or minor, and, if a femal e , I am the head
of a family ; th at the ard ent spirits so receive d by
me
were brough t into th e State on my written order, and
th at I have not, within th e thirty days previo us
her eto, receive d any ard ent spirits of any kind whatso
ever, from any person or from any place wh atsoeve r,
in
excess of th e qu antity allowe d by the prQvi sions of
th e Act of the Gen eral Assem bly of Virgin ia, approv
ed
March 10, 1916, or_cont r.ary to aw, and/th at th e ardent
spi 'ts so r eceived by me are to be used by me
~ /,
I
for
..,
& ,./¢ ✓f-/
,fl"
f-
-¥
"
J'
.
._ ·1,f.A.
I
purpos es .
(S t ate wh ether fo r Scientifi c, S~cr amen t a l, Medicin
al or Mechan ica l )
Sworn to and subscr ibed before me ,
this _ _ ~ ay of _
- --
r
, 191-
Con signee.
.
Agent fo r Sou thern E xpr ess Compan y.
�-- ------------ ~--~--- ----- ----------------FORM 370 - VA .
R evised Ju ne, 1917
SOUTHER N EXPRESS C - MPANY
(In corpornted )
SPECIAL LIQUO
Received at _ __,__---!f- -=--'--~-- ----- Date
RECORD
7 /)
Y
.t'
191
·. / / " '
Affidav it No.- - ~- - -
Co nsianee _ _~__,__L_-=-- --r-:,,;=..;::...~.,.....,,__ _ _(_
:ec'-=•=---•- P. 0. Addre~,...c..._~.,..c.._--"----'---"~ _ _ _ _ _
- - - - ~ - - - - - - = . ~ ~,_ QuantitY
• - -- - ---""--"---'-'---
A dvan ce s to
Coll ect
Sh ipper·..:.,_ ...L~::!~~~~ ::2.'~~~d-5 ;_:_:,.,_
We ight_---'---;.__
EXP RESS CHARGES
PRE P Al])
COL LE CT
Add
U nde r charge
.\
P. 0. Address - - - ~- -..........- - ~ ~ ~ - - - ti- - - - ' - - - - - ' - - - - ' - - - - - ' - - - - - ' - - - ' - - - - ' - - - - '
To Consignee
(OVER.)
�, being duly sworn, depose and say that I am
specified on other side of this form, this day
GT
'J
delivered to me by the Southern Express Company, from _______ ._ __ ____ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within · the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantitv allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or confrllr,y to law; and that t};le ardent spirits so received by me are to be used by me
, ,. ,11' .,·l'
f/ I
for
(....k.'- "
( t.,.1 /
· · C.
1/ ,,/
•·
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
Sworn to and subscribed before me,
/4 /
-;J
thi/ /d,a y of_
{/(._
I/
1
) 19,,1 --.
,, ., /
/ /
Agent for Southern Express Company .
.,
purposes.
.
�F'ORM 370-VA .
Revised June, 1917
SOUTHERN EXPRESS COMPANY
Grottoes, Va.
(Inco rporated)
SPECIAL LIQUOR RECORD
Consignee _ _ _ _ __ _ _ _--,-..,....,c-=----=--- -----
n
n
1
P. 0. Address_ _~.....----·-- - - -
Kind of Ard ent Spirits _ _ _ _ _ _ _ _ _ _ _---,-__ Quanti!Y•- - - - - - - " - ~ - - Way-Bill No·- - - - --=- To _ _ _ _ _-.----.----'--.-= --------
EXPRESS CHARGES
Advance s to
Coll ect
PREPAID
I
I
CO LLECT
Add
Undercharge
Shipper - ~ - ---'-~- - - -----'-C---=---=--P. 0. Address - - - - - - - -- - -- - ~ RECORD OF' NOTICES
To Consignee
To Shipper
(OVER)
I
I
�_.,__.__- '--= ---+- · - = ~ - ---
-+-- +-, being duly swor n, depo se
and say that I am
specified on oth er side of this form,
this day
. deliv ered to me by the Sout hern Expr
ess Comp any, from ----;.,;.,-... ,__- ~-·--- - - - ; th at I am not a
stude nt or mino r, and, if a fema le, I
am the head of a fami ly; th at the arden
t spirit s so recei ved by me
were broug ht into th e State on my writt
en order , and that I h ave not, withi
n th e thirty days previ ous
h er eto , recei ved any arden t spirit s of any
kind what soeve r, from any person or from
any pl ace what soeve r, in
exces s of the qu antit y allow ed by tee
provi sions of the Act of the Gene ral Asse
mbly of Virgi nia, appro ved
Marc h 10, 1!)16f -'<l/o entra ry to I w,
and that the arden t s irits so recei ved
by me are to be used by me
for
'
urpos es.
(State wh ether for Scient ific, Sacra
~
menta l, Medic inal or Mecha nical)
SEP 141917
Swor n to and subsc ribed befor e me,
this _ _ day of _ __. - -, 191 -.
Agent for South orn Expre ss Comp any.
Uon ~ignet).
�"'
-
-- ....... - - ----
FORM 370-VA .
Revised June, 1917
SOUTHER N EXPRESS COMPANY
(In corporated)
SPECIAL LIQUOR
Advances to
Co ll ect
Shipper - - --=-------='------'==-="------""--'---=- --='---'=---P. 0. Address - - - - - - - - - -- - ~ - ~ ~
RECORD OF
To Consign ee
To Shipper
(OVER}
Add
!'REPAID
COLLECT
Unde rcharge
�.f_£ ~
I, ----.,+--=- ------ - - - - - - - - - " ' - -- , ,being duly sworn, depose and say that I am
spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from _ _ __ ___ _______ ; that I am not a
student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
exce·ss of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or,J.lpntrary to law anc'I. tha. t the ardent spir1J:s so received by me are to be used by me
- .Yl-1
for
/
/'-
i?-
A - ~o
~
j
t/
, " ·~
"
-rposes.
(Sta te whether for Scientific, Sacramental, l\iedicinal or l\iechanical)
/)
Swo7· ~,nd suJlsor}1}e~~ef9ie ~... j
.
this
Co nsignett .
l
__/
[1 day of _ ,- ,,1.fkY
~ I
• 191
.
/
'
.,
J
/
"
•
I
Agent for South ern Express Company .
�F"ORM 370-VA .
Revised June. 1017
SOUT HER N EXPR ES S COMP ANY
/
Advances to
Collect
To Consign ee
To Shipper
(OVER)
PREPAID
r
COLLECT
Add
Undercharg e
�,.._
the consignee of a certain shipment
ardent spirits, as
GBO
;
delivered to me by the Southern Express Company_, from
that I am not a
student or minor, and, if a femal e , I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10,
or e ntrary tA1law, and •that the ardent spirits so received by me are to be used by me
rn,
for
1
V//
f- c..,,
r
-'
1/2 · ---t
•
,t ~
,_ '
-- i..
purposes .
(State whether fo Scientific, Sacramental, Medicinal or Mechanical)
~t r .....
, 17
! ./
/ (_(l-( /
I
1
erCons ign ee.
Sworn to and subscribed before me,
this _ _ day of_t _ _ _ , 191-.
,?-
.
/.
r
I
Agent for Southern Express Company.
�FORM 370-VA .
Revised June, 1917
SOUTHE RN EXPRESS COMPAN Y
( In corporated)
, SPECIAL LIQUOR/ RECORD
Received at, _ _ __ _ _ ___
t__: _____ _ Date
,. I
&
1l
191,--
~ - ~- - - ---___c.._ -=-~:.L-~Ouantity_ __,/_ _ _~----'-
------- -'------- -191 _ ,
To _ _ _ _ _ _ _- ' - - - - ~ ~~ ~ ~ ~ - -
.Advances to
Collect
Shipper -"--_:__..c..c=~:..::__--- ==----- -==-- P. 0. Address -
--,!"---- - - - - - '==-=c-=:.__ ,.-"-"~c..,__
RECORD OF
To Consignee
To Shipper
(OVER)
EXPRESS CHARGES
PREP.A.JD
Add
Undercharge
�',
\
.,.-.n< ,
~
STATE OF VI
COUNTY OF
r-.~
~IA,
(., •',
_- //
/I ~
-/,,
,
t.-t
'If;/·
1AA. ' ,
.A
x±lt,)7(!-<q;1 .'M
.
I,
being duly sworn, depose and say that I am
the consignee of a certain shipment o/ ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from ____________ __ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsol'lver, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916,•or contrary to law, and t at the ardent spirits so received by me are to be used by me
A'
j ,;, /
• '
-·'
for
/
" '-" ~ {= ' Y - "'1
,
purposes.
C
-. / f
(State whether fo-r Scientific, Sacramental, Medicinal or Mechanical)
t> \~ 1
Con s ignee.
Sworn to and subscribed before me,
this~
/
/
ay of _ _{_ _ , 191-.
/
"";,:/
V(_,,V / /
/
'
I
I
(
Agent for South orn ,Express Company.
�F"0RM 370-VA.
R evised June , 1917
'\toitoes, Va.
SOUTHERN EXPRESS COMPANY
( I ncorporated)
SPE C IAL LIQUOR RECORD
Received at.________ ____ _ _ _ _ Date _ _ _ _ __ _ 191 _
Consianee,_ _-'-----'---'--"--" - = - - - ' - - - = - - ' - - - - - ' - - - - - - _ _ __
Way-Bill No·- - - - ~ - ~ -To _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Shipper _ _ _ _ _ _ __ _ _ _ _ _ _ __
,
I
RECORD OF" NOTICES
To Consig nee
To Shipper
(OVER)
tll
__,_____ ~ ~ - _!JP
P. 0. Address _ _ _Dl
Advances to
Collect
P. 0. Address - - - -----·--'--'-- ----'----
Affidav it No. _ __ _ _ _
EXPRESS CliARGES
PREPAID
I
CO LL ECT
I
Ad d
U ndercharge
I
�, being duly sworn, depose and say that I am
specifie d on other side of this form, this day
Ya.
deliver ed to me by the Southe rn Expres s Compa ny' from
that I am not a
student or minor, and, if a femal e , I am th e head of a family;
that the ardent spirits so 1·eceive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from any place whatso ever, in
excess of the uantity allowed · y the provisio ns of the Act
of the Gen eral Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y
and that the ardent spirits so receive d by me are to be
used by me
ill'DUOCS,
for
f r
;V
;
~
, '/
'
"-~
purpose s.
(State whether for Scientific , Sacram ent al , Medicina l or
I\Iechaui cnll'
J
,J
'J
Consi gnea.
Sworn to and subscri bed before me,
this _ _ day of _
\
,,,
____.., .,, 191- .
/
t
\
Agent for Southern Express Company .
7
�-----
-
~
- --
f"ORM 370-VA .
R evised June, 1917
-
-~----~-- --(Iucorpornted}
SPECIAL
;rottoes,
Va.
/
Rec eived at __,C
c__,~/..,..,,._ _ _ _ _ ~ - - - - Consi gnee _
ECORD
.1
,_ _..,__..;__ _ _ _ 191
Affidavit No . _ _ __
_
__,Z
~=
u----':. . .{_
.:. -=::.. .;. .=-'--=---=---=-='---------
Ad1"8llCee to
Co1lect
To Consignee
z /
SOUTHERN EXPRESS COMPANY
To Shipper
(OVER)
PREPAID
I
�- ~~--- --~--- ----~-- -- - - - - - - -, being duly
sworn, depose and say that I am
the eonsigne e of a eertain
speeified on o1her side of this form , this day
fl~
- - -- ...,-----.;,,,_,.___~_•____ _ ; th at I am not a
student or minor, and, if a female , I am the head of a family;
th at the ard ent spirits so r eeeived by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
her eto , r eeeived any ard ent spirits of any kind wh atsoever , from
any person or from any plaee whatsoe ver, in
exeess of the quantity allowed by th e provisions of the Aet of
the Gener al Assemb ly of Virginia , approve d
Mareh 10, 1916, or eontrary jo) aw, an)i,.t-hat the ardent spirits
so received by me are to be u sed by me
for
•
,'
(
c·
·
.A.' ~(
·-
(
#/
,, (
pwpose s .
(S t a te whether for Scientific, Sacramen tal, 1\1edicina l or 1\1ech
a nic:.l)
EP 29 1917
Sworn to
nl'-i? '
and subserib ed before m e,
this ___ day of __ - - - - , 191-
.LJ
.
I '\·' '
Agent fo r Sou th ern .Express Company.
I A
~ , r ; _ -~
~
nsign e• .
�-~~-~-~~----~------------ --------SOUTHERN EXPRESS COMPANY
FORM 370-VA.
Revised June, 1917
lirottoes, Va. sPEc1AL
I
( l nco rpornted)
uQuoR ;REcoRo
Received at _ _,•,-;-~'~'- ---,,---cc- - -- ~ - Consignee _ _
__
>t4I
~-- ~--~~.. .,___-_,_______
, c __
_ __
l 91 _
.,
- - - -- - - - -- - - ~ - Ouantity,_ _ _ __ _ __c__ Weioht
Advances to
EXP R ESS CRARGES
Collect
PREPA ID
I
I
I✓
RECORD OF NOTICES
To Consignee
To S~ipper
( OVER )
COL L ECT
l
·,/
lbs.
A dd
Unde rch arge
I
�_,'."---,: z
___;
.A...,,(...
________,z._:=-------c.__-<-+---=----l-;
being duly sworn, depose and say that I am
of ardent spirits, as specified on other sid r?f this form, this day
I
; that I am not a
~
delivered to me by the Southern Express Company, from
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my wl'ittf n order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by th provisions of ilie Act of the General Assembly of Virginia, approved
March 10, 1.916, - -f ntrary to la , and that the ardent spirits o received by me are to be used by me
for
vlCf...,A
/'
(State whether for Scientific, Sacramental. Medicinal or Mechanical)
EP29 1917
Sworn to and subscribed before me,
ft.gent for South ern Express Compa~y.
pu~oses .
�SOUTH ERN EXPRE SS COMP ANY
_s, V
1
(In c orporate d)
SPECI AL LIQUO R RECOR D
Received at _ _ __ __ __ c _ _ - - - ' - - - - -
____
, _
_
191 _
_
Affidavit No. _ ~ -- - -
'2
Kind of Ardent Spir'ts _ _ : _ ~ - - - - - - -- -4r--~ Quantity_ _
~-----":c::.:...~-''~__;__
r
Wei ght+
Way-Bill No.
------- ,1--~/<--_(___ l 9 l _
L
TO ----;; ----,- ----= ---=- ------ -
To Consign ee
-,1
)
EXPRESS CH ARGES
PREP.A.J D
I
I
To Shipper
I
(OVER)
lbs.
From _ _ __ _ __ __ _ _
Advances to
Colle ct
'\,._
RECORD Of" NOTICES
.
,t./
COL L ECT
I
Add
Underc harge
I
�I, ----'=---=. -'-.Jir<"'-- ----""'---------='-------=:._:==---, being duly sworn, depose and say that I am
specified on other side of this form, this day
delivered to me by the Southern Express Company, from ________ ______ ; th at I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within . th e thirty days previous
hereto, received any ardent spirits of any kind whatwever, from any person or from any place whatsoever, in
excess of th e ~u.aatµ allowed by p1,.e provisions of th e Act of the Gen eral Assembly of Virginia, approved
March 10, 1916,jf" c trary to r,,,v, and that the ardent spir' so received by me are to be used by me
~
A~ .d
/
for
/
_.,.,
It...
--~P'--<' urposes.
I
,/
_,(
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
Sworn to and subscribed before me,
this _ __ day of _
- - -, 191- .
Agent for Sou t hern Express Company.
Cons ign ee .
�f"ORM 370-VA .
SOUTH ERN EXPRES S COMPA NY
(Iucorporated )
R evised June , 1917
SPECIA L LIQUOR REC9R D
Consion ee _ _ ___,__-=:c ._-=---,._;_..,_-----=._
....:...__
_ __ _ _ __
I
P. 0, Add ress, _ _ _ _ _ _-'-"-__:_:.:__ __
Wei oht._--''---'b1
-=-- Kind of Ard en t Spiri~---'-- ----=-- -------"C ...C.-~- ~0uantity· ___/:._:._~
._ _ _ _ _.,_~ ~- -~ ' 19 1_ . From_ •- - -- - - - - --"-··''
No.
Way-Bill
TO - - --,--~ c....,-=-- - - - - - - , - - - - - -
Advance s to
Collect
Shipper - - - - - - - - - - - - - - - - - - - -
P. 0. Address - - - ' - ---"-----'--'-- '-·-'-'--=-==-"--'--=--'---"To Con sionee
To Shipper
(OVE R)
EXPRESS CHARGES
PREPAID
COLLECT
Add
Unde rcha rge
�STATE
COUNTY
I , ___,__..,__,~ ==----~..J.---+--"'----"".._=,.____,__ _,_ = '-------, being duly sworn, depose and say that I am
the consignee
specified on other side of this form, this day
delivered to me by the Southern Express Company, from
.
f~
; that I am not
a student or minor, and, if a female, I am the head of a family; ih"[ tf \~~ arde-nt spirits so r eceived by m e
were brought into the State on my written order , and that I have not, within the thirty days previous
hereto, received any ardent l!pirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allo~ ed by the provisions of the Act of the General Assembly of Virginia,
approved Marcl;i 0,11916, or co ' rary to law, and that the ardent spirits so r eceived by me are to be used
Lf_ .
by me for
")
.,/.
P
/
-
(State whether for Scientific, Sacramental, Medieinal or lechan ical)
.· - 9\'
Consienee.
Sworn £land subscribed before me,
this _ _ day of_ _ _ _ _ l9l_ ,
I
{,,.-
I..,.
purposes .
/
' ,
\
A11ent for Southern Express Company.
�F'ORM 370 - VA.
Revised June, 1017
To _ _ _ _ _ ____:::..::.c._
SOUTH ERN EXPRE SS COMP ANY
(I ncorponted)
Shippe r_ -)4--c,,..-_.,_:.____:,=-..=-----"'-.:....:::.::.....,:c:...__ _ __
P. 0. Address - "- - ~ - ~ - - ~ - - - - - -
To Consignee
Advances to
Collect
__,_ _ _ _ _ __
EXPRESS CHARGES
PREPAID
,
-
I
To Shipper
(OVEit)
I
COLLECT
1.)5
Add
Undercha r ge
I
�;
~
1 ,:" ' ,
being duly sworn, depose and say that I am
{
')\
I,
the consignee of a certai~ s~¼pment of ardent spirits, as specified on other side of this form, this day
'4\~\\~~i
; that I am not
I~ •
delivered to me by the Southern Express Company, from
a student or minor, and, if a female , I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whats·o ever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March JO, 1916, or coi\trary to law, and that the ardent spirits so received by me are to be used
-
by me for
£
.I
•j
I
\
,
I
,
I,
,
/
l
' .,,.
•
_,,,
.;,,..
.,
-t
I
I
"'
(State whether for Scientific, Sacramental, Medidn1,l or Mechanical )
purposes.
;a
Consiirnee.
Ai:ent for Sonthern Express Company .
�SOUTHERN EXPRESS COMPANY
F'ORM 370-VA.
Revised J uue, 1917
(Incorp orated)
\itOUfttS , la.
/
SPECIAL LIQUOR RECORD
,1-
Received at, _ _ __ _ __ _ __ _ _ _ _ Oate,_ _ _ _ _ _ _ 191_ . Affidavit No., _ __ __ _
17
ll _ __
OP,S , _---"
Consicnee _ _ _]- -''-'---~---'=----r-,--=-"----'----- P. 0. Address
l¾rot
Kind of Ard ent Spirits, _ _~ ~ - -- - - - -~ - - -Ouantity_ _ _ _.~_.,._ _ _ _ _ Weight
i/
lbs.
I
Way-Bill No., _ __ __ __ _ Date_ _ _:..__ _ _ _:..___ 191_
ro
lirffttoes, Va.
.Adv ances to
Collect
.
From _ ____ ::___ _ __
EXPRESS CHARGES
PREPAID
CO L LECT
Add
Unde rcharge
Shipp er - ~ - -- -- - -- - - - - - P. 0. Address _ _ _ _ _ _ _ __ __ _ __
'------'----'-----'----'------'----'----....l....--'
RECORD OF' NOTICES
To Con signee
To Shipper
(OVP:R)
,
�STATE oF
{:ouNTY
Vrn:;:; A
OJ'/
t,;((:
/
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0
/f
'
,../->__,,
e·
.I .
•,
~rl.A'.v(A,
_;,
-I_ "r___ , being duly sworn, depose and say th at I am
~1- - --v
- - --'"' ~ - - - ~/L,./
I ,- - -- - ~""-
the consignee of JR, ce rtainj i hipment of ~rd ent spip ts, as specified on other side of this form,. this day
c~;. Va,
;
th at I am not
t~ ' .
delivered to me by the Southern E xpress Company, from
A, student or minor, and, if a female, I am the bead of a family ; th at t he ard ent spirits so r eceived by me
were brought into the State on my written order , and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind wh atsoever , from any person or from any place whatsoever , in excess ot the quantity a,Jlo~ ed by tbti, provisions of the Act of the General Assembly of Virginia,
approved March ro, ,t m6,._ or contrary to law, and th R,t the1 it\-dent spirits so r eceived by me are to be used
,;I ~ /
J
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• ,.
,'/
• ,1
/
-;f{,
,;
/
•.
I
I
., - ,., , _,.,
.,.
•
"·
£
(State whet her fo r Scient ifi c, Sacr a me ntal , Medid n a l or ll1echanical )
._..,
by me for
purposes .
I
tbis ___ day of_ _ _ _ _~9l_,
A11:ent for Southern Exi)ress Company.
�F"0RM 370-VA .
Revised June, 1917
SOUTHERN EXPRESS COMPANY
(Incorporated )
/6
SPECIAL LIQUOR RECORD
Received at _ ________ - -- - -- -~ ate,________ 191_. Affidavit No ._ _ _ _ __
Consignee _ _ __ _ _ _
-'-----'-~--''-"---'C...C--------
Way-Bill No,_~ - --~---,--.
Otia ntity_ _ _ _ _ _ _ _ _ _ Weight. _ _ __ lbs.
1
Kind of Ard ent Spirits
P. 0. Address, _ _ _ _ _ __ _ __ __
/
'- ~ - - - - - - -- -
-----'---'---''--...CC..C...CC..C-=--'---
PREPA ID
~
RECORD OF"
To Consign ee
From _ _ ________ _
EXPRES S C HARGE S
TO --------=--= --=-------'------~Shi pper - --
191_ ,
To Shipper
(OVER)
COLLE CT
Add
Unde rcharge
�:::::::,vJ.!N
B Ct_ ')
,,_r It <
k11 /
I,
( ~eing duly sworn, depose and say that 1 am
the eonsignee of a eertain shipment of ardent spirits, as speeified on other side of this form, this day
1
~
~
delivered to me by the Southern Express Company, from
that I am not
a student or minor, and, if a female, I am the head of a family; that the argent spirits so reeeived by me
were brought into the State on my written order, and that I have not, withi~ the thirty days previous
hereto, reeeived any ardent spiri\ s of any kind whatsoever, from any person or from any plaee whatsoever, in exeess of the quantity allowed by the provis_ions of the Aet of the General Assembly of Virginia,
approved Ma 9 ,., 1916, ore ~trary to Jaw, and that the rdent spirits so reeeived by me are to be used
filll\lOO~, Ja,
by me for
~
'
l (
{
A
(
/.-'
,
•~
(State whether for Scientific, Sacramental, Medicinal o~
0r. i _,911
!
Sworn to and subseribe_d before me,
this _ _/_day of_ _ _ _ _/ 91_,
/
t
,)
l
Agent for Southern Ex{)ress Company.
purposes.
echanical )
;
�SOUTHERN EXPRESS COMPANY
FORM 370-VA.
(Incorporated )
Revised June , 1917
lirottocs, va.
sPEc1AL uQuoR REcoRo
Received at, - - - - - - - - ~ - = - , - - - - - -Oate. _ _ --'--_ _ _ _ 191 _.
Consignee _ '- - - - ~ ~ -~ -=----'"--=-'-=---=---=-- - - - - P. 0. Addre~s•~ "'
- - - - -- -----'-- -
,_ ~t----'= ----'-
;~.=:::::=~- - - / -:r~C-=-",/ ~ ~Quantity _ _ _
Way-Bill No.___,~.,__'--.L.._ _ _ _ Date_ _ _ _ _-'--_ _
.1 _ _ _ 191_ .
To _ _ _ _ _
~Sro~n=oc=,s,~
. . V~_
Advan ces t o
Coll ect
Shipper --...,- ~ ---=:........:::....ec=-~---~-----'"--
j
P. 0. Address _ _ _ _ _ _ _ ________
From, ___________
EXPRESS CHARGES
PREP.AID
COLLECT
I
·1
\
.Add
Underchnrge
I
To Shipper _ _ __ ______ _ _ _ _ __
To Consignee
I
(OVER )
�-~~--~-~- --- -·-------~--=~
- - - - . . . - :!:,.....--<=:,..,-,,..,,...._ __ _ _ _....,_..,.._ _ _ _.,,,,,,.,,.,_ __
I'
b ng dnly sworn, depo se and say that I am
I , - ~ -= "----"----'.....;_-- --"----"",::__--'-_,,._=--- '---"""'-'~
the consignee of a certain shipment of ard ent spirits , as specified on other side of this form, this day
0s
T
delivered to me by the Southern Express Company, f r o = - - - - - - - - - - - - - - ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spit!ts of any kind whatsoever, from any person or from any place whatsoever, in excess of the quanti y allowed by the frovisions of the Act of the General Assembly of Virginia,
O, 1 16, o contrary to law, and that the dent spirits so received by me are to be used
approved M
l
.,..
'I
/
,
'
by me for,..:....--'---=----'==- =- =--===--=-=-"=..o:...,.......,.'--'...,,~----- ,--PUrposes.
(State whether for Scien t ific, Sacramental, Medi<-inal or
6- 1917
.Sworn toOCT
and subscribed before me,
Consie-nee.
this _ _ day of_ _ _ _ _ l91_.
I
/
Agent for Southern Express Company .
�FORM 370-VA .
R evised June, 1917
SOUTHERN EXPRESS COMPANY
(I nco rpor at ed)
~1
\J!~\\\t\ I ~ i,
Received at.------,---- ~---------- .,-Consianee.____,/
____..;,.
l
7_ ~ - - ~ ~ ~ ~ ~ - ~ -- - · - -Kind of Ardent Spi_9 ts
)0 s.
9 uantity
1
Way-Bill No.
I
/? !_! ),
To --...,-----. ,,------=-· ------~Shipper -
191 .2.
A dvance s to
Coll ect
EXPRESS CHARGES
P REPAID
CO LLECT
Add
Un de r charge
+--=-..;....::=--- -=-'---~- = c...=,c_____ --Jf
P. 0. Address ~,L--L......'"--"'--'-__:" --=-'-'-"-=-
_.c.---l
' .,..___--L.._
___,J _ _
RECORD OF NOTICES
To Consignee
To Shipper
(OV IIR)
_..__--L.._ _' - -_
_,___
__,__
__,
�/)
.
STAT E OF V IRG NIA
/
COU NT Y
I , -'"'-'-'"..:._--==---' --------":::....:,c::._"""'- - -1,.,.''----'""'=-"--=--' -,r
eing aii1y sworn, depose and say that I am
the consig nee of a certain shipm ent of ard ent spirits , as specified
on other side of this form , thi s day
va
delivere d to me by the Souther n Express Compan y, from
filD}iOP.S ,
that I am not
a student or minor, and, if a femal e, I am the head of a family
; th at th e ard ent spirits so r eceived by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind wh atsoever ,
from any person or from any place whatsoever, in excess of the quantity al lowed by tile provisio ns of th
e Act of the General Assemb ly of Virginia,
approve d,..M di O, 1916, or contrary to law, and that the ardent
spirits so received by m e are to be used
by me for / /
L
-t. , ( (
-1,_ "( /1 (
(Sta te whether fo r Scie ntifi c, Sacramen tal, Medicin a l or Mechan_
ical)
OCT 121917
Sworn to and subscrib ed before me,
this
I?
Alt8nt for Southern ji]xpress Company .
;
purpose s.
Con sienee.
�FORM 370-VA.
Revised June, 1917
SOUTHER N EXPRESS COMPANY
(Iu corpomted)
I~
Kind of Ard ent Spirits_- --
-=--"---- -=-""?--'-- -
Way-Bill No·- -- - - = - - - Advances to
Coll ect
To Consignee
To Shipper
(OVER)
Add
Undercharge
�•
I<'
I
, ,bei~
worn, depose and say that I am
'
the consignee
of a certain shipment of ardent spirits , as specified on other side of this form, this day
arnt
delivered to me by the Southern Express Company, from
Ofl~ 11S
; th at I am not a
student or minor, and, if a femal e, I am the head of a family; that tlie ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
-March 10, 1916 r contrary to law, and th at the ardent spirit so received by me are to be used by me
,
\
I
,
(
for _____ _ _ __ _ _ __ ______ ______ p
oses.
(State whether for Scientific, Sacramental, Med icin al or Mechanical)
Consi cne'3 .
this _ _ day of _ -- -
, 191-,
fo.gent for Southern Express Company.
�F'0RM 370-VA .
Revised
SOUTHERN EXPRESS COMPANY
JuG,ff6TTOES.
, rECIAL
~~~pc~;
R!C?RD
Received at, ________"_ _ _ __ ___ Date
I
!
Consignee, __/ _ __,__J,.._
/
__:_:c:..._....:..._:...___:.-'---'--=--'---------
Kind of Ardent Spirits,~ __________
_ J ._
__
191 _.
P. 0. Address, _ _ _ __c______c__=..:,a:;..cc...._----'---
Way-Bill No•----<"'-"'l-== = - ""
· ~ ~ - ~ - - - ~ - - - 191
Shipper
Weigll..__---'--_ _ lbs.
EXPRESS CHARGES
Ad vance s to
Collect
PREPAID
COLLECT
I
I
-'I
\
P. 0. Address - ---'--'---___;.-_..c::____::.,-:___:____ __ __
RECORD OF'
To Consignee
_J./__,____
7.
_QUJ,1J>ity, _ _ _
1
To Shipper
(OVER)
I
Add
Undercharge
I
I
�~
dnly sworn, depose and sa y that I am
I ,- -'-c-----.;'+----- -'-_._- - -- ----'------ - -;_•_ ·;
the consignee of a certain shipment of ard ent spirits, as specified on other side of thi s form, this day
(
delivered to me by the Sonthern Express Company , from-t+.-l--l-l1-rl-¼f\--lthr-----i~N-- - - ; th at I am not
a student or minor, and, if a female, I am the head of a fami ly ; that the rd ent spirits so r eceived by m e
were brought into the State on m y written order , and that I have not, within the thirty day s previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from an y place whatsoever, in excess of the quantity allow'ed by the provisions of th e Act of the General Assembly of Virginia,
approved March 10, 1916, or contr~ry to law, and th at the ardent spirits so received by m e are to be used
/,,
,
•
by me for
~I
- 1911
Consi11nee.
Sworn to and subscribed before me,
. .
this~
//
purposes.
' " , o, Sd,ooili,, S~••mooOM "-''"'"' o, • ~
~ ~ :• ;
r
I
day of
,7
/
191_.
1
,'
I
/
I
A11ent for Southern' E::,cpr_e ss Compa\,.y .
�FORM 370-VA .
Revised Juue, 1917
SOUTH ERN EXPRE SS COMP ANY
(Incorporate d )
SPECI AL
._ ___ P. 0. Address _ _ __ __ _
/
I
,,,.
Ouan•r •- - - - - - -~ '--_ / _, -+/ ___,/______,,)'--'-- - -~
_
Ad vance s to
Coll ect
Shipper --''---~-- -==---- __:_:__ .,__...-=---- - ~ P. 0. Address To Consign ee
' -'-------' ------"---= -'----'~
=
EXPR ES S CHARGES
PREPAID
CO LLE CT
~
Add
Underch a rge
l
=---:_:_:'---"--- • '--'----' ----'---- --'---.,_ __
_,__ _.,___
_.__
___,
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(OVl<R)
�STATE OF VIR
_/
depose and say that I am
as specified on other side of this form, this day
the
uT01iOt~ , Va.
;
delivered to me b the Southern Express Company, from
that 1 am not
a student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of be quantity apoJ ed by the provisions of the Act of the General Assembly of Virginia,
approved Mar1cb' l ,l),.19161'.pr contrary to law, and that the a,! 'dent spirits so received by me are to be used
by me for
II
f.1
.
•
~
,t
•
__,,, • •· '
'
f
· ' _,,
• '.
·n
(
.
•• .-c
(State whether for Scientific, Sacramental, Medicinal or Mec1'iinical)
purposes .
OCT181911
Sworn to and subscribed before me,
this _ _
,.... day
//
~
:r , /
191_.
///,'-:
,,[,{,
(_
Aeent for Southern Express Company .
J
Consienee.
�FORM 370-VA .
Revised June, 1917
SOUTHERN EXPRESS COMPANY
(Incorporated)
Advance s t o
Coll ect
\ 1--«-.--=-'---+-.,-----='--"-----Ship per - ~
p.
o:~dd ress F-. .<)C__,j_~.:..,._-~'--=·---""=c:...z.-"-=..:__.::__
To Con sig nee
To Shipper
(ov1m)
Add
PREPAID
Unde rcharge
�\
I,
the consignee of
it
, being duly sworn, depose and say that I am
i
,
certain ; hi\iment of ardent spirits, as specifie~ n other side of this form, this day
; that I am not
'h1J4 ff,
delivered to me ~ y the Southern Express Company, from
a student or minor, and, if a female, I am the head of a family; th at the ardent spirits so received by me
were brought into the State on my written order, and thai I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever: from any person or from any -place whatsoever, in excess of the quant}ty a.lowed by the provisions of the Act of the General Assembly of Virginia,
approv~d,.M-ai:ch 10, 1916, or contrary to law , and that the ardent spirits so received by me are to be used
/
,
,,,
I
1i f ,
purposes .
~ ;,.,.....-- I _,:: .J:
I \_ •
by me foi;
1,
J
,f /
(State whether for Scientific, Sacramental, Jl1edieinal or Jl1echanical)
u~ l 19 1917
Ai:ent for Southern EXl)ress Company.
Consi2nee.
�f"oRM 370-VA .
R evised June , 1917
SOUTHE RN EXPRESS COMPAN Y
(I ncorporated)
CROTTOE
l
RECORD
Affidavit No., _ _ _-=- -
Consicnee,_ _ _ _ _ __:_=--___;--=--.c.. ..;;:-'--
_ ; _ _ - - - - - - --
P. 0. AddJess __=----==--- -- - - -~ - - -
'- -..c-'-- ------- ~~,- --Ouantity ,_ _ _,_ _ _ _ _=.,._ _ Weicht-;L: ..-1bs.
- - - -~ -- - - - - 191 _ .
Advenc es to
Coll e ct
From,_ ~ --(- - - -- - - -
EXPRESS CHARGES
PREP AID
- - - - -•- - - - -
RECORD Of" NOTICES
To Consignee
I
I )
To Shipper
(ov1m )
CO LL ECT
Add
Underch a rge
�being duly sworn, depose and say that I am
specified on other side of this form, this day
-+-7'!"!1"'---Hb~f-----,ji,,£--'1.--------i"',E-----,.,/C---j6''-f-J'-----b."'-"""'""-"••
the
e by the Southern Express Company, f r o = - - - - - - - - - - - - - - i that I am not
minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spi~ts of any kind whatsoever, from any person or from any place whatsoever, in exces_t of the quantity allowed by t4,e provisions of the Act of the General Assembly of Virginia,
approved ~ ]
i;,1916, or ntrary to law, and that the ardent spirits so received by me are to be used
r
\\\O~ 10 ,grT
by me for.t':=~~~~
~=~~~~~:2~;:'.l.;:;:;z~~f(,::::;:::==i-,PUrposes.
tate whet er or Scientific, Sa a
Consie-nee.
Sworn to and subscribed before me,
this _ _ day of_ _ _ _ _ l91_.
I
Acent for Southern Express Company.
�f"ORM 370-VA .
Revised June, 1917
SOUTHERN EXPRESS COMPANY
(Incorporate~)
SPECIAL LIQUOR ~ECORD
J
t
t ,
Received at, - ' --~---.c......,-?- - - - - -- ~•ate_ _ _---6-___,..c...._
I
Consignee._
· _'\..__ _ ~----------=:c--cc:--=--:-- - - - - - - P, 0. Address~ ___________,___
'V
EXPRESS CHARGES
Advances to
Collect
PREPA ID
I
I
CO LLECT
Add
Undercharge
Shipper -~::'..L~~'-SL~~~~~~~~~~
P. 0. Address _ _ __,,,__ _-=----==---.--=- - - - - RECORD Of"
To Consig nee
-
To Shipper
(OVT<R)
I
I
I
�STATE
COUNTY
I,-~~~_:__..!!.:...__.!:. _~~~~~JL~ ,e:".J..''.__J__ _
, being -duly sworn, depose and say that I am
as specified <>n other side of this form, this day
the
delivered to me by -the
press Company, fro=---- - - - - - - - -- i that I am not
a student or minor, and, if a female, I am the h ead of a family; that the ard ent spirits so r eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in e~ a~of the quantity a owoo by the provisions of the Act of the General Assembly of Virginia,
7 _ciy.w;Jh,J,916, or c·o rary to law, and
approved Mltfc
that the dent spirits so received by me are to be used
by me for
/
~'
(0
..._.,{_
'
~
purposes.
.
(State whether for Scientific, Sacramental, Medicinal or
. ..
Consi2nee.
i :• '
I
("
Aeent for Southern Express.Comilr
�f'ORM 370-VA .
Revised June, 1917
1l
SOUTH ERN EXPRES S COMPA NY
LI
(Incorporated )
rottllcs, Yr.
SPECIA L LIQUOR / RECOR D
)'1/ )
Received at __1~ - - -- - - ~ - -- - - - Date,_ _ _ _ _ _ _ 191 _ . Attidavit
No., _
__.a.____.c,_ _
Consiunee--'J+-----=- --==:.,_.=:c::.=.===--.,~ - - - - - - - P. 0. Address, _ _ _ _
·_~..:..
" ,..tc:.
:..: U'-"1,.... -
h_~_
~
---
•----... ------- ----__ ,__ Quantity,_~/~ _ _ _
Way-Bill No·- - -'----='- ---- •ate _ _ _ _ _ _ _ _ _ _ _ l 9 I_ . From, _____
___ _
,
/
To _ _ _ _
~ Gr=ot,~to~
es .,. . .V
. .a
. .,~- -
Advances to
Collect
Shipper - -~ - - - - - - - - - - - - - - - i ''
To Consignee
\ Shipper
\
(ov1rn)
EXPRESS CHARGES
__:._
Add
Undercharge
-
�~-.-,.-~--,------- --=-=--- ~-------- ->---,C.,-G,.,. ~,..,.~------- -- - ---
the
I,_....,__,__....,_~..£...-"""--=c._---"'=-=== ==~=-----"''• being
duly sworn, depose and say that I am
sp ecified on other side of this form , this day
delivered to me by th e Southern Express Company, fro
tOP
; that I am not
a student or minor, and, if a female , I am th e head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
he1eto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in 1 xc. ess of the quality allowed by the provisions of th e Act of the General Assembly of Virginia,
approv~J,re'h/10, 1916, ~ contrary to law, and th
he ardent spirits so received by me are to be used
by me
foi l .;
!(,..{!.,
>·
4
purposes.
·
(State whether for Scientific , Sacramental, Madkin
f '),J
19 ·
1
Consi2nee.
Sworn to and subscribed before me,
(
I
.'
\
Ai:ent for Southern Express Company.'-
�FORM 370-VA.
Revised June, 1917
SOUTHERN EXPRESS COMPANY
(Incorporated )
SPECIAL LIQUOR RECO
Received at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0ate _ __
Consignee _ _ _ _ _.;:_____:_" - -=--'-='-.::.......C.=---
-
~
D
}
_ _ _ 191_. Affidavit No., _ __ _ __
, .....H"'-'ro~tt-l-ll01t.CSll--,1P. 0. Add ress _ _;;_
- - = - --
'- - - ----=----- -Weight
- - - -- - -~ --
To - - - - ~ - ~~~,........~ - - - - - -
'-T'
~_,._\_ _---_
Shipper,,.....,,._
Ad vances to
Co1lect
_;::___----=-_c__--=:...._--
I
P. 0. Address --,-- '---'-+--"------------
To Consignee
To Shipper
(OVER)
/
-
,l'J...jaJ.-
lbs ..
)
j
191 _ .
EXPI!ESS CHARGES
PR EPAI D
I
CO LLECT
I
.Add
Undercharge
I
�STATE
/
---='-------'~ -----'= =---=--='--"""----=-"-'..__= = ----'----'--'-"""
the
L.
duly sworn, depose and say th at I am
specified on other side of this form, thi s day
.,
'rmtq~YJ
;
delivered to me by th'e Southern E xpress Company, from
that I am not
a student or minor, and, if a female, I am the head of a famil i 1
fi ent spirits so r eceived by me
wer e brought into the State on my written order, and that I have not, wi'thin the thirty days prev ious
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quanJity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
h 10, 1\116, It contrary to law , and t . the ardent spirits so received by me are to be used
a
Min.
/
by me
fo✓---J
,
'1/
I
~{
t
.
·' J
•
(State whether for Scientific, Sacram en tal, Medic
purposes.
I or Mechanical)
<
- - - - - - - - - - - - - - -c=-o- n-s"'"i11_n_e-e,-
I
t/
I,
l
'
Ai:ent for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
FORM 370-VA .
Revised J nne, 1917
(Incorpor ated)
I
GROTTOES.
-+-- - ~ ---,-,--------:---- - - - -- Oate _ _~ - -- -=""------ - -..;--"'-~~"--~~ -=--""-----=-- - -- -
Kind of Ardent Spi cits _ _
Way-Bill No.
~_
f_ _ _ Weight4
1bs.
___,__ _
_ __::__---=.__!._=-='--~Ouantity,_ _ -'--_::')
_ _ __
f~_,__/_-_·~/_ _190 .
To _____~ ~- - - - ~ - - - - - - - -
To Consignee
.Y.':r.A1..o., ____
P. 0. Address ~ ~~?:..2~~.!a!.J,_ U
_
Advances to
Collect
From, ~ ~ -
EXPRESS CHARGES
r _...,,
~·- -- ~'- ·~/ ~
Add
Underchar ge
PREPAID
- - - -, < - -- -_ _ _ - COLLECT
_ _ __, _ _
To Shipper
(OV!lR)
�-----~-------<----=--.----~---- -~
)
COUNTY O
i• _
_,,.., , , _. - ' -~
(A.A
, - . --
Ii
~
j
,
,,,
,i',.. · G , :7
/ i
I,
( ~-/
l - , being duly sworn, depose and s&y that I am
a:;.,«::
,
I
- .,
, U'
the consignee of r,/ ce rtain shipment of ardent spirits, as specified on other side of this form,
this day
(/
'
delivere.d to me by the Southern Express Company, from~~~~~-~~~~~---i that
I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind wh .. tsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved Mar no, 1916, o I.contrary to law, and th at the ardent spirits so received by me are
to be used
///' I
by me forv
l)
\..._..k.__
,,
'
l...._·" _.A .,.,~
. /(
(
~
·
(State whether for Scientific, Sacramental, Meditin al or Mechanical)
NOV1- 1917
Sworn to and subscri~ed before me,
/
day
of_ _ _ _ _ l9l_,
/
,,
A11:ent for Southern Express Company,
purposes.
Consienee.
�_______
---- ---- ---- -~--______________...,.._.,,....
SOUTH ERN EXPRES S COMPA NY
I {)
,_...,_-,;.- ' - ' - - - - - - ~-
+--~- ouantity_ ..,L-_ ___,/' /-- - - -
'-~'-------'------ ;91-l
Advances t o
Coll ect
From/'--------''---/-J _------'"----'-_._LL------'-- --
EXPRESS CHAR!fES
PREl,AlD
Add
Undercharge
Shipper -,;<c,--+- -__J__.:.__- -+----=--=c'-- '--== =----').._
P. 0. Address -~~-~or--~~~-~~~- '----'---. ...1....-- ------'----'--~-- ...1.---- 1
To Shipper
rovER)
�STATE OF VIRGI NIA,
COUNTU
A
F---'1....,.,..-~~---,---f- r--~ I
I , -- - ~ --++-- - ' ~ - - - ~~ - -- -- - - , being duly sworn, depose and say that I am
shipment of ardent spirits, as specified on other side of this form, this day
the consignee of a
I ,; ,,.
; that I am not
I
delivered to me by the Southern E xpress Company, fro
a student or minor, and, if a female , I am the head of a family; that the ard ent spirits so received by me
were brought into the State. on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
by me for __________ _________
~
_____ purposes.
(State whether for Scientific, Sacramental, Medi<-in al or Mechanical),
"<'J01tsienee .
J
A1tent for Southern Express Company.
�SOUTH ERN EXPRES) S COMPA NY
FORM 370 - VA .
Revised June, 1917
(Incorporated
GROTTOES,
RECOR D
VA:>PE CIAL LIQUOR
1
Received at- ~'---,- --~-,-- __ __ ___
/
191 /
.
c.=c:.ccs==---'---=--'---=::c_------ - P. 0. Add ress_ ' - - - - ------- --'--__L7__,~
-/ ')_
Consionee _--1re--//':
_,,_---1.(_ ~ .-==-=c.:_ --Ouan ti ty, _ _ _-=------ ---'--Kind of Ard ent1Spirits _____Cf'
Way-Bill
N( f
l
From,_ _ '( - - - - _,_I_--''---~
E XP llESS CHARGES
CO LLECT
,
PRE PA ID
Unde rch a rge
_
,____
Collect __, ____ _ ___ ___
____
Advan ce s t o
Ship pe r -
~c.........::~
,
-=--"-"'-""-.c .....:,==c:..!...=-c._ _ _::::._
Add
/
_,_...,:.._ .___-'-_- '
P. 0. Add ress - - -~ ~- ~ --- - -- - - '--_........__ _.,___ _,__ _'--_
To Consignee
To Shi pper
(OVER)
�STATE OF
COUNTY
I,---'= --'.....,,_ '---'----'-----=-----' --- ---,;, - - - , being duly sworn, depos e and say that I am
the consignee of a certain shipment of ard ent s · its, as s ecified on other side of this form, this day
f OTT0£S, V •
;
that I am not
delivered to me by the Southern Express Company, from
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and thai I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allow d by the provisions of the Act of the General Assembly of Virginia,
approved March l " - 1 . .ntra t'I> law, and,that the ~rden.t spirits so received by me are to be used
I
by me for
(:!J~l ..,
purposes.
(State whether for Sciijntific, Sacramental, Medi<·inal or Mechanical)
tQJ 131917
Consienee.
(
l
(
1
A11ent for Southern Exp ss Company.
\
�FORM 370-VA .
Revised June , 1917
SOUTHERN EXPRESS COMPANY
(Incorporated)
GROTTOES. V .PECIAL
LIQUOR RECORD
191 _ . Affid avit No.
Date
I
Wei ght
Quantity
191 _ .
I'
_,__~------ ----71
To _ __,__
A d van ces to
Collect
Sh ipp er :__,__fi_~_ -""'.~~~~~L~c..._!"!:_~ -
RECORD OF NOTICES
To Consignee
II/J711
To Sh ipper
(OVER)
,
lbs.
From
EX PRESS C HARG E S
PREPA ID
CO LLECT
Add
Unde r charge
/
l
�·- ·- ·- -~ -- -· .. -··----~ -..,..,.---- --,-.--- - --.,. . .,. . . - -------- .,----...
S TATE OF
COUNTY
' I,- - --;tl~#--J~ --.l'----1-~~~,,,.,.,~~ ~ :....::=~-:U. , being duly sworn, depose and say that I am
sfROTTb~~s1J~f
the
this form, this day
delivered to me by the Southern E xpress Company, f r o ~ - - - - -- - - -- -- - ; that I am not
a student or minor, and, if a female, I am the head of a family ; that the ard ent spirits so r eceived by m e
were brought into the State on my written order, and that I have not, within the thirty day s previous
hereto, received any ardent spirits of,_ any kind wh atsoever, from any person or from any place whatsoever, in excess of the quantity allowed' by the provisions of the Act of the General Assembly of Virginia ,
approved March 1 1
,· or cont ry to law, and'that the ardent spirits so received by me are to be used
.
',
f
Sworn to and subscribed before me,
this _ _ day of_ _ _ _ _ 191_.
/,
Ai:ent for Southern Express Company.
Consianee.
�FORM 370-VA .
Revised June , 1917
SOUTHERN EXPRESS COMPANY
(Incorporated)
~PECIAL LIQUOR RECORD
Receivedat, _ _ __ _________ _ _ _ Date
'
}
191 _ . AffidavitNo., _ _ _ _ _ _.:--..
From _ _ _ _ _ _ _ _ _ _-4
Advances to
Collect
Shipper _ .:..:_..!..:!_~~ ~ ~ ~ ~~ - ~ -~~:,,.J
P. 0. Address - - - ~ - - - - · -- -- - -=
RECORD OF NOTICES
To Consign ee
To Shipper
I
(ov1rn)
EXPRESS CHARGES
PRE PAID
Add
Undercharge
�I, ___,_,c___....,.,~=-=--=--:........:= --=:........:_.:,c._....t,.#-- - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me oy the Southern E xpress Company, from
l/
(\ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess f e qnantit al!'tlwed by the provisions of the Act of the General Assembly of Virginia,
a p p r v,
, . 916, or 9ntrary to law, af"d that the rdent spirits so received by me are to be used
by me for_+_L..~cot!:._.,,_ _,~.J.~~~:i.,..,,,,_~ ~dD..~~----PUrp oses.
(State whether for Scientific. Sacramental, Medicinal or Mechanical)
ubscribed before me.,
I
this _ _ day of
/
i
191_ .
~
Aiient for Southern Express Company.
�F'ORM 370-VA .
R evised
JuC#ifrroEs
.
SOUTHERN EXPRESS COMPANY
(Inco r porated)
raPECIAL LIQUOR RECORD
•
Received at _ ~ - - - - - -
•
/
Date
Advances to
Co11ect
191 J
A!fid avitNo . _~~
EXPRESS CRAR<,XS
Add
Under charge
PREPAID
I
To Consignee
To Shi pper
(OVER )
- --=,
�/
COUNTY
I,~--4.,,___ ___,,c..___=-='---=---"""'.,_..'-----L--'-=,:;__-duly sworn, depose and say that I am
the consignee of II certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from
,I
; that I am not
a student or minor, and, if a female, I am the bead of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits 'of any kind whatsoever, from any person or from any place 'wh!ltsoever, in exce~s of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved M, ; ; 1916, or co rary to law, and that the ardent spirits so received by me are to be used
~ ,., /~ _;/
.•:/1/ /J
A,! _,,:c~ ~:c_ ,.f/
by me for
.
(State whether for Scientific, Sacramental, Medirinal or Mechanical)
,,
; ~,
/ ' V
-· .
Sworn to and subscribed before me,
j..
1
tbis_,_ _ day of : ,.
-I
~~
,
1,
.,.
; l
. >
~-
~
Agent for Southern Express Company.
.
~
purposes .
1
f
~
,.
I
,J/1"
= '/ / ,',,...,";'·.
1,p./ !,. 1.,t,.,,....,
Consienee.
�FORM 370-VA .
Revised J uue, 1917
SOUTHER N EXPRESS COMPANY
(Incorpor at ed)
f
SPECIAL LIQUOR RECORD
~-/~~-.191-/.
Received at _ _ _ _ _ _ _ _ __ _ _ _ _Date _ _
Affi davit No,_ __,
~- - - -.
1
Consianee _ _ ___,'--~ --..._~,~~--:'._~~~~+-- - - -- - -- P. 0. Address_ ' - - - - -Kind of Ard ent Spirits- -----,-- - -- - ---- - - ,----,.- .
Way-Bill No.
To
,
Shippe;--~
/C /
_____, _____ 191_:J
,.,
kt
(
To ·Consignee
E XPRE SS CHARGE S
P REPA ID
I
I
r
RECORD OF NOTICES
To Shipper
(OV!CR)
/
lbs.
From_ / _ ~ - -- - - -
Advan ce s to
Coll ect
IF
--~--
' oh /
- _ _ _ _ _ _ _ We1
CO LLEC T
f9
Add
U n de r charge
I
�I,-----,,____- l-_.__
__c__-""-__c:.--= ---=--....:__::_::.__
_,...__,,,c.,
the
being duly sworn, depose and say that I am
as specified on other side of this form, this day
,...
delivered to me by the Southern Express Company, from •
; that I am not
a student or minor, and, if a female, I am the head of a family; that the ai dent s~irits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the qu nti~y allowed by the provisions of the Act of the General Assembly
of Virginia,
appr""""'u1m =ch 10, 191 or contrary to lnw, and that the ardent spirits so received by me are
to be used
/)g
•
,
~
f or
,,d_
.
purposes .
(State whether for Scientific, Sacramental, Medicinal or Mechanical )
Sworn to and subscribed before me,
I
·
•
this--r1-J-da y of I
. _.,,,
: :)
j 9l_,
.I
Aeent for Southern Express Company.
~
6
,
/ '\
Consienee.
I !. :.'1'
'
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.
(':?
Cc, ,
''
1
�FORM 370-VA .
Revised Juue, 1917
SOUTHER N EXPRESS COMPANY
(Incorporated)
LIQUOR ) RECORD
f /
Received at.- - - - - - - ' -- --hr- _ _ _ _ _ _ _ Date
Consignee-=~~ ----'"'--"'--='-;'--r - + - ~ - ' - - - - - - --
191_
.
s ___,- ~'--7---+-'i.-i-i---=-"~
P. 0. Addresgc
/_f_---i------
- - - - - - - - -~--0uant ity_ _ _
(6
Kind of Ard e9 t Spirits,~....
Way-Bill No.
)
/
('
Advances to
Coll ect
191 "__).
To Consign ee
To Shipper
(OVER)
'---------1-- lbs.
From _ _ _ _ _ _ _ __
EXPRESS CHARGES
PREPAID
--~--1--~--
RECORD OF NOTICES
-.ai--.i+-- -
COLLECT
Add
Undercharge
�COUNTY
__,,._.,,L,_J"--"'=---'------==:.....::......,-==11--"""""=----"'---- - - ,
being duly sworn, depose and say that I am
as specified on other side of this form, this day
the
T
delivered to me by th e Southern
press Company, fro=~---- --'-~------ ; th at I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spi rits so received by me
were broug_ht into the State on ID{ wl'.itten order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kill(l whatsoever, from any person or from any place whatsoever, in excess
quantity a lowed by the provisions of the Act of the General Assembly of Virginia,
approved March 1 ,
6, or co rary to Jaw, and that the ardent spirits so received by me are to. be used
01)
~
,
V
by me for _ __'.__!..._~~~:...: :...~~~~..,,,_'.J., ..L.L~od~4---- purposes .
<S•• .,..,. ,o, '"'""''· SMeom'"'"'·M"''''"'' o, Mm>o,,M,~
·
~
._7
Sworn to and subscribed before me,
I
.,
r
\
Agent for SouthJ,rn Ex1>ress Company .
/~✓
�F'ORM 370-V A .
Revised June, 1917
SOU THE RN EXPR ESS COM PAN Y
GrlOTTlJES.
(Incorpo rated)
LIQU OR REC ORD
Received at ___ ___ __ _ _ __ _ _
_ _Oate __~ - - -- -
.i-,J==ee.. .-
Way-Bill No. _ _ _
- ~ ------'/ ___ 191 _
To _ ___ ___ ____ ___ ___~
-Advance s to
Collect
Shipper _ _ ___ ___ ___ ___ ___
_
P. 0. Address _ _ _ _ __ .....:.____ ____ _ _
RECO RD OF'
To Consignee
To Sh ipper
IOVER}
.
From _ __ _ ___ ____
EXPRES S CHARG ES
PREPAI D
COLLEC T
Add
Underch arge
�STATE OF
COUNTY
I,---~---~ -~~~-~= =---~~- , being dnly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
OTTQES, VA. ;
delivered to me by the Southern Express Company, from
that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
,w ere brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved ~Ma;i:1;)1 O, 1916,
contrary to law, and t f t the ardent spirits so received by me are to be used
by me for
A
C/
"i
\..1(.
{_ f'!.
✓
\
:.,)J,~
i
'. .c
.
purposes .
(State whethe&---foL--ScieDtifi c, Sacramental, Med-icinal or .M.echanieal)_ _
Sworn to and subscribed l;>efore me,
this _ _ day of_ _ _ _ _ l91_.
Ai,,nt for Southern Express Company.
-
Consignee.
�l'ORM 3T0-VA.
Add
PREPAID
Uudercbar1e
To Shipper _ _ _ _ _ _ __ __ _ _ __ _ __
/
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�- ----- ,---~
~
---~-=-,,,-=-~-~~~-----~------------- SPIRITS FOR
PERSONAL USE
__,.~..:_--'"- -===--== ---=-----.,.__-""''--, being duly sworn, depose and say that I am
sp_ecified on other side of this form , this day
delivered to me by the Southern Express Company, from ______ __ _ __ ___ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into 1.he State on my writt(ln order, and th at I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever; from any person or from any place whatsQever, in •
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
,.
Sworn o and"Su scribed before
thi/
.cJ
day-1,f
/
e,
- , 191_ .
Aeent for S outhern Exvress Comvn.nr .
Consi"nee.
�f"ORM 370-VA.
C JlTT E
Received at
Consionee
a;-tJ
2
Advo.n ce 11 to
Co ll e.-t
PREPAID
To Shipper_ _ __ __ _ _ __ _ _ _ __
ArrlDAVIT rOR A DENT SPIRITS rOR PERSONAL USE.
(OVJ:R)
�T
SPIRIT S FOR
PERSO NAL USE
I,'-:::'.'..~
~~:__~~ ~~~=_ .__:::_ =--=- --y sworn, depose and .say that I am
the consigne e of a certain shipment of ardent spirits, as
on other si\l,e of this form, this day
delivered to me by the Southern Express Company , from ____ __
_____ ____ ; that lam not a
student or minor, and, if a female, I am the head of a family; that the
ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within. the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er; in
excess of the quantity allowed by the provision s of the Act o·f the General
Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw, and that the ardent spiri'is o r~ceived
by me are for my own use, at
my own home, and that the said ardent spirits will
e used in r olation of Jaw.
Consi&'nee.
'
~
Ai:ent for Southern Express Company.
�EXPR ESS COMP ANY
SOUT HERN (lucorpo
mted)
FORM 370•VA
LIQUO R
/
Received at·- - -~...1 --'-.--.........,_ _ -._ _ _ _ _ _ Date
c,.,~
Consign ee - - ---'---i .'----1--- -"''""-.-- -==C""- i~=-'---- -'-~-'\1,
1
/0
191 _
/
-
Affidavit No. _ _ _ __ _
----- -/-~' ----- - -- - ----" --- /_
Kind of Ardent Spirits / /
Way-Bill No._ _..,...,..__ _
/
·
/
RECO RD
_
~ - - -~ -- - - - Weigh .___ __ lbs.
--'-.,___-'---Advnncea to
Collect
191_]
From
I
EXPRES S CHARGE S
/J/
Add
Uud e rcha.rge
To Shipper _ _ _ _ __ _ _ __ __ _ __ _
(OVER)
�PERSONAL USE
STATE OF
COUN'1'Y OF-++-R--1---¼-
¥'--..l.c----rl
_ _.....,,___ __ ___;,.,,,,=...c_-='----- - -- ----'-',e...- - , being duly sworn, depose and say that I am
specified on other side of thi s form, this day
deliver ed t o me by t he Southern Express Company, from _ _ __ ________ _ _ ; that I am no t a
student or minor, and, if a femal e , I am th e head of a family; t hat the ard ent spirits so r eceived by me
were brought into th e State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place wh atsoever, in
excess of the quantity allowed by.the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or cont rary t o law, and that t he ardent spirits so receiveq by me are for my own use , .at
my own home, and th at t he said ardent spirits will not be u sed' i.n violati no( law.
l_f
0 onsh:nee.
J\ge 111i for $d'uthern Express Company.
�SOUTHER N EXPRESS COMPANY
FORM 370-VA .
(I ncorporated)
SPECIAL LIQUOR RECORD
(:
Received at _ __ ~-"-',______ :;;---:-----::-::-==c: --- Date_ _ __ _ ___ rn
iL
Affidavit No.
~
Consionee
~~---- ---/-==-+- - - '=:c_- -------:--,-----,-:...-----,-:,"i=:. ._;t~i;t~~~~;~
- - - ~ -~-Amount _____ _ _ _ _ _ __
,.._..,,-...:_,._:;::-""~J.---
Way-Bill No. _ _ _ _-:--:=--:--tAdvo.n cea to
Col le rt
To
Ad <1
Uuderc hn r ge
To Shipper_ __ __ __ ____ __ _ _ __
/
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVIIR,)
�FOR '(/ DENT SPIRITS FOR
PERSONA L USE
STATE 0
- , being duly sworn, depose and say that I am
as specified on other t de of this form, this day
I,
the consignei o
lam not a
delivered tome bythe Southern Express Company, from _ _ _ __ __ _ _ _ _ ___ ; that
by me
received
so
spirits
ardent
the
that
family;
a
of
student or minor, and, if a female, I am the head
previous
days
thirty
the
within
not,
have
I
that
and
order,
written
my
on
State
the
into
brought
were
in
hereto, received any ardent spirits of any kind whatsoever, f~om any person or from any place whatsoever,
approved
Virginia,
f
o
·
Assembly
General
the
of
Act
the
of
provisions
the
by
allowed
quantity
the
of
excess
own use, at
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my
law.
of
violation
in
used
be
not
will
spirits
ardent
said
the
that
and
home,
own
my
Sworn to and subscribed before me,
7
L
Aeent for Southern Express Company.
11 I?, • tt"-9
Conslenee.
�FORM 370•VA .
T C ----'"'---c--'------"--_..:.._--'---'----'----'-_..;c._---"-''---- - - -
Advsucee to
Collert
EXPRESS CHARGJ,;S
Add
Uud e r r, barge
Shippe~
-=--l.-4-"--~---+---,---To Shipper_ _ _ __ _ __ __ _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVJCR)
�FOR
FOR PERSONAL USE
, being duly sworn, depose and say that I am
I,
on olhe1: side_of this form, this day
specified
as
spirits,
ardent
of
the consigrnie of a certain shipment
____ ; that I am not a
delivered to me by the Southern Express Company, from ___ _ _ _____
spirits so received by me
student or minor, and, if a female, I am the head of a family; that the ardent
the thirty qays previous
within
not,
have
I
that
and
order,
written
my
were brought into the State on
any place whatsoeve r, in
hereto, received any ardent spirits of any kind whatsoeve r, from any person dr f :oi'n
of Virginia, approved
ssembly
al
Gene
the
o
Act
the
of
provisions
the
by
excess of the quantity allowed
are for my own use, a:t
March 10, 1916, or contrary to law, and that the ardent spirils so received by me
• ln.iot.tin n •! lsw
r t b
myo= bnme, snd tb,lth,.• id ,ro,nta /
Sworn t;o and subscribed before me,
_;,
I
this ___day ~ ~ - - - - , 191_,
J
A11:ent for Southern Express Company.
�FORM 370-VA .
Advances to
Collert
Add
PREPAID
Und e rc harge
RECORD Of' NOTICES
To Consignee _ _ __ _
~ - - - - - - + - -- --+-----
To Shipper _ _ _ _ _ _ _ _ _ _ _ __ _ __
(OVER)
�FOR PERSONAL USE
I,
, eing duly sworn, depose and say that I am
foe consign ee of a certain shipme nt of ardent spirits,
as specifie d on other side of this form, this day
deliver ed to me by the Southe rn Expres s Compan y, from
___ ____ _~ ~ = - - - ; that l am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so receive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisio ns of the Act
of the Genera l Assemb ly of Virgini a·, approve d
March 10, 1916, or contrar y to law, and that the ardent
spiri\s so receive d by me are for my own use, at
my own home, and that the said ardent spirits will not be
used in violatio n of Jaw .
Consiine e.
;
�fORM 370-VA .
'
EXPR ESS COM PAN" l
SOU THER N (lucorpo
r&ied)
LIQU OR,. '}E_;CO RD
, /.:)
----: ;r-c: ----- t~---=.--.-: ~-= -=- Date
Ad'f'nnc ee to
Co1lecli
RECO RD Of"
-,--_ _
To Consionee ___ ___ ___ ___ _
__
/
'
COLLECT
A~d
Undercb ar~
__ __
To Shipper ____ ___ ___ ___
USE.
ARDE NT SPIRI TS FOR PERS ONAL
(OVER)
�,-..- -
.,
-- --- - -
- - ----
. -~
SPIRITS
FFIDAVIT . ~r
ORDE
:NT
S T ATE 0~'
COUNTY
I,
_/
F
.
.
~j.~~'f1
,-'f.,L,
t{_',#~//,,✓-;r-;;"J--s __ ....
, being duly sworn, depose and say t hat I am
the consignee of a certain shipment of ardent spirits, us specified on other side
of t his form, this day
delivered to me by the Southern Express Company, from _____ _ _ _____
___ ; that I am not a
student or minor, and, if a female, I am the head of a family ; that t he ardent
spirits so received by me
were brought into foe State on my written order, and that I have not, within
the thirty days previous
hereto, rece ived any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of tbe ·quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary t o iaw, and t hat the ardent spirits so received by me
are for my own use , at
my own home, and that t he said ardent spirits will not be u sed in violat ion of law
.
J
'
I
A2ent for Southern Exvress Company .
Consienee .
�SOUTHERN EXPRESS COMPANY
FORM 370-VA .
( I ncorporated)
rt
Rece'.ved a~
Consignee
IT
~
ES
-
'
Add
Und e rchor~ e
PREPAID
!
To Shipper _ __ __ _ _ _ _ _ __ _ __
ARDENT SPIRITS FOR PERSONAL USE.
(ov 11:a)
�SE
I am
, =---- -- - - - - - -_cc-=,.- -"---- ----, being duly sworn, depose and say that day
of this form, this
the consignee of a certain shipment of ardent spirits, as specified on other side
• ; thatlamn ota
delivered tomebyth eSouthern ExpressC ompany,° from C,L., , ,.,·L• ,
so received by me
spirits
ardent
the
that
family;
a
of
head
the
am
I
student or minor, and, if a female,
the thirty days previous
were brought into the State on my written order, and that I have not, within
any place whatsoeve r, in
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
of Virginia, approved
excess of the quantity allowed by the provisions of the Act of the General -Assembly
for my own use, at
are
me
by
received
so
spiri1.s
ardent
the
that
and
law,
March 10, 1916, or contrary to
.
my own home, and that the said ardent spirits will not be used in violation of la~
~
Consienee.
�SOUTHERN EXPRESS COMPANY
( lncor porated}
LIQUOR
,
~
CORD
').
- -'--~-'--- - 1Dl _
From, ________ __--=.
Way-Bill No,, - - - ~ -- - - -
To - ----+t•>---:--,c-7.-= ==--c·.--~= ·- - - -- -
Advance11 to
Coll ect
EXPRESS CHARGES
COLL ECT
Mrl
Uuder ~barft:e
I
To Shipper _ __ _ _ _ _________ __
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(OVER)
�7;
A FFIDAVIT
J
fOR
STATE
COUNT
~
C
.
I
RDENT SPIRITS FOR
~V/l.4J~
1A
t ' y),., ., ;
W I/
PERSONAL USE
,.
'
·
.
emg duly sworn, depose and say that I am
ment of ardent spirits, as SI?ecified on other, i ide of this form, this day
,,..._ _,___--='------ --+---.:.._--'""""-=:..,,,'"'------'-----,
. - . CS
V
delivered to me by the Soutnern Express Company, from
,
; that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
• were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from ai:iy place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General As·s embly of Virginia, approved
March 10, 1916, _or contrary to law, and that the ardent spiri\s so receive·d by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
I
r-/
Sworn to and subscribed before me,
t
1. \.
A&"en, for Southern Express Company.
I
Consienee,
�FORM 370•VA.
SOUTHERN EXPRESS COMPANY
( I ncorporoted)
/
SPECIAL LIQUOl;t ,RECORD
01
Affidavit No._ _ _ __ _
~ - -~ bs.
Advances to
Collec t
EXPRESS CHARGES
Add
Uud c r c bnqi; e
RECORD OF
To Consicnee _ __ __ _ _ _ _ _ __ _----F--
To Shipper _ __ _ _ _ _ _ _ __ __ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
/
( OVJ:R)
�T SPIRIT S FOR PERSO NAL USE
...._~,......._...:..._--=-------= -------- -- ----~- ---'-· - ~ -being
- -duly
, sworn, :depose and say that I am .
the consi,gnee of a certain shipment of ardent spirits, as specified on
other side of this form, this day
delivered to me, bythe Southern Express Company , from ____ _ _
__ _ _ _ ___ ; that lam not a
student or minor, and , if a female, I am the head of a family; that the
ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received
by me are for my own use, at
my own home, and that the said ardent spirits will not ·e ·used in violation
of law.
Consienee.
,.
Ae:en• for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
FO RM 370 ... VA .
«••roo•-•
ECORD
101 _
,,
Received at_ ·-ii:::cn-,-----r..---,,,--- pi- - - --
7
J
7,
Affidavit No.
/
/ __:___
Consignee _ .>....,;'-------'-"=-..:!.;:.- ~"'-...,-r.,-'~;,....,~'------ '~~--1-----~c""-- · - - - -- - ~ r -
_
Kind of Ard ent Spirits,~,,_________
Way-Bill No.
To
<I 7 V
,
/ _ _____;,._ _.,....,._
L ___
Date_ _ _ _____,'-----____:c~_1 91/ .
Advonc e a to
---'----''--.f-'-"'
We"ht~
?2'
lbs.
Fro: ~4n;,tP>1
EX PRE SS CHARGES
//
A dd
Uu de n;barge
Collect
)
RECORD Of" NOTICES
To· Consignee _ _ __ _ __
----=_.;:::' - - ' - " - - - , < - -
To Shipper _ __ _ __ _ _ _ _ __ _ __
/
(OVJ:R)
�FOR PERSONAL USE
1, -\.-l.e:'-'-~~~~~ ..:::~~~::::_'::.J__:..._~~~~~--, being duly sworn, depose and say that I am
the consignee of a certain shipment of rdent spirits, as specified on other side of this form, this day
. I
delivered tome by the SouthernExp s Company, from _ __ __ _~ - ~ ~ -- - - i that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my writt en order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
Sworn to and subscribed before me,
= ..,
t'
Ai:eni for Southern E:,:press Company.
'I I·
Consienee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
( luco rpo rntcd )
• " SPECIAL LIQUO
6
ORD
Affidavit No., _ _ _ _ _ _
Advaure s t o
Coll ec t
l 'RE l'A ID
CO LL EC T
-i-r
To to nsig nee _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER )
�, being duly sworn, depose and say th at I am
shipm ent or ardent spirits, as specifie d on oth er side
of this form, this d-0.y
delivere d tome by_tbe Southe rn Expres s Compan y, from
~
~~ 1' •
; that I am not a
student or minor, and, if a.femal e, I am the bead of a family;
th at the ai'dent pirits so r eceived by ·m e
were brough t into the State on my written order, and that
I have not, within tne thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisio ns of the Act
of th e Genera l Assemb ly of Vi-rginia, approve d
March 10, 1916, or contrar y to law, and that the ardent
spirits so r eceived by me are for my own u se, at
my own home, and that the said ardent spirits will not be
used in violatio n of law.
Uonsie:nee.
tbi
;\g:e ut for Sout,h ~rn ExvreRS Company .
�F O RM 3 70-V A.
SOUTHERN EXPRESS COMPANY
(Incorpo rate d)
LIQUOR
RECORD
., I
Affidavit No._ ·
.Advance s to
Collect
_ To Shipp er _ _ _ _ _ __
To Consign ee _
/
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( o nR-)
�SPIRITS FOR
PERSONAL USE
STATE Oi'
COUNTY
,, - - -=--'--------=-- - ~==~,c.~,,._...._~_t._- _""_"_"__.._- _..._-:__
-"':a.,.,2:-'eing duly sworn, depose. and say that 1 a n,
pecifi ed on other side of t h is form, this day
delivered to m e by the Southern Express Company, from _ _ _ _ ______~ -- - - ·; t hat I a m not a
student or minor, and, if a femal e , I am the head of a famil y ; that the ard ent spirits so r eceived by m e
were brought into the State on my written order, and that I have µot, within th e thirty days previous
hereto , r eceived any ardent spirits of any kind whatsoever, from any p er son or from any place what soever, in
excess of the quantity allowed by the provisions of the Act of the Gene ral Assembly of Virginia, approved
lfarch 10, 1916, or contrary to law , and that the ardent spir its s eceived by m e are for my own use , at
my own hom e, and th at the said ardent spirits will not be u se m l(lijlatio of law.
-<1-
c
- - - ~ - ~ · - - · - - ~ -~
�.:.K
FORM 370-VA .
__,. ,__~____,_,_ 10,i' . '""""I
___ __,___ __
Advtmcee to
Collert
PREPALD
CO LLECT
/
Aclrl
Uurle r cha rge
To Shipper_ __ _ _ _ _ _ _ _ __ _ __
SPIRITS FOR PERSON AL USE,
(OVER)
�- , b~fng duly sworn, depose and say that I am
....,~-.__......., . , . . . . ~ - ~ - - - - - ; - - - - - - - - # I ~ - its, as specified on other side of this form, this day
a certain shipmen t o_f ardent s
1
="7" -- r l =- , - -- - - ; \hat l am not a
delivere d to me by the Souther n Express Comp a y, fro-..~ ~ -"f-"-c,h=-'
ard en't spirits so received by me
the
at
th
family;
a
of
head
the
am
I
student or minor, and, if a female,
within the thirty ditys previous
not,
have
were brought into the State on my written order, and that I
or from any place whatsoe ver, in
person
any
from
ver,
whatsoe
kind
any
of
hereto, received any ardent spirits
ly of Virginia , approve d
Assemb
General
the
excess of the quantity allowed by the provisio ns of the Act of
are for my own use, at
me
by
received
so
spiri\s
ardent
the
that
and
March 10, 1916, or contrary to law,
,r~ siolotinn nf I•~
my nwn homo, •nd th,t th, ••id o,dont spi,ito
wia:o
6,
.
Cons1enee.
A11:en, for Southern Express Company ,
�FORM 370
TTOEs. ·v
I
.SOUTHERN (EXPRESS
Inco rporat ed) COMPANY
SPECIAL LIQUOR
RECORD
)j/
Affidavit No. _ _ _ _ __
Kind ·at Ard ent S~i rits,_ _ _ _ _ __ __
- - ~ - - - - " - , l ' C - --
Way-Bill No. _ ---=__,_--=----__;;_____ Date_ _ _ ____..'--'----=--=----- AdVfHlC68
Collert
to
PREPAI D
Add
Oud erc ba r ge
0
RECOAD OF NOTICES
To Consignee _ _ _ _ _ _ _ _ __ _ _ _- + - - - To Shipper_ __ _ _ __ _ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVIIR)
�SPIRITS FOR
PERSONAL USE
delivered to me by the Southern Express Company, from , •
; that 1 am not a
student or minor, and, if a female, I am the head of a family; that tlie ard /nt spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw.
fl ol
s]
J ld before me,
this ___'day of /
C:
\ '
, 191_,
tJ J)~u)QAi:en, for Southern Express Company.
Consienee.
�SOUTHER N EXPRESS COMPANY
FORM 370•VA
(l ucorpo raliedJ
SPECIAL LIQUOR / RECORD '
_ ....,.___,.~ =-,,~ - - - -- - - - ---Date._ _ _ _ _ _ __ 191 _
:'\
I
RECORD Of" NOTICES
To Consignee~-
~
}
/
__ __
_ _ .,__
- - - - -/~~/~ //
/
Affidavit No._'- --'- -
~
,_______
57
- '---- -'-''----"------- ,'-"~ - --'-'---....,,_- Amoun,t.__ _/_ _
_ _ _ __ ___ _ __/ _ _ 191 _
Advnnr e a: to
Coll ect
I
7
Weich .___ __ lbs.
firom, __r_ _ ....~ _ _ _ ___ _
J,.XPRESS CHARGES .
A~ d
Unde r ch ilra:e
To Shipper_ _ _ _ ____ __ _ __ _ _ __
l
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE .
(OV JIR)
�AFFIDAVI T FOR ARDENT SPIRITS FOR PERSONA L USE
STATE OF VIRGJNIA,
COUNTY
m•-+--- -- - - - - -
,j.,
~,
ihe consig ee
6f
, being duly sworn, _depose and say ihat I am
,
ecified on other side of ihis form, this day
~
spirits,f!h
a certain shipment of arden{
f
J
fTOES. VA
;
that I am noi a
delivered to me by ihe Southern Express Company, froM'_ U
by me
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
previous
days
thirty
the
within
not,
have
I
that
and
were brought into the State on my written order,
in
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever;approved
Virginia,
of
Assembly
General
the
of
Act
the
of
excess of the quantity allowed by the provisions
own use, at
March 10, 1916, or contrary to law, and that the ardent spirils so rec eived by' me are for my
law.
of
vfolation
in
used
be
not
will
spirits
my own home, and that the said ardent
1u1_
rr
Sworn to and subscnb
JJ
before me,
this ___day ot- +---'--• 191_
t'..
/"''J ;';//4(
,_ ✓ 7
/1
A11ent for Sonthern'Expr ess Compauy.
k ,,,,
�,f
FOAM 370•VA.
Affidavit No._ _ _ __
Advau ce e to
Colle, t
Adrl
PREPAID
Oude rc hnrge
RECORD (!)F NOTICES
To Consignee _ _ __ _ _ _ _ _..:.__c~'----'-'--+--
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ __
AFFIDAVIT FOR AR -,=-NT SPIRITS FOR PERSONAL USE.
(OVl: R)
�STATE OF
CouNJ' ...,_....::..--=-----'---_.,,,,,_--==------=-------=----------,-- --,---+
the consignee of
delivered to me by the Southern Express Company, from ,I'-+ - -- - ---=----='--'---=:...:...=-- - ; that l am not a
student or minor, and, if a female, I am the head of
am y; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any·ardent spirits of any kind whatsoe • r, om any pe.r son or from any place whatsoe.v er, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me are for my ~wn use, at
my own home, and that the said ardent spirits will not be used J n ~iola'tion of law.
l,
Sworn to and subscribed before me,
'?tf:
~
v
19L /. ,
Aiient for Southern Express Company.
Consi~nee.
�SOUTHERN EXPRESS COMPANY
FORM 370-VA .
(I ncorporated)
,
LIQUOR' RECORD
_ __ _ __t _ 1n1
Kind of Ard ent Spirits,_ _ -+----=,,, - -- - - ·- - ~ ~ --+--Amoun (__ _ __ _ _ ___::__ Weigh"- ~~=--- : bs.) ;,
1
Way-Bill No•-..,.-.-,:cc:,z::='-="===--- Date_ _ _ _--+- /
191 I
/le,
---,
.--
To
l
/
' ,r--'' '--~-----.c..:....:.cc....,._
Shipper..,,_
\'
Advan ce s to
Co ll ect
~ :c.,...~-
EX PRESS CHARGES
PRE PAID
CO LL ECT
Arlrl
Oud c r1:bnrge
(
-
I
I
;\ J
I
RECORD OF NOTICES
To Consignee _ _ __ _ ___::.c... - " - - --'-'- - - E - - - To Shipper_ __ ________ __ __ _ _
/
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVJ:R)
.,
�FOR PERSON AL USE
I,
the consi
am
:=--- being duly sworn, depose and say that I day
-.,..,;~~~~=::~S::~::::~::::~:_::~:_::::=---:___
as specified on other side of this form, this
1
. " , rr- " ,
of ardent spirits,
. .
- -- -- - - i that lam not a
delivered tome by the Southern Express Company , from ___---'--~~ardent spirits so r eceived by me
the
that
;
family
a
of
head
student or minor, and, if a female, I am the
witnin,_, the thirty days p'revious
not,
have
I
that
and
order,
written
my
on
State
the
iµto
were brought
or from any place whatsoev er, in
person
any
from
er,
whatsoev
hereto, received any ardent spirits of any kind
of Virginia, approved
Assembly
e"Gerieral
i
of
Act
the
of
s
provision
the
by
allowed
quantity
the
excess of
for my own use, at
are
me
by
r"':e~~ived
spi_pl.J!JjO
ardent
March 10, 1916, or contrary to law, and that the
of· law .
violatio,n
rn
be•U:sed"
no
will
spirits
ardent
said
the
that
and
home,
my own
Sworn to and subscribe d before me,
this_ [ a!cf
t
191 ,191_.
t G / )( :cJ
A11:ent for Southern Express Company,
�l'ORM 370-VA,
SOUTHERN EXPRESS COMPAl'll
(lncorporMed)
~I
Affidavit No, _ _ _ _ __
I
Ad1'81lCe • to
Coll ect
I
EXPRESS CHARGES
I
Add
Undercbarae
PREPAID
RECORD Of' NOTICES
To Consignee _ _ _ _ __ ~ - - -~ ~ -- ~- - To Shipper _ _ _ __ __
_ _ _ __ __ _ _
~:'·
(OVIIR)
�----~~---~~-~-~~---~----~~--~----------------
delivered to me by the Southern Express Company, from ______ _____ ___ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within °the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
al Assembly of Virginia, approved
excess of the quantity allowed by the provisions of the Act of the Ge
ivjd by me are for my own use, at
March 10, 1916, or contrary to law, and th at the arden~ spirits so
,
low.
myown homo, md th,tlh,saihn lont spi,its wHI t • us,d ~
Sworn to and subscribed before me,
ii...illl..
Consie-nee.
,.
-
�SOUTHER N EXPRESS COMPANY
FORM 370-VA .
r
(lucorporat.ed )
SPECIAL
. /
R.E
Advsn ce a to
Collect
PREPAID
' RECo'AD OF NOTICES
To Consion ee _ _ __ _ _ _ _...:..__ __ _ _ __
To Shipper _ __ _ _ _ _ _ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(ovn.l
�SPIRITS FOR
AFFI/V~T FOR A~ENT
STATE
COUNT
~L /
~~
--µ~•
-- ~
/
-CiY~
PERSONAL USE
~
I,
,'
the consignee of a certain shipment of ardent spirits, as
,
being duly sworn, depose and say that I am
pacified . ~ o1hv side of th_is form, this day
; that l am not a
'
'
delivered to me by the Southern Express Company, from
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirhs so received by me are for my own use, at
my owo homo, ond thol tho " " .,d,ol •Pi,ilo wi!J ; : io
•:;•~:~r: JJ-_
.J
f'"
Consienee .
. ~,
Aeen, for South• .
�Ad-.1111cea kColle ct
PRE PAID
To Shipper _ _ _ _ _ __
( OVER )
_ _ _ __ _ __
�depose and say that I am
__,.._.=_,.-"'"-=-"'"""-.i.:~ ,-,~ "---""-'""'""--=~c---, being dulyotsworn,
her .side of this form, this day
I
;
that I am not a
o
L7' •
~ f
delivere d to me by the Souther n Express Compan y, from
eceived by me
r
so
spirits
ardent
the
that
student or minor, and, if a female, I am the head of a family;
thirty days previous
the
within
not,
have
I
that
and
order,
written
my
on
were broug ht into ihe State
any person or from any place whatsoe ver, in
hereto, received any ardent spirits of any kind whatsoe ver, from
General s embly of Virginia , approve d
the
of
Act
ihe
of
ns
provisio
the
by
excess of the quantity allowed
rec · 'J y e are for my own use , at
so
spirits
March 10, 1!)16, or contrary to law , and that the Iardent
violat1
in
u~e-a
be
not
will
spirits
ardent
said
the
my own home, and that
~ orn to and subscrib ed before me,
t i_]_ :1¥,J917
191_,
/
Agent for Southern Ex11ress Company .
\~
�,oRM 370-VA.
-----'--+--D_
191]
o___
Affidavit No~ __
I
Add
PREPAID
Unde rcharce
RECORD OF"
To Consignee _ _ _ _ __ __ ______,,__ __
To Shipper _ __ __ _ _ _ _ _ _ _ _ _ __
AF"F"IDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OV ER)
�FOR PERSONAL USE
STATE 0~'
COUN'l'Y
OF='=f---P.1'---"""~~::::;;if;z:::/,?_,,.
I, _ ___________ _ _______:,..,__ , ,being duly sworn, depose and say that I am
,the -consign~e.of a certain shipment· ·o f• ardent spirits, as .specified on other side · of t his' form, this day
~
.·
'
· delivered to me by the Southern Express Company, from __________-"-'-"'--; that I am not a
student or minor, and, 'if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received an:y a,rd'ent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the G~neral Assembly of Virginia, approved
March 10, 1916, or"contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will noi ~ ;·v!,o1 tjon of law .
.< 1 ;;rf ,[J~c.4✓
Cous ie-nee .
Sworn to and subscribed before me
c:.~
I
of
i'
t his _ _/_ day
l
I
7
, 191 / .
/
Aeent for Southern Ex11ress Comvany.
�FORM 370-VA.
SS COMP ANY
SOUT HERN EXPRE
nco r po rnted)
(I
SPECI AL LIQUO R
--,---'-'--:--~ -~-- t-- Date_
RECO RD
lbs.
'-- - -- - - - - --Weioht
_
_
__
_
__
_
___
From
_ _ _ _ _ __ _ _ _ Jg'iZ__
Advances to
Collect
RECOR D OF
To Consionee- - - - -- - - - - - -- - - ~ -
EXPRESS CHARG]; S
PREPAID
COLLECT
Add
Unde r c harge
To Shipper____ _ __ ____ ___ _ __
NAL USE,
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
(ovsa)
�NT SPIRI TS FOR
PERS ONAL USE
- , being duly sworn, depose and say that I am
,,. - - - - - - - - - - - - - - - - - - - - - as ,specifi ed on o1her side of this form, this day
the consig nee of a certain shipme nt of ardent spi,rits,
a
from ___ ___ ___-"-,-_ _ __ ; that lam not
deliver ed tome by the Southe rn Expres s Compa ny,
me
by
d
receive
of a family ; that the a: dent spirits so
studen t or minor, and, if a female , I am the head
that I have not, within the thirty days previo us
and
order,
written
my
on
State
the
into
were brough t
from any person or from ariy place whatso ever, in
ever,
whatso
kind
hereto , receive d any ardent spirits of any
ed
the Act of the Genera l Assem ply of Virgin ia, approv
excess of the quanti ty allowe d by the provisi ons of
for my own use, at
are
me
by
d
receive
so
spiras
ardent
the
that
March 10, 1916, or contra ry to law, and
not be us,e d in viol'f!tion of law,
my own home, and that the said ardent spirits will
Consien ee.
A11:en, for Souther n Express Compan y.
�-~ -- -- -- -- -- -~
,oRM 3T0- VA.
SO UT HE RN EX PR
ESS CO MP AN 'J
(luco
rpora ted)
{:
LIQ UO R /RE CO RD
I
_ _ _.,_/_ __ _ 191 _
Ad•a nce e to
Colle ct.
.!'RE PAID
To Shipper __ __ __ __
__
Af"f "IDA VIT f"OR ARD
ENT SPI RIT S f"OR
PER SON AL USE .
(OVE R)
?--__)'__
Affidavit No.__
A~d
Uude rcba r1e
___ _ _ __ _
�---------------------~ ~~-~------------------~--SPIRITS FOR
PERSONAL USE
STATE OF
COUNTY OF------,Mj'-~r-c--a.,,.-,1---,.,,_-""'_,A
I, - - - -- - - - - -- - - -- -- - -- -- , being duly sworn, depose and say that I am
. the consignee .of a certain .shipment of ardent spirits, as spe,,;:ified on othei: side of this form, this day
delivered to me by the Southern Express Company, from ________ ______ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brougM into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent.~_pirii.s so receiv~d by me are for my own use, at
my own home, and that the said ardent spirits will not be used in v_iol11-tron of law .
_
I
-
Con~-enee.
Sworn to and subscribed before me,
thi~
/
(...,.
d-a y o~~- - - -, 191_,
")
(
/
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I
---·-
A1,?ent for Southern Express Company .
�SOUTHERN EXPRESS COMPANY
FORM 3TO--VA ,
(Incorporated)
'""'"' •·- ~
Advan ce s to
Collec t
Add
Und e rc harge
PREPAID
{
1
RECORD OF NOTICES
To Consign ee
I
)
/
To Shipper_ _ __ __ _ _ _ _ __ _ __
AFFIDAVIT FOR7 - ; .T SPIRITS FOR PE_RSONAL USE.
(OVER)
�Ta
•;t,~VI T F O ~ N T SPIRITS FOR PERSON AL USE
~: :~r1!/ • ~~
}l
doly ,w,rn, d,po,, ~d "Y th,t I om
the consignee of a certain shipment of ardent spirits, as specified on other side
of this form, this day
-:r.
T
r
r
delivered to me by the Southern Express Company, from
1 •
. ; that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of _the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law
.
�SOUTHERN EXPRESS COMPANY
FORM 370•V A
( Incorporated)
Advnu ce s to
C ol lec t
RECORD OF NOTICES
;c _,,
)--..,.
J-i
7J..-'---To Consignee _ _ _ _ __ '-'0
PREPAI D
To Shi pper _ _ _ _ _ _ _ _ _ _ _ _ _ __
A:ENT SPIRITS FOR PERSONAL USE.
I
(OVER)
�SPIRITS FOR PERSONAL USE
COUN
; ..:c__------=---=--- -===----=----=""-------::. . :,= --------=---- - --=-------- being duly sworn, depose and say that I am
the consignee of a certatn shipment of ardent spirits, as s1pecified on other side of this form, this day
... . . , ......
~
delivered tom~ bithe Southern Express Company, from ______________ ; that I am not a
student or minor, an'd, if a female, I am the bead of a family; that the ardent spirits ·so received -b y me
were brought i~to the State on my written order, and that I have not, witp_in th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person·or f om_~~] place whatsoever, in
excess of the quai;itity allowed by the provisions of the Act of the Ge -er~l Assem~ o_f Virgilifa 1 approved
March 10, 1916, or contrary to law, and that the ardentl pirits s e eived by e are for my own us e, at
my own home, and that the said ardent spirits will not be used 1r1 ol'At-ion ·o
.
@t:l4
Swo
this _ __ day of.~----, 191_,
t{
(
Agent for Southern ExpreRs Company.
, .
�FORM 370•VA.
SOUTHERN EXPRESS COMPANY
(Inco rporated)
'l
SPECIAL LIQUOR
- - - --'------="-- 191 _
Consignee
1/.
Affidavit No., _ _ _ _ __
-- - ---='-------'. . ::__--~--'~r --~-'-'~ - - --~1-=----- -..,.-,c'---,- ~-+----~tl1-+
lbs. ,(
c__,._
.Advsucea to
Coll ect
>1 / j if
_ __ __
Arlrl
Oud e rc barge
PREPAID
J
To Shipper _ _ __ __ _
AFFIDAVIT FOR ARDENT SPIRITS' FOR PERSONAL USE,
(ova:a)
_ _ __ _ _ __
�delivered to me by the Southern Express Company, from _____ _____ ____ ; that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirils so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation o~f law .
Sworn to and subscribed before me,
this _ _day of _
(
, 191_,
~~~~
Ae-eni for Southern Express Company.
�foRM 370•VA ,
SOUTHERN EXPRESS COMPANY
(Incorporu.t od )
To Shipper _ __ _ __ _ _ _ __ _ _ __
AFFIDAVIT FOR ' RDENT SPIRITS FOR PERSONAL USE,
(OVIIR)
�- ~ F~D,,IT ,FOR
SPIRIT S FOR
PERSO NAL USE
STATEfe/6.i,~~_,
,·
COUNTY OF
- ----,LI - - - - - - - \ - - - - = , : _ __ _ _ _ _ _
being duly sworn, depose and say that I am
sp cified on other side of this form, this day
_ _ __,.
__ ; that l am not a
e by the S~uther n Express Compan y, from _ _ ____ ___ ____
delivere
th at the ardent spirits so received by me
student or minor, and, if a female, I am the head of a family;
not, within the thirty days previous
have
I
that
and
were brought into the State on my written order,
onor from any place whatsoe ver, i_n
pe
any
from
ver,
whatsoe
kind
any
of
spirits
ardent
hereto, received any
Assemb ly of Virginia , approve d
ral
Ge
the
of
Act
the
of
ns
excess of the quantity allowed by the provisio
by me are for my own use, at
c
spirit
ardent
the
that
and
law,
to
contrary
or
March 10, 1916,
law .
of
ation
vio
in
used
e
not
will
my own home, and that the said ardent spirits
Sw~~ore-::7
•~
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/
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~
Consh1nee.
7 / , ~,R ~
Aeen, for Soutp ern Exvress Company ,
~;,~
�SOUTH ERN EXPRES S COMPA NY
(Inco rporated)
SPECIA L LIQUOR " RECOR D
'- ---~"- ----
- - - - - - - -- Amount _ _ __ ~ - - - ~-WeightL
---~ ---'-/-_
_/_:___
_ 19 1_
Advances to
Collec t
RECO~D OF NOTICES.) /
To Consignee
/
1
I
/
J2
From~ -
- --
EXPRESS CHARGES
PREPAID
_/-=---/_
Jt
-~_ _
Add
Uude rcbnrge
To Shipp er_ _ _ __ _ _ _ _ __ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE,
( OV l:R)
__,l bs.
�,PE,Rs'o NAL USE
delivere d to me by the Souther n Express C
- - - - - - -· - - - - -- - ; that l am not a
student or minor, and, if a femal e, I amt head of a family;
th at t he ardent spirits so received by me
were brought into the State on my written order, and that I
h ave not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spiriis
so received by me are for my own use, at
my o= homo, ond th,I th, ,oJd ...... , • .,... will
ho oo,d in ''"'•"· · of low
F
·o
Consi1rnee .
Ai:ent for Southern E.xt>ress Company ,
�PREPAID
RECORD OF NOTICES
To Consionee _ _ _ _ _ _--1~•~_,--f--1---f. _ __
To Shipper _______________ ___
DENT SPIRITS FOR PERSONAL USE.
( OVER )
�FOR ARDENT
L USE
--~<---- -f=--- - -~ ,c__~::::__- - -- -- ---'lc""''
being duly sworn, depose and say th at I am
~pacified on, other side of this form, this day
me ythe Southern Express Company, from _ _ _____ ____ _ __ ; that
I am not a
· or, and, if a femal e , I am the l:tead of a family; that the arden t spirits so received
by me
were broug t into the State on my written order, and that I have not, within
th e thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by th e provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, ifr contrary to law, and that the ardent spirits so received by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law
.
ta:c7;: t ,
Swor t-nd subscribed before me,
t-1
'-
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n---d ·.
19L,
;\gen~ for Southern Express Company.
t3
Oonsi2nee.
�/'ORM 370-VA.
G
Add
AdTaocee to
Coll ect;
PREPAID
Undercbarae
To S~i pper _ __ _ _ __ _ __ _ _ _ __
AFF"IDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
\
(OVER)
�·- --- -- -~====~~~-~ - ~ ~------ --------- -- -~•-..r-t
-
. / .( / ]A) FIDAVIT:OR A"
USE
ENT ~ PIRITS
STATE':, ~>,,/~
· ~ {._~ /4..,.,,,.~.(,,,L J
COUNT~YJZ
1.:?-~
. ,:J ~ - ~
vf/l/ir1- Ufv
(\
·
I, - - - - - - - - - - --- -=--=c....--""-"''----
- - - being duly swornl depose and say t hat I am
the consigllee of a ceftain shipment of ardent spirits, as specified on ot!i,e .sid~ 'of t his form, this day
delivered to me by the Southern ExpreSs Company, from
• ; that I am not a
student or minor, -and, if a female, I am the head of a family; that the ardent spirits so received by me
were brougM into 1he State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violat ion of law .
l
Sworn to and subscribed before me ,
Ar; ct . .
V
tiQJ),,-t- A
Consie-uee.
�F"oRM 370.,.V A • .
Consignee - - -~- --""~ ~--" ---c
r-?- c~=
l"'"- ----~ -~~- ~--- '-----
- ~ - - - - ~ -- - - --;1~~'- l\moun
I~ I
I
6
)
----c----=- - -
-,------- '--- -~-
/
191 _
I
()
To Shipper _ __ __ _ _
7
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONA L USE,
( OV ER)
I·
_ _ __ __ __
�delivered to me by the Southern Express Company, from _ _ __ _ ____ ______ ; that l am not a
student or minor, and, if a female, I am the head of a family; that the ard ent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are for my own use, at
/
/
my own home, and that the said ardent spirits will not be used in vio ation of law.
71£&
t1,· J
~u;f, t~1kt-1--j/1
�FORM 370•VA
SOUT HERN EXPR ESS C-OM PANY
( lncorpor nterl)
LIQU OR
Kind of Ard ent Spirits_
Way-Bill No.
_ .;;;;-~~~-=--+--~__,_=--"c...-...--'--'-___
f _ _Dote ~-~
Amount _ _ --,-£.~ -=-___:_...p==---->= !!
- - -- ~--~
/ --'~- /
0
Aclvnn<"e8 to
Coll ect
,,
EXPRES S CHARy ES
COLLEC T
A<ld
Uuile r chnrge
RECO RD OF NOTIC ES
To Consignee _ __ __ ~ '---' _...,_,___,_ _,
____
To Shipper _ _ _ _ _ _ _ _ _ _ _ __ _
__
(OVJtR)
�FOR PERSONAL USE
STATE
COUN'l
eing duly sworn, depose and say that I am
ecified on other side of this form, this clay
delivered to me by the Soul; Eirn Express Company, from,~--- - - - -- - - -- ~ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that t he ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be usea in violation of law .
.
Conshtnee.
�- -- --- -- --- ~
FOAM 370•VA ,
SOUTHERN EXPRESS COMPANY
( 1 ucorpo r at ed)
06
Affidavit No . _ _ _ __
Advn n cee to
Collect
PREPAID
RECORD OF' NOTICES
Add
U ud e r chn rge
_ _ _ __ _ _ _ __ __ __ _
To Consion ee _ _ _ __ _ _ - - - - , C -~ ~ - - - ; L - To Shipper
/
AFF'IDAVIT FOR ARDENT SPIRITS F'OR PERSONAL USE.
(OVEtl.)
�- - - - - - = - - - ~=----- -~>"'- +------ -, being duly sworn,
depose and say that l am
' e of
the consigne
speci~ed on other side of this form, this day
delivered to me by the Southern Express Company , from _ _ _ _ _ _
_ __ _ _ ___ ; that l am not a
student or minor, and, if a female, I am the head of a family; that the
ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received
by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation
of law .
.
a L 1J( ot c.-U✓Ja Ii,
f
A11en, for Southern Express Company,
Consi11nee.
�SOUTHERN EXPRESS COMPANY
FORM 370-VA .
GROTTOES.
(Ipcorpo rat e d)
o
VA . SPECIAL LIQUOR RECORD
Affidavit No.__
l
_ __
Kind of Ardent Spirits_ _ _ _~ - -- -- ~ - ~ - -Amount_ ---,.-._ _ __ __ _ Weioh ~ ___ lbs.
Way-Bill No. /
To
l
/
/
J/ I (
- --
- ~- - -- - 191~
GRO f
Ad vo.nce e to
Co ll ect
From _ _ _ _ _ __ __
EXPRESS C H Al<GES
PREPA ID
Add
Undercha rge
Shi;-7
_ _ _ _ _ _ _--,-_ ____,--------=c-; - : - - -
To Shipper _ _ _--0'-------- - - - - -- - - -
(O \'l!R)
�FOR PERSONAL USE
STATE
COUN
of ardent spirits, as
l"
·delivered to me by the S.outhern Express Company, from ___ _ __ _ __ _
____ ; that I am not a
student or minor, and, if a femal e , I am the head of a family; that the ardent spirits so received by m e
were brought into ihe State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from 'any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of ·the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me .a re for my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw.
Consignee.
�---------...,.,..--.,-----------
--- --------------------- ----- ~
SOUTHERN EXPRESS COMPAN'l
l'ORM 370-VA.
Gfit. TT
(locorpora&ed)
1•
!=v.
SPECIAL LIQUOR..-SRE b
Received at _ _ _ _~ - -~,-,-,._"
"'
( ~~~
Consignee - - - ~Kind of Ardent
Date
_,
c;,...,,
- -+--+---- -- - ~~ ~,___ _,._ _..,mount _ _=
Way-8ill No,_ _ __ _ _ __ _ Date _ _ _ _ _
To
c7---F-/
___,_____
I
,/
/6
Affidavit No._ _ _ _ __
7
~(_ ___ ,-;-----
-----'--ci- - ---19✓
AdT8DC81 t,o
Coll ect
P R E P AID
";"~ 1-c
RECORD OF NOTICES ~ /
To Consignee
_
'
To Shipper_ _ _ _ __ __ ____ __ _ __ _
ARDENT SPIRITS FOR PERSONAL USE.
( OV E R )
\
�----- --- - - ---- - - -~ -- - -- -------- ~
--- ----- - ~ - --- --- -
FOR PERSONAL USE
.delivered to me by the Southern Express Company, from ________~ -..i..- - - ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in· violation bf law.
Consi2"nee.
Sworn to and subscribed before me,
Agent for Southern Exv·ress Comv,mr.
�FORM 3 70-V A.
SOUTHERN EXPRESS COJ\fPANY
(Incorpo r ated)
/
SPECIAL LIQUOR RECORD
I
/
;
Affidavit No._ _
Advnncc e t o
Collect
0
I
Add
Uuderc h nrgo
PREPAID
I
To Shipper _ _______ ___ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(ov,rn)
�~FFID~'(I~ FOR A R / T SPIRITS FOR
~TATE
r1{~i~r-lt-~ ( /f,{_._,~{(__,,/L,t.A~
OUNT ~
-
JJ' ,. , .·---r/ •• , • / •;
~,V
~, ·· · ., ·,., ;.. .,;;/..,,/
PERSONAL USE
-
r( ' .,,,
t,,:;/ ~ ~~
, being duly sworn, depose and say that I am
the consignee of a certain shipfu ent of ardent spirits , as specified on other side of this form: this day
delivered to me by the Southern Express Company, from
,
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent sp irits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or froi:µ any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly ·of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
Consignee.
·- ~ ;;±--i,.--, 191_
){du/4).
A~ent for Southern '
vress Company.
�fORM 370-VA.
Affidavit
______
No.d
Consignee - - - -- - :Z..-"'c:...J=~- - - - -- - - - - ----"'---- --~---- -- -~f'-----~,_,.~~-- - -- - - + - - -I- - Amoun ,.__ _ _ _ _ _~_,,,,"---Weiah/ /
-
-
-------"'---- Date_
_
~
-'--;_) _,,):..____ _ 191
_ /,
AdTDDC81
'7
/
to
ColJect
RECORD OF NOTICES
To Consianee _ _ __ _____---'-"'-----
/
A~d
Undercbaa-19
-..._
I---'--
- - ----1-
AFFIDAVIT FOR ARDE l
./4 Jf
To Shipper _ _ _ _ __ _______ __ _ _
' SPIRITS FOR PERSONAL USE.
(OVKR)
�------------- --- -----~---------~----------------- ------FOR ,RDENT
~~
. SPIRITS FOR
S T ATE OP
PERSONAL USE
VJ
COUNTY O~'-----=---""'711'--="1-"'' - -r-'-J./-
I, -----='--'"""''-----II''---"''-----.!..__""'--= - " ' -~ - - -- - - - - , being duly sworn, depose and say that I am
_t he consignee of a cert ain shipment of ardent spirits, as ~pacified on other side of t his form, t his day
delivered tome by t he Southern Express Company, from _________ _ _ ___ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into t_h!l_ State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the Gene~al Assembly of Virginia, approved
March 10, 1916, or contrary t o law, and that the ardent spirits/So received by me are for my own use, at
my own home, and that the said ardent spirits will not be u et. in ~ lation of law.
I
Consi2nee .
)'\.k:.,...:2.,
~
Aeent for Soutftern Express Com1>any.
"--
z~
=,,-·-~
wc~~YL
�FORM 370•VA .
~f
Affidavit No._ _
Add
U ud e rc-hnrge
J
RECORD OF'
To Con sign ee _ _ _ _ _ _____- - ' - - ~ F - - - - + - - To Shipper _ _ _ _ _ _ _____ _ _ _ _ __
(OV ER)
�DENT SPIRITS FOR
PERSON AL USE
- ---'------ =,......,,= "-·-'---- -'---=='--=--=--- , being duly sworn, depose and say that
I am
S}lelJified. ,o n o her side of this form, this day
delivered to me by the Southern Express Company, from _____ _ __ _ _ _
~ - - ; that I am not a
student or minor, and, if a female , I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not , within
the thirty days previous
hereto, received any ardent spit-its of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of th e quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are for my own u se, at
my own hom e, and th at the said ardent spirits will not be used in violation of law.
Consienee,
�FORM 370-VA.
SOUTHERN EXPRESS COMPANY
( lucorporat~d)
To Shipper _ _ _ _ _ _ _ _ _ _ __ __ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PER!;?ONAL USE ,
( onk)
�/ '/'F'FIDA
/T
F'OR ARD(T SPIRltS FOR PERSONAL USE
·' y\.._...-(1
-e
~ '-'
, being duly sworn, depose and say that 1 am
s specified on o1her side of this fo1·m, this day
~ r n :~n;J>fj;rde t s
urottoes, Va.
s~J~ ( e '.
;
delivered to m..:n-.#'tt#\
a , from
that I am not a
student or ~ or, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brou t into the State on my written order, and th:it I have not, within the thirty days previous
hereto, received any ardent spirits of any kind wliatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to Jaw, and that the ardent spirits so received by me are for my own use, at
my own hom.e , and that the said ardent spirits will not be used in violation of law.
1
<Joush:uee.
"'
l
1
I,
Acent for Souther11 Exoress Oompauy.
�SOUTHERN EXPRESS COMPANY
FORM 370--VA.
•
rr
(Incorporated)
' _ _'---,..-~-.L..._~-·-'-1--~-Received .at _
Kind of Ard ent Spi ri; s- - F - - - -- ~ -'----~c+---r'----Way-Bill No· -- -- --==----'--
To
-1)
Shippe ·Y f r t /
T
Advnn ce1 to
Collec-t
Add
PREPAID
U ud e rc harge
1
RECORD OF NOTICES
t,
To Consionee _ _ __ _ __:_/~_c__..:...:;__,:___
__;__
To Shipper_ __ _ __ _ _ _ __.,~ - - -
/
(OVER)
�IDAVI~ FOR A " T SPIRITS . FOR PERSONAL USE
STAT
COUN
"t(,.(~ ~
i ~
1,/lf O ~ ~ l y sworn, depose and say that I am
~
:_'-;,
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from ____ __ _ _ __ ____ ; that l am not a
student or minor, and, if a female, I am the bead of a family; that the ardent spirits so received by me
were brought into the St ate on my written order, and that I have not ~ within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, fro'!l any person o~ from any place wliatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiril.s so received by me are for my own use, at
.
my own home, ·and that the said ardent spirits will not be used ln viol"ation of law.
\>-('~ ~~
.
Sworn to and subscribed before me,
11~,·191_ ,
v.. . . . ,. .,---==:
7t t1
It
\
1~
Aiient for Southern Exvress Comvany .
I
Consi~nee.
�To - - -- -- - - -~ ~ ~ - - - - S
Advances t o
Collert
EXPRESS CHARGES
PREPAID
Add
ip~ef-- -- - - ~ ~ -- - - - - ~ -
v
I
/
)
To Shipper~•-
I
- - - - - - - - --
AFFIDAVIT FOR ARz : T SPIRITS FOR PERSONAL USE .
( OVER)
Uude rrhnrge
COLLEC 'f
- - - --
�SPIRITS FOR
PERSONAL USE
~, ---+-,,...="' ---L---'---- - - - - -- - -~ - , being duly sworn, depose and say that I am
of a rd ent spirits, as specified on other side of this form, this day
e by the Southern Express Company, from _______ ·- - -~ -- - i that I am not a
student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by me
were brought into t he State on my written order, and that I have not , within the thirty days previous
h ereto , r eceived any ardent spirits of any kind whatsoever, from any person or from a ny place whatsoever., in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or ·contrary to law, and that the ardent spirits so r eceiv:lid by m e a re for my own use, at
my own home, and th at the said ardent spirits will not be used in violati~ of law.
rioni,,,to. n~
thi~ -
V
~~
SU
day o
I -
Consignee.
scribed before me,
~ 17
,191 _
{/ /(
A
(
• (
1
i
Agent for Southern Expres s Compan y.
�FORM 370•VA ,
SOUTHERN EXPRESS COMPANY
{Incorporated)
.Advao ce e to
Colle ct
Arlrl
Uud e rc ba rR e
PR E PAID
To Shipper _ __ _ _ _____ _ __ _ _ __
AFFIDAVIT FOR "
ENT SPIRITS FOR PERSONAL USE.
,.
(ov1111)
�DENT SPIRITS FOR
PERSON AL USE
;J--
"'!t-'1-
.
_:.,e...=::...::=:. . . , = =c.. ., .e::=-- -...:_-=--=--=-=--- -, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side
of this form, this day
delivered tome by the Southern Express Company, from _____ __ _ ____
_ _ ; that 1 am not a
student or minor, and, if a fema le , I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, witb,in
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that t he ardent spirits so r e c ~ nfe
y ·are for m y own use, at
my own home, and that the said ardent spirits will not be used in violati
.
,
~J-q t[ /')
Swr;f
andsu
t his__:~~ ~ ;,:_-½:~ --)
'
"
~
Consienee.
�F"ORM 370•VA.
Advouce s to
Colle(: t
PREP AID
COLL ECT
Adrt
Uud e rc ba rge
J
To Shipper _ _ _ _ __ _ __ _ _ __ __ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE.
I
(OVl:R)
�FOR PERSONAL USE
I am
,--....,_-=------ - -- - - - -- - ------- -->.-, being duly sworn, depose and say that
pacified on other ~i1e of this· form, this day
_ _ ; that lam not a
delivered to me by the Southern Express Company, from _____ ___ _ .,..,..,c-;-_
so received by me
spirits
ardent
the
student or minor, and, if a female, I am the head of a family; that
days previous
thirty
he
t
within
not,
have
I
that
and
order,
written
my
were brought -iµto the State on
any pla·c e whatsoeve r, in
hereto, received'a ny ardent spirits of any kind whatsoeve r, from any person.or from
of Virginia, approved
excess of the quantity allowed by the provisions of the Act of theGenei a::A~sembly
are for my own use, at
March 10, 1916, or contrary to law, and that the ardent spirils so r ll.QJl· d by me
,
· !J,W. /
my own home, and that the said ardent spirits will (,'.!be Used in viol , ;
l
Sworn to and subscribed before me,
-+~..__.7__ , 191_ .
t~ ~~ A?
A119nt for S olthern Express Company.
~
..
�SOUTHERN EXPRESS COMPANY
(In co rporated)
SPECIAL LIQUO f!
1
EC
RD
7
- - -----+---------+-- ~ - -- •ate_-+-~ - ~ -19 1_
Co nsig nee
-
GI
Affidavit No.___ _ __
- ~ ~ -- - - '=-=;:...-,:. '--'-=---=----=---------,, - - - - - - -- - - - --
"""""'-- -=---------.J-----,,--{mo unt._~_ _/_ _
- -----,~"-/-
~_ _ _Weio hL .2f-
___.,___-----'1/
---~~1Advnnce e t o
Coll ec t
PRE PAID
_
lbs.
I
CO LL EC T
A ad
U nde r<' h urge
ti
To Shipper_ _ _ _ _ ______ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(ovn)
1/
�FOR
PERSONAL USE
~, - - - ~- ---~ - -- -- -- - -- - - - -- , being duly sworn, depose and say that I am
the cons igz of a certain shipment of ardent pirits, a · specified on other side of this form, this day
delivered to me by the Southern Express Company, from _ _ _______ __ _ _ __ ; that I am not a
student or minor, and, if a femal e, I am the head of a famil y ; that the ardent spirits so received by me
were brought into t he State on my written order, and t hat I have not , within the thirty days previous
hereto, received any ardent spiI·its of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at · ·
my own home, and that the said ardent spirits will not be used in violation of law.
rJ
Consignee.
Ag-011 t for S~u?i:a;; ~~xpress Uompan.).
�SOUTHERN EXPRESS COMP.AN'?
,oRM 370-VA.
( lucorporMed)
SPECIAL
Affidavit No
Advaucee to
Collect
;:;
A~d
PREPAID
Underchar11e
RECORD OF NOTICES
To Consignee _ _ __ _ _---'-"-+-
+-''----'-- - -
To Shipper _ _ _ _ _ _ _ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�r--
------ --- - -- - -- ---- -- --- - - -- - - -------------
FF; rVIT\ FOR
ff DENT
SPIRITS FOR
PERSONA L USE
J ~-\_ ~
r;7f1J..~/.f.: /,f./J t.A.COUNTY
"' L/ '.
-~--c. · '..__/ ,<_ ~·· -t // /
,
·
I,
the ~-onsi?nee of a certain shipment of
'
"
~l ' _, being duly sworn, depose and say that I am
spirits, as s_pecified on other -side of this form, this day
I am not a
delivered to me by the Southern Express Company, from _____ ____ _ ~ =- - i that
by me
student or minor, and, if a female, I am the head of a family; that the ardent spirits so r eceived
previous
days
thirty
the
within
not,
have
I
that
and
were brought into the State on my written order,
in
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
approved
Virginia,
of
Assembly
General
the
of
Act
the
of
excess of th e quantity allowed by the provisions
own use, at
March 10, 1916, or contrary to law , and that the ardent spiJ'its_,so received by me are for my
law.
of
iolation
c
sed
be
not
will
my own home, and that the said ardent spirits
Consialnee.
Ae;ent for Southern Express Company.
�FORM 370•VA .
SOUTHERN EXPRESS COMPANY
(Inco rporated)
SPECIAL LIQUOR RECORD
- - ~- ~ - ~ ~ - - -------r'---+'"-' OJate _ _ __ __ _
Advauces to
Coller t
EXPRESS CHARGES
PREPAID
COLLECT
RECOFID OF' NOTICE
)
To Consia nee
To Shipper _ _ _ __ _ _____ __ __ __
/
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(OVIC R)
�SPIRIT S FOR PERSO NAL USE
__ ; that l am not a
to me ·by the Southern Express Company , from ____ ____ ____
so received by me
spirits
ardent
the
that
family;
a
of
head
the
am
I
or minor; and, if a femal e ,
within the thirty days previous
not,
have
I
that
and
order,
written
my
on
State
the
into
brought
were
or from any place ~hatsoev er, in
hereto, r eceived ~ ny ardent spirits of any kind whatsoev er, from any person
of Virginia, approved
Asse1:p.bly
ral
excess of the quantity allowed by the provision s of the Act of the Ge
e for my own use, at
a
ni~
by
ived
'li9tf·
spirits
qent
a
the
that
and
March 10, 1916, or contrary to law,
my own home, and that the said ardent spirits wt t ; / ; (t jn \~
efore me,
ti
A119n, for Southern Express Company.
;;t
~to; u /d {
ili
4{
1
Jt_
'1-:>,u.,.. .1- '2.-C-c:,
fi:c!.~
Cooru~.. { _
�(lncorporMed)
SPECIAL/ LIQUOR !
'- -- -~
Consianee - - - -~ ~ - - - -
_
/.__Date
- -/_ ,/____,
ECORD
1/
2-- -- -'--- - -- - - - ::..::.__ _!,=;:.-- - - -- - - -- - - -
1/
Way-Bill No·---- - ----"----
To
Mf"AN"J
SOUTHERN EXPRESS C
,oRM 370-VA.
/
19,l
Ad...-ancea to
Collec&
/
Weich
Amoun
,
r
From
EXPRESS CHARG&8
PREPAID
COLLECT
A~d
Uoderchar1e
Ship' r~ - - - ' - - - -- -"-+---'-,;- --,'-----,'--,--~ -~
If
RECORD OF' NOTICES
To Consiane·e
)
To Shipper ______ ______ ___ _ _ _
AF'F'IDAVIT F'OR Az ; ;T SPIRITS F'OR PERSONAL USE.
(OVIIR)
�-- -- ---- - - - --- --,, - - - - ---- -- --- - - - -- - -- - - - -- - -- - -NT SPIRIT S FOR PERSO NAL · USE
, being duly sworn, depose and say that I am
.
I,
on ot her side of this form, this day
specified
as
the consi_g_rie~ of. a certain ·shipme nt of ardent spirits,
____ _ __ ___ ; that I am not a
delivere d to me by t he Souther n Express Compan y, from ____
the ardent spirits so received by me
that
family;
a
of
head
he
t
am
I
female,
a
student or minor, and, if
withtn the thirty days previous
not,
have
I
were brought into the State on my written order, and t hat
or from any place whatsoe ver, in
person
any
from
ver,
whatsoe
kind
any
of
spirits
hereto, received any ardent
ly of Virginia , approve d
Assemb
General
the
of
excess of the quantity allowed by the provisio ns of the Act
are for my own use, at
me
by
received
so
spirits
ardent
the
hat
t
and
law,
to
March 10, 1916, or contrary
,
law
o
2
n
violatio:
in
be,1ised
my own home, and that the said ardent spirits will not
/·
,do
A&:ent for Southern/ir.xvress Comv11ny.
1
�------- -----~- ----·----'---·- -------- -------- --·-,oRM 370-VA.
SOUTHERN EXPRESS COMPAN"l
(lucorporMed)
AdvBl.lcee to
Collect
A11d
!'REPAID
Uudercharao
To Shipper _ _ _ _ _ _ _ _ _ _ _ _ __ _ _
SPIRITS FOR PERSONAL USE .
(OVER)
�- ------- -- - -- --- ----- - --DENT SPIRITS FOR
FFIDAVIT FO ~ "
S TATE
COUNT
;i /.. . -:,c . 9(i<_,:t,,,,. t,.._
,
, ,,
/ ~'-
,;/
~
'l,,/\.. ..-,,i.°' l..,;-l .._ ,._
I,
the consignee of a certain shipment of ar
,, ;
PERSONA L USE
·
______ ___ ______ ; that I am not a
delivered to me by the Southern Express C
that the ardent spirits so received by me
family;
a
of
head
he
a
I
female,
a
if
student or minor, and,
previous
were brought into the State on my w tt order, and that I have not, within the thirty days
in
soever,
what
ace
pl
any
from
or
person
any
from
;
whatsoever
kind
a
o
spirits
ardent
hereto, r eceived any
provisions of the Act of the General Assembly of Virginia, approved
excess of the quantity allowed by
own use , at
March 10, 1916, or contrary to law, and t hat the ardent spirits so r eceived by me are for my
my own home, and that t he said ardent spirits will not be used in violation of law.
Cousie-nee.
Sworn to and subscribed before me,
(
Ai.::en t for Southern-'Exv r8ss Comvany.
�SOUTHERN EXPRESS COMPANY
FORM 370 • VA .
(Incorpo rated)
(~ ..if
Received at _ _ _ _ _ _-=-''--~ - - - - ~ -
RECORD OF NOTICES
EXPI!ESS CRAI!GES
Ad vn.n ce a to
Co ll crt
P REPAID
I
I
COLLECT
1J
Add
Uu de rc harg e
I
::
To Consignee _ _ _ _ _ _ ---"- "-------=- -- -_j_.,___
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVS R)
�AFFIDJWIT FOR ARD.C h SPIRITS FOR
~ .,
ST
(
·- ·
Co
d·'.A_✓
I '
,
' .
,'
/
tf .:
,,11/ Pl.--.
- • 7
·
c ,.,_,..,;
,I
A
PERSONAL USE
•
~ (= (
~
being duly sworn, depose and say that I am
I,
on other side of this form, this day
specified
as
spirits,
ardent
of
shipment
certain
a
of
the consignee
delivered to me by the Southern Express Company, from ______ _ _______ ; that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirils so received by me are for my own use, at
f
my own home, and that the said ard_ent spirits will not be used ; viola,
•
/
6. '/
Consie-nee.
Swo ) to and subscribed before me,
thi ___day of.~-~-- , 191_
I
Apn• for Southern .Exvress Company.
�FORM 370•VA .
1
Affidavit No . _ ~ - - - -
/
/
s.
~
Advsuce a t o
Co ll ert
RECOR D OF NOTICE S
EXP R ES S CHARGE S
PRE P A ID
Add
Uud e rr. b urge
To Shipper_ __ _ _ _ _ _ _ _ __ __ _
To Consionee _ _ _ _ _ __
J
NAL USE.
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
(ovsa)
�FOR PERSONAL USE
✓/
. /,, /
_ _,,,~-==---------'=--------- 1-------""-' , being duly sworn, depose and say that I am
specified on other side of this form, this day
______________ ; that l am not a
student or minor, and, if a female, I a
e ead of a family; that the ardent spirits so received by me
were brought into the State on my w · ten o der, and that I have i:iot ; within the thirty days previous
hereto, received any ardent spirits o any ki whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by t e pro sions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law,
that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used i 'il'.i~ of law.
.
't
t; 1&j (
•
J,,.,, 7
e before me,
Aeent for Southern EX1>. 1ess Company.
"''
r
J
t/
Consienee.
�FORM 3TO•V A
TT-
__,,___ _ _ _ _ _ 19 1_
A rhnnres to
Collect
RECORD OF NOTICES
/.
I
__
To Consignee ___ -------~~ --~_--.,/ ./
AFFIDAVIT FOR AR Z
From ____ _______
EXPRESS CHARGES
PREPA ID
COLLECT
Add
Under c hnrge
To Sh ipper _ _ _ _ __ ______ ______
T SPIRITS FOR PERSONAL USE .
(OVER)
�NT SPIRITS FOR PERSONAL USE
a cert~in::shipm ent
' ·. ,
me by the so'uthern Express Company, from
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or fr.om any place whatsoever, in
excess <;>f the quantity allowed by the provisions of the Act of the Ga-p-eral Assepibly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spi1:its sQ.receiv~ d by me are for my own u se, at
my own home, and that the said ardent spirits will not b~ us~d i~ 1~J~ iqn of Jaw .
· .'• {
r_ \ /
t!
;\geut [or Southe
�w
=.. -=
=-z
m as
::a
£¥&
SOUTHERN EXPRESS COMPANY
{ lncorporo.t.ed )
R i'oRD
SPECIAL
Kind of Ard ent pirits_ ~ - - - - - - - --+--~c-i'-c--L-
;:•·BIII No.
t
'-
••-n-ce-,-,o_] g J /
- - - - 4 - - - ' ----=A=d=-
A dd
Co ll ec t
h' pe
EX PR ESS CHARGE S
P REPA ID
COLLECT
Uu de rc hu.r ge
_ ----""""'..,_-'~,-,._~..--+---=~
__
_){
RECORD OF
To Consi cn ee _ _ __ _ __
=___.,,_~--~ -- -
To Shipper _ __ _ _ _ _ _ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(ovn)
�SPIR ITS FOR
PER SON AL USE
;r ,
STA
/
.
I am
- + - - • being duly sworn , depos e and say that
I, - - -- -- ~ - ~ - - - - - - - - - day
this
form,
this
of
v·<hi
er
•.-0s
"tied~u
et
s
, ·as
of a certai-n shipm ent of arden t spirits
l
L
. the consig. nee
,
·
·
. .
'- •
'
.
. . . U1 ' i I
that l am not a
·.
any, from ___ ___ ___ ___ __ ;
delive redt o me by the South ern Expre ss Comp
ed by me
receiv
so
s
spirit
t
head of a family ; that the arden
stude nt or minor , and, if a femal e, I am the
previo us
days
thirty
the
within
not,
have
I
that
order, and
were broug ht into the State on my writte n
, in
oever
w~ats
place
any
frorp.
or
n
whats oever , from any perso
hereto , receiv ed ·any arden t spirit s of any kind
appro ved
ia,
Virgin
of
bly
Assem
al
Gener
the
of
Act
ions of the
exces s of the quant ity allowe d by the provis
my own use, at
the arden t spiri1.s so receiv ed by me are for
March 10, 1916, ·or contra ry to law, and that
.4_
law.
of
ion
violat
in
used
be
not
s will
my own home, and that the said arden t spirit
~
Sworn to and subsc ribed before me,
thf F
Ai:en, for Southe rn Expres s Compa ny.
-{
J~
CA ,.// /
Consienee,
�SOUTHERN EXPRESS COMPANY
FORM 370•VA
(l ucorporntt,d)
Affidavit No._ _ __ __
Consion ee _
= - - --
- - -- - ~,1-/_
--L--;,.:_;;~~-'--'' -'-'---'-~---=------ -,-----,.--·-
- - - - - - - - ~ ~ --
Amoun ~ - - - ' - - - - --,,<-7-c--Weioht= - t - ' lbs.
_ _ _,,___ _ _ __ _ 19
Arlvnnree to
Collect
To
I
RECORD OF NOTICES
To Consignee _ _ _ _ _ __ ~.,._~~-
lL
From _ _{_ _/_
EXPRESS CHARGES
J>REPAID
COLLEC T
I
·1 1
1
_ ~ --Add
Onde r cbt1.rge
I
To Shipper _ _ _ _ _ _ _ __ _ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OV ER)
�= - - - - - - -- -:.......i'----"=- - - - - ---1-- - - - , being duly sworn, depose and say that I am
specified on other side of this form, this day
delivered to me by the Southern Express Company, from~--- - - - · - -- -- -- ; that I am ne t 11
student or minor, and, if a female, I am the head of a family; that the ard ent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or frem any place whatsoever, in
excess of the qnantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so r·e ceived by me are for my own use , at
my own home, and that the said ardent spirits will noi be used in violation of law .
.,
subscribed before me,
y f
1917 ,
tA..
191_
,
ltil
;\geu\ for Southern Exvress Company.
�~
-
___________________________ ___
F"ORM 3 7 0-VA.
.,..,.,,,_..,,,,~- - - --,
..,.__,,,,,...
SOUTHERN EXPRESS COMPANY
(Incorporated)
Advoucee to
Collect
PREPAID
Add
, COLLECT
I
Underc; harge
To Sh ipper_ __ __ _ _____ __ _ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�STATE
COUNTY
; that l am not a
•
e by the South ern Expre ss Comp any, from
receiv ed by me
so
s
head of a family ; that the arden t spirit
stude nt or minor , and, if a femal e, I am the
days previo us
thirty
the
within
not,
have
I
order, and that
were broug ht into the State on my writte n
oever , in
whats
place
any
whats oever , from any perso n or from
hereto , receiv ed any arden t spirit s of any kind
ved
appro
ia,
Virgin
of
bly
Assem
al
Gener
the
of
ions of the Act
exces s of the quant ity allowe d by the provis
at
use,
own
my
for
are
me
the arden t spirit s so receiv ed by
March 10, 1916, or contra ry to law, and that
law.
of
lation
vi
in
s will n°J/J used
my own home, and that the said arden t spirit
.
~
- .
t)f -
Consii nee.
Aien\ for Southl rn EXl)ress Compa ny.
�FORM 3TO•VA.
SOUTHERN EXPRESS COMPANY
(Incorpo rated)
SPECIAL LIQUOR RECORD
Date
19 1_
A_
Affidavit No.
1
-" bs.
Weioht _ _ _ _,
Ki nd-of Ard ent Spir!ts_ ~ - -- -- -----'---.,,,...,,,_
- - - Amount
Way- Bill No,_ _ ___,~_ _ _ _ Date_ _ _ __ _ ~ - - - -- 191_
To _ _ _ _ _.~---'--..;,._-'--- --'-------'------
Advsucea to
Collect
I
From
EXPRESS CHARGES
PREPAID
COLLECT
l
To Shi pper
( OVII R)
Adrl
Uud e rr.harge
�I
PERSO NAL USE
SPIRIT S FOR
I
STATE OF
Cou~TY 01';_::;y. -',_,...-..., ;,.'<7'~-= :-.,/-~
-ff_,._,,....,.._,__----'------'= '"""''----=-J'-.....:,= ~='-.....:,...,_==-•
as
being duly sworn, depose and say that I am
of this form, this day
~ ~ ther
.!~ecJ~~~
s ii¥\J~
; that 1 am not a
•
•
l -~'
delivere d to me by the Souther n xpress Compan y, from ,
received by me
so
spirits
ardent
the
that
family;
a
of
head
the
student or minor, and, if a female, I am
days previous
thirty
the
within
have not,
were brought into the State on my written order, and that I
ver; in
whatsoe
place
any
from
or
person
any
from
ver,
whatsoe
kind
hereto, received 1:tnY ardent spirits of any
d ,
approve
,
Virginia
of
ly
Assemb
the General
excess of the quantity allowed by the provisio ns of the Act of
use, at ·'
own
my
for
are
me
by
received
so
spiri\s
ardent
the
that
March 10, 1916, or contrary to law, and
in vjolation of law .
my own home, and that the said ardent spirits will no be used
-
A11ent for Southern Express Company .
i.
•
�f"ORM 370•VA .
SOUTHERN EXPRESS COMPANY
(Inco rporated)
-~~-~- o___·
1!l17
Affidavit No.~
Add
PREPAID
RECORD Of' NOTICES
To Consignee _ _ __ _ _ _"- - ~ --
-----,<---
Unde rc ha rge
To Shipper_ _ __ _ __ _ _ _ __ _ __
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONAL USE.
(ona)
�- --+..F--------- ---='----- ----~-'----- , being duly sworn, depose and say that I am
specified on other side of this form, ibis day
~
- - -- - - -·- - ~h~ •~ - - i ibat lam noi a
siudent or minor, ·and, if a female, I am the bea of a family; that the ardent spirits so received by me
were brought into the State on my ;Written order, an -ibat I have not, within the thirty days previous
hereto, received any ardent spirits of a ny kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of 'the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and·that the ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardeni spirits will not be used in violation di Jaw,
1
c.-
-;f- ,I / '
'
t
r
(;(}
t_
Conshtnee.
Sworn o and subscribed before me,
A11:en, for Southern Ex/ress Company.
�SOUTHER N EXPRESS COMPANY
FORM 370-VA .
(Incorporated)
"
SPECIAL LIQUO.'.RJ R
Received a•---~-~ -~~__, __ _ _ _ _
___,_ _
Date__,,.-
1/
~~- HJ L r-
Affidavit ~o.
.___ __, bs,
_ ___ _____ __,t
Add
Unde rc ha rge
Advnuce a to
Co l lect
RECORD OF NOTICES
To Consia nee
~/
I
/f
'
J
I
j
To Shi pp er
=============================--
AF'j DAVIT FOY -DENT SPIRITS FOR PERSONAL USE.
I
(ova:al
V
�PERSO NAL USE
duly sworn, depose and say that I am
---4- ---=- ---"""'-- --- ----+ ---c~ ---, being
form, this day
specified on other side of this
____ ____ ____ __ ; that lam not a
that the ard ent s·pirits so received by me
family;
a
th head of
not, within the thirty days _previous
have
I
that
and
rder,
my
on
were brought into the State
on or from any place whatsoe ver, i~
any-pers
from
r,
ye
hereto, received any ardent spirits of any ind whatsoe
Assemb ly of Virginia , approve d
General
the
of
,4ct
thli
of
ns
provisio
the
by
allowed
excess of the quantity
by me are for my own use, at
received
so
spiriis
ardent
March 10, ·1916, or contrary to law, and that the
ofJaw.
violation
in
used
be
not
will
spirits
ardent
said
the
that
my own home, and
>?
~
onsi11noo.
�,oRM 3TO-VA.
Add
Ad1'8DC68 io
Collect
PR.BP.AID
Uodercharae
To Shipper _ _ _ _ __ _____ _____ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE .
/
(OVIER)
�lRDENT
'OR
I(/ AFFIDAVIT:
S TATE
oJt'nGtf;[I/"
/4
SPIRITS FOR
.
PERSONAL USE
I
~f ..~/
<· ,~f,~_
COUNTYOF \~!:1-:('f!}
/ · ?~
/J Jt: ,, / ;,r//(/&.,V..
'l!! _. ( , ~ b eing duly sworn, depose and say t hat I am
I,
spirits, as specified on other side of this form, this day
ardent
of
shipment
certain
the consignee of a
delivered to me by the Southern Express Company, from ______ ___ _ _ _ _-_; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirit; so received by me
were broug~t into the State on my w1·itten order, and foat . I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and 1;hat the ardent spirits so received by m e are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
7'5'._{/
.
(
Uonsie:nee.
Sworn to and subscribed before m e,
(._ .t
J..
\
(.A
Ae:ent for Southern Ex.9-ress Comvanr.
�FORM 370•V A.
SOUTHERN EXPRESS COMPANY
{I nco rpo r a t ed)
To
I'
Advnuce s to
Colle c t
Shippe /-,---~-----~-,---~--H- -- -
To Consianee
To Shipper_ _ _ _ _ _ _ _ _ _ __ _ __
AFFIDAVIT FOR A'RDENT SPIRITS FOR PERSONAL USE,
(OVl:R)
�/7) _AF7Av1-r.._ FoloE NT
SPIRITS FOR PERSON AL usE
A ..-U-t_
,f
STA,(,o;f~tA✓l/'ff~
--< ~~,...,. :
COUNTY
' ~~ ~
O}'D//
, r:r/L
I , _,,.,,c.-_ -'------'--the consignee of a certain
---'-----'---------
~
being duly sworn, depose and say that I am
specified on o~ er side of this form, this day
-----l-....,.."----,
C ~ TO
;
that 1 am not a
delivered to me by the Southern Expr
spirits so received by me
ardent
the
that
family;
a
of
head
e
female,
a
if
and,
minor,
or
student
order, and that I have not, within the thirty days previous
were brought into the State on my
whatsoeve r, from any person or from any place whatsoeve r, in
kind
y
of
spirits
ardent
any
received
hereto,
of Virginia, approved
excess of the quantity allowed by the provisions of the Act of the General Assembly
are for my own use, at
me
by
received
so
spiri1.s
ardent
the
that
and
law,
to
contrary
or
1916,
10,
March
.
my own home, and that the said ardent spirits will not be used in violation of law
\
Consie-nee.
· ed before me,
A&'.ent for Southern Express Company.
�,oRM 370-VA.
/0
Ad..-ancea t,o
Collecli
Add
PREPAID
Undercharae
To Shipper _ _ _ _ _ ______ ___ _ __
ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
�--
--
T SPIRI T S FOR PERSONAL USE
S T ATE
o
,,> _,,.,, // _./ /'
" '--~> :...,....,-
~?
I, - - - - - - - - - - - - - - - - - - - - -- , being duly sworn, depose and _sa_y that I am
the consignee of a cert ain shipment of ardent spirits, as ~Hified on other side of this form, this day
''TOE •
'r • . ; tha~Iamnota
.deliveredtomebytheSouthernEx pressCompany,from .
student or minor, and, if a femal e, I am the head of a family; that the ardent spirits so recei'.ved by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoev:er, in
excess of the quantity allowed by the provisions of the Act of the General A_ssembly of Virginia, approved
March 10, 1916, or contrary to law, and t hat the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of la.w .
.
Uonsie-nee.
�(
A
....
~
7~
Kind of Ard ent Spi its,_ -r-cc~,..---- -- - ·- --+--=- -- Amoun
'.3
0
Way-Bill No.
_.,
To --+- - - -~'--"- - - -"-~ -- - -- -
{
Shipper
/?t{{
7
191_
Ad..-DUc ea
Collect
'?J(Jlq-e
- - -----'-RECORD OF" NOTICES
17
To Consion ee - - -- - ---'-- -"---- - - /- ~ ,____ _
AF"F"IDAVIT F"OR A
From
to
PREPAID
Add
Unde rchar1e
To Shipper _ _ _ _ _ _ _ _ __ _ _ __ __ __
I
DENT SPI RITS F"OR P ERSONAL USE .
(ovn)
�I,
the con.sigi;iee of , a certain shipment of ardent spirits, as
delivered to me by the Southern Express Company, from ______ _____ ___ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my nwn home, wd lh>t lhe '"" Mdenl, · ·
~JZ~~
f
Sworµ to and subscribed before me,
.... i.J
this ___day o.___ _ _ _ , 191_,
A"ent for Southern Exvress Comvan:r.
~ .
Consi2nee.
�SOUTHERN EXPRESS COMPANY
F'ORM 370•VA .
(lnco rpomted)
SPECIAL LIQUOR RECORD
Advan ce s to
Co ll ec t
EXPRESS CHARGES
PREPAID
A•M
Unde rc ha rge
RECORD OF NOTICES
To Consian ee _ _ __ _____- + - -- - ~- - To Shipper _ _ _ _ __ _ _ __ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVIIR)
�A ~ T S FOR PERSONAL USE
- - - - - - - - - - - -- - - - - - - - - - , being duly sworn, depose and say that I
am
specified on other side of this form, this day
delivered to me by the Southern Express Company, from
'
,
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardeni' spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used. !11--violation of law .
Consi2nee.
A11en, for Sou the Pb Express Company.
�,FORM 370-VA.
GROTTOES. V .
f
U'
Consign ee - -~ - --------,~--r----
~
Received a
- -----~--- 191_
----'-:--~--------"----,--,- - -~ - -~ - --+--
Advonr.e e t o
Co ll ec t
PR EPAID
COLLECT
.Md
Un dc rc·hnrgo
)j
./.
AFFIDAVIT FO
{
~
7.
( I) To
.
Sh ipper _
_ _ _ _ __ __ _ _ _ _ __
ARDENT SPIRITS FOR PERSONAL USE.
(o v~!!)
�• ,/ / ' AFFIDAVIT., FOR Ar ; ENT SPI RITS FOR
op;j/(r.Jlj
STATE
couNTY
,
~:;&
£/A'.&x(A,1
.:"' :, '- _.-LL-
r, A,l
,;:Jc ,.;- • t-- C, r l~--ff '.
u,,· tl / 1L/.~"I
-~ i, ~
·
'
the cqnsign ee of a cert
PERSONAL USE
/j
Z/!.k (~--~ ~.
··
c.., - ~ , being duly sworn , depose and say that I am
_ s ipm ent of a rdent sp irits, as sr ci~ed on ~ther side of this form, this day
~-
delivered to m e by the Southern Express Company, from
·
; that I am not a
student or minor, and, if a female, I am the h ead of a family; that the ardent spirits so received by me
were brought into \he Sta te on my written order, and that I have not , within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any pl ace whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that th e ardent spirit s so rec eived by me are for my own use, at
my own hom e, and that the said arden t sp irits will not b e u sed in violation of law .
./
iT
Swo
-ndif!ubsc, ·
fore m e,
-
this _ ___,
day o~f_- _ _ ___ , 191 _
A,eent for Southe rn Ex1•ress Compauy.
•
I
.i--.,•,
. _ : .. .-;
~-,_
Consignee.,
�SOUTHERN EXPRESS COMPANY
FORM 3 7 0•V A
J
(I nco rpo rated )
;OTT~f
SPECIAL LIQUOR ""IRECORD
Received at, _ ___.,.,'---- --=---'---'-'----- - - - - -Date, _ _ _ _,.___ __ 19 1_
7
Affi davit No.
V
Consignee - ~- ~ ----=---.+---,---,.-+--- - ~ - - - -- -- -- /--,~-cc-,-~~
..~ - - -----''--Kind of Ard ent Spirits _ _ ___,_~_ _ __ ,___.,,,__-----,/~- Amoun ~ - - - - - -__,~-
A d va n r-e s t o
Col lect
PREPA ID
A~d
Und er ch a r ge
RECORD OF NOTICES
To Consignee _ _ _ _ __ _ -,,-_ _ ___,)~--- To Sh ipper_ _ _ __ _ _ _ __ _ _ _ __ _
AFFIDAVIT F9 1 :RDENT SPIRITS FO R PERSONAL US E.
(OVE R)
�If
'
AL USE
PERSON
, being duly sworn, depose and say that I am
.
,
on other side of this form, this day
specified
as
pirits,
ardent
of
ent
shipm
the consignee of a certafo
; that I am not a
~;I",...·-.,
deli~ered to me by the Southern Express Company, from
r_eceived by me
so
spirits
student or minor, and, if a femal e , I am th e head of a family; that the ardent
days prevrous
thirty
the
within
noi,
have
I
that
and
order,
written
my
were brought into the State on
any place whatsoeve r, in
hereto, received any ardent spirits of any kind what.soeve r, from any person or from
of Virginia, approved
excess of the quantity allowed by the provisions of the Act of'the General Assembly
are for my own use, at
March 10, 1916, or contrary to law, and that the ardent spirits~o r eceived by me
my own home, and that the said ardent spirits will not be used in violation of 1:1,w.
utlU \ I
Cousi&:nee.
,,,.,,------·
------~-------------------
�F O RM 370 ... VA .
G
SOUTHE RN EXPRESS COMPAN Y
( I ncor porated)
SPECIAL LIQUOR RECORD
Consign ee
"j 0
/
19 1_
'
AffidavitNo.~
-,~ -- - ------''- -'
/_-----,
_,,._
- --'--"'--- ---,/--"-''- ---- ---+~ =c-'--' --------/---,,~,:-')
__ __....,,'-Kind of Ard ent Spirits,_ _ _ _ _ __ ______ _ _ _ Amou nt __ _ __ _
/ ~ - ~ -Date_ _ _ _ __
__
t)
Way-Bill No._~
_:)_
_
,.._,___ _ Jb s.
/
191 /
Advances t o
Coll ect
Ann
Uude rcha rge
To Shipper _ _ _ _____ __ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
(OVIIR)
Jtl
�FOR PERSONAL USE
, _,,::c_____,,.,.c::.___:._~__:=-:_:+---=-c::.__---=----~---, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent
specified on olher side of this form, this day
del ivered to me by the Southern E xpr ess Company, from _ _ _________ ___ ; that I am not a
student or minor, and, if a femal e , I am the head of a family; th at the ard ent spirits so received by me
were brought intq the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will not b,e u sed in violation of law.
Consianee.
-.:-...i:_• ·,
·,
'- .
�SOUTHERN EXPRESS COMPANY
FORM 3 TO•VA .
(l nco , pornted )
SPECIAL LIQUOR
Kind of Ardent Spiri ts_ _ _ __ _ ____-=--~ ~--'-
Way-Bill No.
/ L
7Y
To --'-- -~ ~ - - - --
- - - - - -- -
A dvance s to
Collec t
EXPRESS CHARGES
PREPA ID
COLL EC T
Adrt
U n derc h ar ge
ShipQer_ ~ - - ~ '- - - ------,-,L---'-'-- -- -- /
RECORD Of" NOTICES
To Consignee _ _ _ _ _ ___ ,_~----;.- - - To Shipper _ __ _ _ _ __ _____ _ _ _ _
Af"f"IDAVIT f"OR / RDENT SPIRITS f"OR PERSONAL USE.
(OVJ: R)
�,.
u y sworn:--depose and say that I am
other side of this form, this day
j
;
delivered to me by the Southern Express Company, from
that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916,_or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Aa,en, for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
FORM 370 .. VA ,
(lncorpo raied)
SPECIAL LIQUOR RECORD
)
,_ _ _ _ __ _ 191_
,_
_
. ; __c;,'----- -- -
c/6
Affidavit No ,_ _ __ __
-------'-f
/ Amo unt,_ __ --'---=-----=---=,-..,,n ,._
/
...--=-:::-::::--.,---c'--;'--- Oate_ _ _ _ _ __ _ ~/_ __
Advnu ce1 to
Collect
Add
PREPAID
Uu de rchaqie
RECORD OF
To Consignee _ _ _ __ _ _ ~-~ --'--~~ -.-.--- To Shipper_ _ _ _ _ _ _ _ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(ov11al
�delivered tome bythe Southern Express Compa
__________ ____ ; that lam not a
student or minor, and, if a female, I am the
of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from a; y person or from any place what oever in
excess of the quantity allowed by the provisions of the ct of th Gen al Assembly of Vi~,ij&lll,,-l~m>ved
March 10, 1916, or contrary to law, and that the ar nt s
ved by me are for
my own home, and that the said ardent spirits wil ot b
�F"ORM 370-VA .
_,,.
Advauces to
ColleC" t
RECORD OF
To Consia nee _ _ __ _
----=:_ _ _-=----=-- --'-- -,E.--
EXPRESS CHARGES
PREPAID
Add
Underchar ge
To Shipper _ _ _ _ _ _ _ _ _ _ __ _ __
AL USE.
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
(OVIIR)
�PIRITS FOR PERSONAL USE
STATE OF
COUNTYu•·n "-c./-----.,c+,~--'--...;=
I, - -=----=-'-'---- - - ' ' - - - - - ' - - ' - - - - - - ' - ' ' - -·, being duly sworn, depose and say that I am
the c<msignee _of a certain shipment of •ardent spirits, as specified on other side 9f this form, this day
delivered to me by the Southern Express Company, from _ _ _ _ _ __________ ; that l' am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, ·within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General As~embly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiras so ·received by me are for my own use, at
my own hom e, and that the said ardent spirits will not
used- in 101ation o , law.
be
~7;), (.'
C.~/
Consienee.
�F OA M 370•VA
('
SOUTHERN EXPRESS COMPANY
(I ncorpo rated)
1,- Affidavit NO·~ - - - --
Way-Bi ll No,,-1'----_..,,,,,,,.
To ----===.i,...,~..-;...-;----'---~r - - - - -- - -
PRE PA ID
I
To Shipper __________ __ _ _ _ __ _
(OVKR )
�T SPIRITS FOR PERSONAL USE
=-__:e::.__~=----~=.L~ -,
----+~'-l,--_:__ _ _
being duly sworn, depose and say that I am
specified on other side of this form, this day
delivered t
by t he SouthernExpr·e ss Company, from ________ _ __ ___ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
heret o, received any ·a rdent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary t o law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violatidn·of law.
Sworn t o and subscribed before me,
J\5!'ent f lSouthern Exvress Company.
Consi~nee.
\
�SOUTH ERN EXPRE SS COMPA NY
( lnco rpore.ted)
Affidavit No~ %
Advance s to
Collect
To Shipper _ __ _ _ _ _,_ _ _ _ __
Af'f'IDAV IT f'O/
AROENT SPIRITS FOR PERSON AL USE.
(ovsa)
�FOR PERSONAL USE
say that lam
' being duly sworn, depose andform,
-i~~L-----:~+~~~~~?-----::~~~....;;;;;;;:;;as:;;;;'specified
this day
on other side of this
QTT!" ~ , \Ji, · ; that l am not a
delivered to me by the Southern Express Company, from [
student or minor, -and, if a female, I am the head of a famby; that'the arden~ spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever·, from any pe1·son or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia., approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in, violation .of law .
Conshinee.
A
~
7
L
l
A11ent for South t n Express Company.
�FORM 370•VA ,
SOUTHERN EXPRESS COMPANY
( l nco rpo rnted )
• EC~ RD
/
- -~ - -- - - 191_
Affi davit No._ _/~/_ _ _
!T/
/ 1
- - ~ - - -- - -- - - ~ ~,,__Amount _ __ _ __ _ __ _
I
- - 1 917
- - - ~ ~-
A d va nce s to
Coil e<'t
Y'\
Ad rl
PREPA ID
COLL ECT
t..
,I
Uud e r r. hn rge
(
\
RECOAD OF'
To Consio nee _ __ _ _ _ __ _____ _ .,.__ _
To Shipper _ _ _ _ _ __ _ __ _ __ __ _
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(ova:al
lbs.
/'
I
�delivered to me by the Southern Express Company, from _ _ _____ _______ ; that l am not a
student or minor, and, if a female, I am the head of a family; th at the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within . the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be ed in violation of law .
tf
7i<;
l
I I,
(., l \,,
Consienee.
A11:ent for S ~ n Express Company.
�FO AM 370-VA.
SOUTHERN EXPRESS
(Incorporated)
OMPANY
jj
D
Received at
Co nsignee
t~t
D~e
To
7
-- - - -
7
Amo""'
)
Advan ce s to
Collec t
bs
rn7
EXPRESS CHARGES
PREPAID
COLLECT
Add
Undercha rge
To Shipper _ __ __ _ _ _ _ _ __ _ __
/
AF"F"IDAV I T F"OR ARDENT SPIRITS F"OR PERSONAL USE.
( OVIIR)
�USE
STATE
COUNT
--""""-~ ----== --'c.._4--',..."'--~_. :._____.:=------__, ,,.r..., being duly sworn, depose and say that I am
specified on other side of this form, this day
delivered to me by the Sou, hern Express Company, from ________ ______ ; that lam not a
student or minor, and, if a female , I am the head of a family; th at the ardent spirits so received by me
were brought into the State on my written order, and that I have not, withi n the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home, and that the said ardent spirits will. not be used in vfofalion of law .
Consianee.
�FOAM 370--VA .
V
Affida,;1 {
__
Consignee - - ---==--.:._---1--,c_.,,,....-,-::;=.-~.::..__:...==---=="'-----_,,,_----'---~--+---F-------:-- - ---.=,=./_ __ _ _rl/__
~~=;a: ==:":; t;;,~;;: ;~--~- - ~ - - r---c; - Amoun c_
_ _-=------= -.:,..,_------+:-Weight_: .zz:_ Jbs.
1
~~.,.,..,.,-,.----~-- --'"'-- - Date_ _ _ _ _ _
1- -
__,~<;- =/---·-
Advauce e to
Colle<'t
/. •
L
Ad d
Undercbo.rg e
J
To Shipper_ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(O VER)
�T S PIRITS FOR
i,
PERSONAL USE
- ~~---rJ-__''>!!!___:,C~ ~~::_.::::::::::__::::L ~ c:._, being duly sworn , depose and say that I am
th e consignee of a
sp'ilcified on other .side of this form, this day
p.ei lv~red to me
e Southern E:ip_ress Company, from
~ . . ; that I ilm not a
student or minor, and , if a female , I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I have not , within th e thirty days previous
h ereto , received'any ard ent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of th e Act of the General Assembly of. Virginia, appro"ved
March 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for my own use, at
my own home , and th at the said ardent spirits will not b&. Rsed in violation bf l aw.
lY.
-
S f orn
.
t. ..J
- .
an subscrib"ll b efore me,
th1s_,,.,_ day of
)
JI ,
191_
A2en t fo r Southern Express Company.
I -
I
v
Con si2nee.
�Add
Undercharae
I
-;1
T-+--
RECORD OF' NOTICES
L
I
To Consionee _ _ _ _ _ ~ ---i
_ ,_,
7,___
- __
To Shipper _ _ _ _ _ _ _ _ _ _ _ __ __
AF'F'IDAVIT F'OR ARfENT SPIRITS F'OR PERSONAL USE.
(ov1rn}
�, b ·
duly sworn, depose and say that I am
specified on other side of this form, this day
delivered to me by the Southern Express Company,' f r o m ~ - - - - - - ~ - -~ ~ - - ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent splrits so received b_y me
were brought into the State on my written order, and that I have not, within the thirty, days previous
hereto, received any ardent spirits of any kind whatsoever, from any p erson or from.any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly 9f Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received -by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
I
Agent for Southern Express Company.
Consh:nee ..
�FORM 3TO•VA.
SOUTHERN EXPRESS COMPANY
(Incorporated)
SPECIAL
ECORD
S,.).
7
_<~
Affidavit No.~
lDl
I
,,
Advnuce a to
Collect
lbs.
Add
PREPAID
Ondercbar,q:e
RECORD OF NOTICES
To Consign ee _ _ __ _ _ _ _ _ _ _+ - - - - To Shipper _ __ _ __ _ _ _ __ _ _ __
(OVER)
�DENT SPIRITS FOR
PERSONAL USE
being duly sworn, depose and say that 1 am
specifieu on other side of this form, this day
.J--'----'""":::__ ___::_::::::i_.L..,1.-__::::_=--___.:=---_ _ _ __;_,
delivered to me by the Sou the
xpress Company, from _ _ _ _ ________ _ _ ; that 1 am not a
student or minor, and, if a female, I am the head of a fa!llily; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirils so received by me are for my own use, at
my own home, and that the said ardent spirits will not b
in-violation of law.
I
:/
Conshirnee.
~
__:_
A119n• for Southern E~press Company.
�l'ORM 370-VA.
SOUTHER N EXPRESS COMPAN~
11
1
-'-----'-----;= .t ,. ,. . ~
(lncorporaied)
GP
RD
AdTBUC68
Coiled
RECORD OF
Tq Consignee _ _ _ _ __ _+---- ~ - ~ ~ - - -
Add
to
PREPAID
Underchar1e
To Shipper _____ _____ _____ __
AFFIDAVIT FOR
(OVJCR)
�-
~
S TATE OF
COUNTY
I
F
SPIRITS FOR
FIDAVIT FOR
~
~•
./
4" /,,,.. i
1b
PERSONAL USE
.'//
,J •
rVl.
1('
-~ .,,;l,-AA_
'°
J'J
l!:, .,,,, . • / 1 I
_ a,/ <-/ .,,/
, being duly sworn, _depose and say that I am
ee of a certain shipment ot/dent spirits, as specified on ot her side ~of this form, t his day
to me by the Southern Expr~ ~ompany, from _________ _ _~ - -- ; that I am not a
student or minor , and, if a female , I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and t hat I have not, within t he thirty days previous
hereto, r eceived any ~rdent spirits of any kind whatsoever, from any person or from any pl ace whatsoever, in
excess of the quantity allowed by t he provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits w~
d in} ~ Jion of lawq
.,,,
Consi&:nee .
l
A&:ent for Southey,{ Exvress Compsuy .
�FORM 370•V A
TTO~:
SOUTH ERN EXPRESd)S COMPA NY
(lucorporute
SPECIA L
Consign ee
Way-Bill No. _,,~~..,___
To - - - - - ~ ~~~~ - -- - - - - - -
Advnn ree to
Co l lee r;
A <l d •
PR E PAID
Unde rch a rge
S~ , , , . ~ -- - - - ---'-i- ---i--"- ----
RECORD
_ _ _ _ _ __ _ _ _ __ _
. To Consignee _ _ _ _ _ _+---'=- ....,_~- 1---- To Shipper _ _ _
USE .
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
(O VER )
�I
ENT SPI RITS FOR PERSONAL USE
STATE OF
C OUNTY
F-"'~'----"i;::...-.,1',i""-___;;,q~_-,,,.'-t
arue nt spirits, as
delivered to me by the Southern Express Company, from _____~ - - - , - -- --,,...-- i that I am not a
stud.e nt or minor, and, if a fem a le, I am th e head of a famil y ; that th e ar ent spi~its so r eceived by m e
were brought into th e State on my written order , a)ld that I have not, within th e thirty days previous
her eto, r eceived any ardent spirits of any k ind whatsoe~r, from any person or from any place whatsoevet , in
excess of the quantity allowed by t he provisions of th~ A/t of the General Assembly of Virginia , approved
March 10, 1916, or contrary to law, and that the ardent ;;pirits so r eceived by me are for my own use, at
my own home, and th at the said ardent spirits will not:;. used in : o~at!~n ~f l~w.
M
fore me ,
-.:✓ ·
C
Oousjinee.
J\eeu\ for Sohthern Exv ross Company.
,.
�,oAM 370-VA.
SOUTHERN EXPRESS COMf"Al'n
(lucorpor&Md)
Ad'Yance1 k>
Collect
RECORD OF NOTICES
-To Consignee _ _ _ _ _ _~--~-~~---+---
A~d
PREPAID
Undercbarae
To Shipper ______ ______ _____
I
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVIIR)
�FOR PERSONAL USE
depose and say that I am
, --~~"'-------= ---'--"--"'- - - - ' - - - - - ' ' - ' - - - --=::_-, being duly sworn,
the consignee -of a certain. shipment of ardent spi_rits, as_ specified on other side of this form,·this day
V
; that I am not a
:J .
delivered to me by the Souther~ Express Company, from
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State..._o n my written order, and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
I
Cousienee.
Sworn.Jo and ubscribed before m e,
t h"s
fj da f~
,,,,..-,
/
t-z J.
191_ )
)
Ae-ent for Southern Ex't>res s Company .
�- -- ----- --S COMPA NY
SOUTH ERN EXPRES
ln co rpomted)
FORM 370 - VA .
{
LIQUOR RECOR D
-
-
-
Affidavit No,_ _ _ __ _
,
Way-Bill No, __,,___ _ _----'--- --
To
191_j_
I
Received at- --..-----" -c:;..::.-~;c._ _ _ _ __ _ Da te
Advoacea to
Collect
-'-...-,R- ~--- ~ ~
EXPRESS CHARGES
PREPAID
COLLECT
~
SliiP P. r ~✓--1 () ~, /)
RECORD OF NOTICES ;
7: / }
I
To Consi onee ____ _ __J._/--';,;__--'--/____ __
I
'
A drl
Uud e rcb nrg e
I
To Shipper_ _ _ __ ___ ____ __ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE.
(ova:a)
�ENT SPIRITS FOR
PERSONA L USE
STAT
-----,-;f -------- '--- - - - - - - - - - , being duly sworn, depose and say that
1 am
specified on other side of this form, this day
delivered o me by the Southern Express Company, from ____~~-~~ ~--- - - ; that
l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
.
'
~~
Sworn to and subscribed before me,
r,
(
-----~
Conshrnee.
�FORM 370-VA .
SOUTHERN EXPRESS COMPANY
(Incorpo rated)
Kind of Ard ent Spirits,_ ~ - - -- -- - _______.,___
I
I
Way-Bill No·- - - - - ~ - -Ad vau ce e to
Coller t
.Add
COLLECT
To Shipper _ _ _ _ _ _ _
NT SPIRITS FOR PERSONAL USE.
(OVl:R)
Und e rch arge
_ _ _ __ __ _
�STATE OF
COUNTYv.>" 't,)~-#-- ~- _ J"',-.Q,
1, "'-~-- -------= -------- -----,;., :...-, being duly sworn, depose and say that
1 am
the consignee of a certain shipment of ardent
specified on other side of this form, this day
delivered to me by the Southern Express Con:ipa
_ __ _ _____ _ __ ___ ; that lam not a
student or minor, and, if a female , I am the hea of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed _by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are for my
own use, at
my own home, and that the said ardent spirits will not 'be used in violation of law.
/.
· Consienee.
�FORM 370•VA .
SOUTHERN EXPRESS COMPANY
(In corporated)
Consignee
EXPRESS CHARGES
Advauce e to
Colle<' t
PREPAID
I
I
COLLECT
~l·
Add
Uud e rc harge
I
-RECORD OF NOTICES
To Consignee _ _ __ _____~ - - " - - - - - - - To Shipper _ __ _ ____ ______ _ __
(OVER)
�FOR PERSONAL USE
being duly sworn, depose and say that I am
a certain shipment of ardent spirits, as specifiedr on oJher side of this form, this day
-"-4'--------"'"'-----""--- - - - - ' - - - - - - = ' - - - - - - - - - ,
delivered to me by the Southern Express Company, from _ _ _ _ __________ ; that l am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever ,.from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Swu7 - • ,ud.h,~efore m~,
I~
this~
,· /
L' '·
··
.~
,~
nU/ jl?A
. ?-'I
/
f.·
.
7
.
91_
. .
..
\.
\
.
Uonsh!nee.
~
~- ~
A11en, for Soueforn . press Company.
-
�FORM 370 - VA.
R evise d June . 1918
RES S COM PAN Y
SOU THE RN (EXP
Incor porate d)
_ _ _ __ _ ,
To _ _ __ ___._,...___ __ __
Advan cee to
Collec t
,,__--=~-= -.!'- 1
Shipper,__,.-v --=-• -=-- += _::---=---.
P. 0. Address
REC ORD OF NOT ICES
---'' ---- -"-c .=.. ---To Consignee _ __ _ _ _---''---
-
_______
To Shipper _ _ _ _ _ _ __ _
(OYE R)
_
�I, -.LL~"----_,,_~:_:_--i-,:'-------1'----'...,'-'-'=""-"-"""'-""-----I-- -- -, being duly sworn, depose and say that I am
tbe consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
frogROTTQ£
A.
;
delivered to me by the Southern Express Compan;y:,
that I am not
a student or minor, and, if a female, I am the head of a family; that the at dent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoner, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrar~ to law, and that the ardent spirits so received by me are to be used
l,y
me for
/
/(
f. ,
A
_,{J.,.'
,
purposes at my own home, and in con-
(State -..hether for Seiemtific, Sacramental, lledicinal or Mechanical)
formity with law.
,
MAY 20"1919
lz, / _)'; ~---
Sworn to and subscribed before me,
ibis
Ai:ent for Southern Express Company.
Consi~nee .
�FORM 370- VA.
Revised June, 1918
SOUTH ERN EXPRES S COMPA NY
(Inco rporated}
LIQUOR RECOR D
Advances to
Coll ect
EXPRESS CHARGES
PREPAID
COLLECT
Add
Undercharge
Shipper _ _ --;:=---:;:-;--"--=--=c:----:-;;------'=-=='-----='----1
P. 0. Address - - ---"----- ---____:--'----=:::__To Shipper _ _ _ _ __ _ _____ ___ _ __
(OVER)
�------:1-~1-___ :,;;;;,:::=--+•"-4 =.-~r'-A',1 ----¾-
, being duly sworn, depose and say that I am
specified on other side of this form, this day
delivered to me by the Southern Express Company, from,.- --,-+--,t--t,-+-+-P--,,- -..;,,_.,._____ ; that I am not
a student or minor, and, if a female, I am the head of a family; that t e ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of 11.ny kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
to l!\,W, and that the arde spirits so received by me are to be used
approved March 19, 1
~
Cousie-nee.
t;his _ _~ ay of_-,--~ ...I
/
t
ii
�FORM 370- VA.
Revispd June, 19~
Received at
SOUTHE RN EXPRESS COMPAN Y
( In co rporated )
GROTTOES~pqi lAL
LIQUOR RECORD
Consign ee _ _ ~ ~ - - -- ~ --,--- - - - - - - -""-- P. 0. Add r.ess_ ~ +
- - - - - - - ~ --
/
Advftnce11 to
Col lect
PRE PAID
RECORD OF
To Consignee _ _ _ _ _ _c____,c__ __ __ __
,
_
(OVER)
To Sh ip per _ _ _ _ _ _ _____ _____ _
�=~~~----------- ~---------- - - - -~-~--8'IATE
OF
COUNTY
q_
t(
Vr;&GINiA.,
/)
~-/U..,4t
I
/
l
Lt(...,{..
I.. .Gvlt ,,,6'1:, Y ~
auly sworn, depose and say that I am
b 1·
l,{ :, r
{(
the consignee of a certain shipment of ard ent spirits, 1as specified on other side of this form, this day
I,~ { 1
I
; that I am not
.., '
delivered to me by the Southern Express Company, from
a student or minor, and, if a female, I am the bead of a family; that the lirdent 'spirfts"so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place wh at soever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contr~ry to law, and that the ardent spirits so received by me are to be nsed
\_...- h
by me for
/
··4 /
/!,. A
(. . •
· · "'
..-: t r.A f
r\
pnrpose11 at my own home, and in con-
(State whether for Scieil!tific, Sacramental , Medicinal or ~hanical)
-;---
formity with law.
A
G; (~ L
l1 L 19
Y
~o rid suoscribed before me,
'? ~,{ 't i
(
Ai:ent for SoutherB E~ress Company.
~
l_
C~ nsie:nee ,
�FORM 370- VA .
Revised June, 1918
SOUTHERN EXPRESS COMPANY
(Incorporated)
Kind of Ardent Spi rits=----==-----------H'c,,--r-c-..,..-
Way-Bill tio,,~ _,/'--_( _ __..,.'--------Advan ce s to
Collect
· To~hipper _ _ _ _ __ __________ _
(OTI:R)
�,....
STATE OF v1Jrny.. ,
. ,h
COUNTY OF . 1
.(--='
'
l; :
_r ' • • ·
r
~
I'
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111A.,,~ .,.,_..,, \
•
t· .. )· \
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\
,I
J , .. /f . I
i'
.
I p : ~ ,.; _,,
,,. t.\., , .,, ~ I ,,. ...,,
'(_ " .,.,; • ., L , bemg duly sworn, depose and say that I am
tlae consignee of a certain sq3 'm~ t of ardent spirits, as specified on other side of this form, this day
q: 1~
delivered to me by the Southern Express Company, from
t,
,
; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent splri s so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoner, in excess of the quantity allo..,wed by the provisions of the Act of the General Assembly of Virginia,
approved M~ 1,9, 1918, or cpntrary to law, llJld that the ardent spirits so received by me are to be used
by
1110
for
11 , ;
,
(/ . 'c
'
•
f. ,.,_ ·,
' f
·'
_ - '· - '
\~_
pnrposeil at my own home, and in con-
(State whether for Scien,tific, Sacramental, Jledicinal or Meclianical)
formity with law.
('
/,. l
Consie::nee.
Agent for Seutl\ern EJ<press Company.
�FORM 370- VA.
R evised J une , 1918
COMPAN Y
SOUTHE RN EXPRESS
)
{In cor porated
.Ad vei nce s to
Co11ect
'T'" ,,,~,; F'"
EX P R E SS CHARGE S
J;
Ta,
RECORD OF NOTl<j:E'.S
To Consig nee_ _ _ _ _-r-----+ -------- -----
To Shipper _ _ _ __ _ _ ______ _ _ __
(OVE R)
�r
,-
J'i
.. '1
I,
i .
"' ·.
'
tlae consignee of a certain shipment of ardent spirits, as
1
,..-n~ng duly sworn, depose and say that I am
1fied on other side of (his form, this day
, },, ,--·..
"" / t:f
delivered to me by the Southern Express Company, from
(: •,·
· '\ .:... ✓ ·t - ~ I am not
a student or minor, and, if a female, I am the head of a famil,:; that the ardent spirits so received by me
were brought into the State on my written order, and that ,I ave not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve from any person or from any plac!'l whatsoner, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits 110 receiv'e d by me are to be used
., ,. . ,,,..
L
l,y me for
f
•
'
_,,,f, ;__,.,,,
formity with law.
Sworn .
lhl•
_,,,,,,.
.
-7} )'\. ,· t' ,-L ~ A_
.v
purpose11. at my own home.,.and in con(Stato~ hether for Scientific, SacrameDtal, llediciDa! or llrechanical)
'
re me,
/ff~ '
191_ . .
Agent for Southern E:<press Company,
�f"0R M 370- VA .
SOUTHERN EXPRESS COMPANY
(lnco rpo rnted)
r
SPECIAL LIQUOR RECORD·
I
y--
- - + - - - - --
V
Affidavi t No._ __ _ __
191_
I
.Ad vnnces to
Collect
EXPRESS CHARGES
PREP.A.ID
COLLECT
WarTax
Add
Collect
Unde rcharge
Shi ppe r~ --s,.,~- - -
P. 0. Add ress _ ~ - - - -~ - - - - ~ RECORD Of" NOTICES
To Consign ee _ __ _ _~ -- - - - + - - --
To Sh ipper_ _ _ __ _ _ _ _ _ _ _ _ _ __
(OVE R)
�J
--""-----''----__L-'------"------"'--------''------=------ , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
'q
;
that I am not
delivered to me by the Southern Express Company, from
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatrnever, in excess of the quantity allowed by the provisions of the Act of the General As~embly of Virginia,
approved Marfh 19, 1918k ~ contrary to law, and that the ardent spirits so received by me are to be used
/ / ,.-) 1
f',
.
v'!A.-tl
~
at my own home, and m con---------Purposes
___'-"""=---J
/
·,-i
, , '- _ ,,. , ""--'r;"'
by me for _ _ _ ____
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
formity with law.
/.
l O ,-,
• I''
Consii:JJee.
Swo~n to and subscribed before me,
lt
Agent for Southern Express Company.
�F"ORM 370- VA .
SOUTHERN EXPRESS COMPANY
Revised J une. 1018
RT 0
(Incorporsted )
,I
SPECIAL LIQUOR R,ECORD
Advance s to
Collect
PREPAID
To Shipper _ __ _ __ __ _ _ __ _ __
(on:&)
�, ,.--------------------~--------·---------- -~
I,
the consignept a certain shipment of arde
, being_duly sworn, depose and say that I am
spirits , as specified on other side of this form, this day
delivered to me by the Southern Express Company, from
a
; th at I am not
a student or minor, and, if a femal e, I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia ,
approved March
,or. contr,:;_r
1to h\w, and that the arden spirits so received by me are to be used
19,'1.
'
• t,J'/,1 0
by me for
l t- ,A_.,.
.
I
~~
< . . ..,(1-,
·
/
(State whether for Scientific, S11cramental, Medicinal or Mechanical)
purposes at my own home, and in con-
formity with law.
Consi1:Dee .
Agent for Southern Express Company.
�FORM 370- VA .
SOUTHERN EXPRESS COMPANY
R evised June, 1918
(lncorpornte d)
LIQUOR RECORD
Received at _ _ _ _ --c------r'-- ---- - - -- •ate
/
Way-Bill No. _ _ _~ .- ~__,,_.~-
To - - - ~ - ~ -~-
.Advnnce8 to
Collect
PREPAID
COLLJ1~CT
WorTu
Coll ect
Add
U ad erc bnrge
RECORD OF NOTICES
To Consignee _ _ _ _ _ _ __ _ _ __ __
r--_
To Shipper _ __ _ __ __ _ ______ _ _
l
(OVER)
�,-.------------------------------------=--~~~-- ~
COUNTY
depose and say that I am
I, -~--c-'---+- - - - - - · - - c,#-- - - - - ~ ~- , being duly sworn,
side of this form, this day
other
on
specified
as
,
spirits
of
e
the copsigne
;
ROJ'T
that I am not
delivered to me by the Southern Express Company , from ,...
by me
eceived
r
so
spirits
ardent
the
that
a student or minor, and, if a female, I am the head of a family;
previ ous
days
thirty
the
within
not,
have
I
that
and
order,
written
my
on
were brought into the State
person or from any pl ace whatEO hereto, received any ardent spirits of any kind whatsoev er, from any
General Assembly of Virgini a,
the
of
Act
the
of
s
provision
the
by
allowed
ever, in excess of the qu antity
so r eceived byme are to be u sed
approved March 19, 19~ ' J ttrary to/law, and t.hat the arde spirits
by me for
·
, L£.,.4 ,; - . , --
•~ r -
·~i;·
·
(State whether for Scientific, Sacrament al, Medicinal or Mecha cal-)
formity with law .
.
(
Sworn to and subscribe d before me,
this _ _
J
day
of_j_ l
191
?,l ,\}/ )lfi
\
I
Ae:e nt for Southern Express Company.
purposes at my own home, and in conI
�FORM 370- VA.
Rev ised June, 1918
SOUTHE RN EXPRESS COMPAN Y
(In co rporat ed)
P R E P A ID
W.arTax
Collect
Add
U n de rc h a rge
To Shipper _ _ _ _ __ __ _ _ _ _ _ _ _ __
i
(OVER)
�r
...._~ ....,,i;,,,,~ ===...-:L-_::__::__='..._-__-.,.==-~--~':, being duly sworn, depose and say that I am
the consignee of a certain shipment of ard ent spirits, as specified on other side of this form, this day
f;'
delivered to me by the Southern Express Company, from _ ______· - - - - - -- i that I am not
a student or minor, and, if a female, I am the head of a family; th at the ardent spirits so received by me
were brought into the State on my written order, and that I have ·not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place' whatsoever, in excess of the quantity a~owed by the provisions of the Act of the General Assembly of Virgin ia,
approved Marc JA, 1918, or ontrary to law, and that the ardent spirits so 1·eceived by me are to be u sed
/.
Mr,
('
by me for/
. /
•
" "'" •••~" <o,
formity with law .
'
;
,
1 · ,0(.../')- _...,f\ ...,..,,/
s.;.,,rn,, S•cr=•"'•'• x"';j
;"' MooO.,,MO
f/..y
purposes at my own home, and in con•
V
·
Consiguee.
Sworn to and subscribed before me,
191_
J
Agent for Southern Express Company,
�SOUTHER N EXPRESS COMPANY
FORM 370- VA .
(In co rporated)
Revised J,me, !018
R CORD
LIQUOR
I
~ -~ - - Date
Advances to
Coll ect
•
Y
19 ~
EXPR ESS CHARGES
PREPAI D
Add
Undercharge
P. 0. Address
..,/'--- - --'~ '-+--- --
To Consianee _ _ _ _
To Shipper _ _ _ _ _ _ _____ _____ _
(OVER)
�---- ---- ---- ~-- ---- ------ --- --- -~~~~,~~~-
.
STATE OF
I, --==....,..= ~-~~ ----~ ~-= -= ~ - -, being
duly sworn, depose and say that I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
delivere d to me by the Souther n Express Compan y, from _ ____
____ ____ _ ; th at I am not
a student or minor, and, if a female, I am the head of a family;
that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatso ever, in excess of the quantity allowed by the provisio ns of the
Act of the General Assemb ly of Virgini a,
approve d_Ma_Jr ~ 19_, 1918/ or \ontrary t_? Jaw, and that the ardent
spirits so received by me are to be used
'--')·, )1'-J} .I\' ..../4,..Q_.,.{___.AA.....,-i;
by me for
.-' /. ._ ·
()
~
(State whether for Scientific, Sacramen tal, Medicinal or Mechanic
al)
formity with 1 w
I\ ,
1
919
. ·: "),
'
/ ,.,. .
Sworn to and subscrib ed before me,
n
purpose s at my own home, and in con-
/
L
Consigne,e. ;
·,
ihis_-_ _ day of ____ __
I.
191
'/.
Agent for Southern Express Company .
\
�FO RM 3 70- VA .
SOUTHER N E XPRESS COMPANY
(I nco rporate d )
SPECIAL LIQUOR
RECORD
_ _ _ _ _ _ __ 191 _
Affidavi t No ._ _ _ _ __
- - -- ~ - - - - -___,,,..___,,- - - Qua nti tv-., .--~-~~~ ,___ _ We ioh ~ ~ - ,.........._ _ __ _ 19 17
To Shippe; _ _ _ ____ _ _ ·------- -,- ~
(O VE R)
�~ ~ - - - - - -- - - -- ~ - - - - - - - - -- -, being duly sworn, depose and say that I am
shipment of ardent spirits, as specified on other -side of this form , this day
delivered to me by the Southern Express Company,' from _ _____________ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and -that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March :W, 1918, or contrilTy to law, and that the ardent spirits so received by me are to be used
by me for
r -✓271
/,
;!( - ✓" ..
-.·
~'
'
~ IJ
1~
\.-
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
formity with law.
1/
Sworn to and sub cribed before me,
2'
~
thi,
purposes at my own home, and in con-
j{<..,,'-{ t
'I
I ~ 191-, .
Ai:ent for Southern Express Company.
C6nsi&:Dee ,
�FO RM 3 7 0 - VA .
Revised June , 1918
SOUTHE RN EXPRES S COMPAN Y
( Incorporated )
RECORD
SPECIAL LIQUO
_ I _,.e:..__ _
Rece ived at_ ____--,-_ __ _ __ _____.,....._ Date _ __
Quantitx--- ~--t':.-t" c:::;;r---
- ---'----- - - - -- --'--·-· Way-Bill No.___..,.,-..-;-.~.';""..- - - -
- -~-- --- -191
To - ------'-,,-;;---='-'---" i>ff'--~"=~ "--- - -=--- 1
A dv an ce B to
Co l lect
WarTu
Collect
Shipper _ ~ -=--- ~-=--=-- -----=,-----=--=-- =-- -•
P. 0. Address _ _ _--'-- - - - - --=--- RECORD OF
To Shipper _ _ _ _ __ __ _____ _____
(ona)
�I,~ :_i~ SJi_'._1,~ ~~~:::::'.~ ~~ :...:.__~ __
the consigne~ of a certain
{_/
delivered to me by the Southern Express Company, from _ _ _______ _____ ; that I am not
me
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so 1·eceived by
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed-by the provisions of the Act of the General Assembly of Virginia,
, or contr y to law, imd that the ~ den:~pirits so received by me are to be used
approved March 1 , 1
by me for
\..,.
~£~ ,__,.,~
purposes at my own home, and in con-
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
formity with Jaw.
Con si &Dee.
Ai:ent for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
FORM 370- VA .
Revised June . 1918
(Inco rporat ed)
(
5
'/ __~+-----+--To Consi on ee _ _ _ _ _ _r_.,,..
RECORD OF NOTICES
L...,;
To Shi pper _ _ _ _ _ _ ______ ____
(OTI:R)
�t,;1
,$#_/ '-~_, "'·t • L/2'--1.J ·.
Vrnoi~ ,
STATE OF
~
COUNTY OF
f
" '
/0
'
1
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# ....I
., ~ -'\/} ( /
,'"!i
/J
.
,_,,, ,.. ....,..
,.
, -..,.4._. -
'
cl{t o· I Ad f_ t.R/L
A
, being duly sworn, depose and say that I am
1,
as specifie d on other side of this form, this day
the consign ee of a certain shipme nt of ardent spirits,
_ _ _........,.....__..__.___,,,,_.-:=-iL--"-'""-''- i that I am not
deliver ed to me by the Southe rn Expres s Compan y, ·f rom
that the ardent spirits so receive d by me
family;
a
of
a student or minor, and, if a female, I am the head
not, within the thirty days previou s
have
I
that
and
order,
written
my
on
were brough t into the State
person or from any place whatso any
from
ever,
hereto, receive d any ardent spirits of any kind whatso
Genera l Assemb ly of Virgini a,
the
of
Act
the
of
ns
provisio
the
by
allowed
y
ner, in excess of the quantit
receive d by me are to be used
20
spirits
ardent
the
approve d March 19, 1918, or contrar y to law, and that
.
/,r• ,
llymef or
, ·,
,I
ft _
i
•
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l
,·
. _,. · , .
I ./
( ·
'
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purpos e11atm yownh ome,an dincon .,. 4' n·"l or Mechani
cal)
(State whether for Sciell!tific, Sacrame11ta1, Medicina
formity with law.
y( ~
v
Consiene e.
thi
Agent for s ·outhef, ,furess Company .
�ESS COM PANY
SOUT HER N EXPR
nc orporat ed )
(I
SPEC IA't LIQU OR RECO RD
f~
191 ~ . Affidavi t No.
EXl'RES S CHARGE S
PREPAI D
Ship per----'-----'-''--+'----"--=:._+',_;_c~:,.,c---=-'----"'-=F--\.P. 0. Address
RECOR D OF'
To Consionee
To Shipper
(OV IIR
�'
COUNT
- -7''-"l"-"--
""---L-----"'--'=_ ,_."--'-"'-----""'"- ""=----F------ ,
being duly sworn, depo!!e imd say that I am
spirits, as specified on other side of this form, this day
n,u, Ta.
deliv·e red to me by the Southern Express Company, from _______ _______ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allow8{1 by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contri11ry to la~ , and that the ardent spirits so received by me are to be used
- ~,1
by me for
'
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I
I!
,,.
r'
I
• ., I
.
A..' a4,.,. ,·r''---· .,
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
purposesatm yownhome,a ndincon-
formity with law.
\..;ou .s ii;:u ee.
Aiient for Sonthern Efpress Company.
�F"0RM 370-VA .
Revised J une, 1918
SOUTH ERN EXPRES S COMPA NY
(l ucorpornt ed)
ECIAL
Received at ~
LIQUO/R<:>Rf/i lRD
+---19
-c..,--+- , P - - - + - - - - - - -- Date _ ____,_/_ '-'1-
Consignee _ _ _~____. -~~~=~ ~=F--- --f"'-1-f_
J
.' I
To _ _
-r-----,-----r-- - - - --\----',f-r--.-.,.-~--'--------,'------l
.Advances to
Coll ect
Ship t er-"--'-----""'-7-~-=-=--r ---J'-----.- ----f-~-"
P. 0. Address
RECORD OF"
To Consignee
---
To Shipper
(OVER
�the consignee of
delivered to me by the Southern Express Company, from ______________ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent sj>irit·s so· rpc.~ived by me
were brought into the State on my written order, and that I have not, within ·the thirty days previous
hereto, rEceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantj.l;y allowed by the provisions of the Act of the General Assembly of Virginia,
~nd that the ardent spirits so received by me are to be used
approved March 19, 1918...o'r J.Atrary to
7 - r,-T,.
I
by me for
formity
, \
,-
J
x•
'
~,
/
.
•;
11
i
1
.purposes
'-- ,J
.,... . ',_ ·
·
l
(State whether for Scientific, Sacramental, Medicinal or IIIechanical)
Titc •1 6 'V 8
at my own home, and in con-
_[ ~ - ' - = - - - - - = - - - - - =:....:...___ c:7"
Co ns i~uee.
Sworn to and subscribed before me,
this _ _
aa;:f_--+-/___, 191_,
,,
A11ent for Southern Express CoIQ:e-llJ'.
�FORM 370- VA .
R evised J un e, 191&.,
SOUTHERN EXPRESS COMPANY
( lncorpornt ed)
LIQUOR
'/
To
.Advan ces to
Co1lect
EXPUESS CRA.RGES
PREPA.ID
WarTu
Collect
Add
Unde rcharge
Shipper- - ~ ~ - ~ - ~ - ~ - -- - - - -,
P. 0. Address _ _ _ _ _ _ _ __ _ _ __ _
To Shipper _ __ _ __ __ _ _ _ _ _ _ _ __
(O'l"KR)
�•. "I'
~ c._,'------+-+-- -""='----"---=--- - - - - -- -, being duly sworn, depose and say that I am
specified on other side of this form , this day
"f:.f"':•
t·.,·~ •
r• -
'
j
·, r'l
'
that 1 am not
"
.. .~..
delivered to me by the Southern Express Company, from
a student or minor, and, if a female, I am the head of a family; that the ardent sp-irits .so received by me
were brought into the State on my written order, and that I have not, within the· tiiirty days previous
hereto, received any ardent spiritf of any kind whatsoever, from any person or from any place what~oever, in excess of the quantity allo);ed by the provisions of the Act of the General Assembly of Virginia,
918, or co hary to law, and that the arc nt spirits so received by me are to be used
approved March
1
~
by me for
v r ,L,,\o__,, ,
'
I
'
-
-1,:
•
'
;
,
I'
purposes at my own home, and in eou-
(State whether for Scientific , Saernmental, Medicinal or Mechanical)
formity with law.
L; (
Consie:nee.
Sworn to and subscribed before me,
�F"ORM 370-VA .
SOUTHERN EXPRESS COMPANY
SPECIAL
Add
Undt:irc b11rge
RECORD OF" NOTICES
To Consignee
To Shipper
( OVll:R
�1, ,
, being duly sworn, depo8e ,md say th at I am
the consignee of a certain shipment of ar dent spirits, as specified on other side
of this form, thi s day
delivered to me by the Southern Express Company, from -i:~~--'-...r:..-4c'!~t-}--- ---'t.co:....
- - - i that I am not
11 student or minor, and, if a female, I am the bead of
a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, rrneived any ardent spirits of any kind whatsoeve r, from any person or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virii:inia,
approved March 19, 1918, or contrary 'l,o law, and that the ardent spirits so received
by me are to be used
by me for
-<Tl
1
v'
\
~
Ll.?..A
. '-......,,..___
~ 1..,...,.-Y
i
(S tate whether for Scientific, Saeramen\a_ l, Jlleqieinal or llleehameal)
purposes at my own home, and in con-
formity with law.
\,;c., n s ii;uee.
Sworn to and subscribed before m e,
this _
__
'"d~ ;;,~
'l
1
....,
I_,.
Aient for Southern Express CoQl~~-
�SOUTHERN EXPRESS COMPANY
FORM 370- VA.
Revised June, 1918
(incorporated )
0
PECIAL LIQUOR
I
mmo
.1 ~
J: bi~:
EXPRESS CHARGES
To Shipper _ _ __ _ _ __ ______ _ __
(Ol'"l<R)
�~.=-i"-=--1-----_:,,::_=-------- --'----I--- - -- -,
being duly sworn, depose and say that I am
aSG"QetiYto
V
~ :r "
· of this form, this day
delivered to me by the Southern Express Company, from _ _____________ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place wha.t rnever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
fary to law, and that the ardent spirits so received by me are to be used
approved March 19, 19l~
by me for
~
(
t
purposes at my own home, and in con-
(State whetJi,er for Scientific, Sacramental, Medicinal or Mechanical)
~
w)_
formity with law. ."
~~·
- o_n_s_ie_D_e_e_.
1=,'"'r-t----;......;-'-'~-,~----C
---c=;o,----r
Sworn to and subsci;ibed before me,
'"'" tti f_ ,,'"~
,,
f
A~ent for Southern Express Compa,;y.
�FORM 370-VA .
Revised J une, , 91 8
SOUTHE RN EXPRESS COMPAN Y
( I ncorporated)
. PECIAL LIQUOR RECORD \
~ - - -- - - - = - + - - --
Date
/ ) /
{.c
~"=-....::: '--+--=-,-- 1.____,L.::...= -_:___l~·-
--t-· --------
·- - -~ ~~------ J'-----'~ - Ouantity-c--'- ---"'Way-8ill No. - ~ - ~- - ~ -
PR E P AI D
P. 0. Address-
To Consignee
I ·,
-
--:--i::-::;-;--
- -- -;..-::..-::..-::..-::.-:..":..
. ':..-::..-::"Tl9_1_1_....__Fr_o_m..::.~.::.::.::.::.:::.::::.::.::::;.::.::.::.::.::____-:
To _ --,,+-'""~' -rl--,,-=-'- -- -'-'-'-+-~-++ -1
Ship
RECORD OF NOTICES
191 _ . AIU
I tC,
I
To Shipper
(OVIIR
�1:hAT E
o;JjJJ,
.~ IA,
. .
I
C OU N TY O
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r r) {
[1
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f.' 1 ,J-
f ),•
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t
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. . / \ -' '--'<...-, l \ •
'-)
~
\_.
, being duly sworn, depose and say th at I am
the consignee of a cer in . ~hipment of ardent spirits , as s cified on th,er : id~
this forp:i, this day
6
0
delivered to me by the Southern Express Company, from
· ; that I am n ot
a student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by m e
were brought into the State on my written order, and that I h ave not, witliin the thirty days previous
hereto, l'ECeived any ardent spirits of any kind wh at soever, from any person or from any place whatsoever, in excess of the quantity allowed by th e provisions of the Act of the Gene~! Assembly of Virgini a,
approved March 19· 1p1s, or cont(ary to law, 1.tnd that th ,a rdent spirits so received by me are to be used
I I '1i\_
~ f! fi...
j1 I , •
.
/
_.1, I . I / 1.
,
y
'
by me for
, .'
_ ,
' -· _,,,_..
_.,
-- » _
purposes at my own home, and in con-
J:L(.
(S tate whether for Scientific, Sacramental, Medicinal or 111echanicall
formity with law.
.t?e
A119nt for Southern Express Company.
t._11:~
-l/r-h=
~
usi~uee.
�FORM 370- VA.
SOUTHERN EXPRESS COMPANY
(Incorporated)
Revised June, 1918
(
LIQUOR RE &{RD
i,,!~
("
c
Received a.___~:::__ _ .,___ _ L_....___ __,_____ 0ate_ _ _--r/-¥~~
~ =-- -191 _
Consignee _ _-="'--...c.._-=c=c_____,.,,:.:.,:.,=--
)
'-';.:.--'--'r--'-----'----''----=- -- - P.
Affidavit No.~ -- - - ~
0. Address _ _ __ _ _~ - - - -- -
QuantitY= - ~ - - ' - -- -- -
~ ~- -- - - - - - -,------;!'--+-
---ac-,-.,--,--- -=--- 191 _f_
Ad vnnc e s to
Collect
Fro m_ ~ ~ ~ - ~ ~ ~ - - - ~ - , - EXPRESS CHARGES
PREPAID
CO LLECT
War Tax
Collect
Add
Undercharge
(
To Shipper _ _ _ _ __ _ __ _ __ __ _ __
(OTER}
�C
-
-- ~ - - ~ --
-
- -------- ---
I, _ _ __.___."'--_ ,____ -'"'--·'-----.c.__..c....____ ___ , being
duly sworn , depose and say that I am
the consign ee of
s pirits, as specified on other side of this form, thi s day
delivere d to me by the Souther n Express Compan y, from _ __,,==-~
~---=c·='-- -''----'= '---- ; th a t I am not
a student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver,
from any person or from any pl ace what~o ever, in excess of the quantity allowe::i..by the provisio s of the
Act of the Gen eral Assemb ly of Virginia ,
approve d Mareh 1 :J.,!H , or contr ' y to law, and that the ardent
spirits so received byme are to be used
7·
by me for
l
,.
,,,-
V
rJ
{
(State whether for Scientific, Saernmen tal, Medicinal or Mechail'rc
al)
formity with law.
l;
Swor
~
purpose s at my own home, and in conJ
-
nd subscrib ed before me,
191
Aiient for Southern Express Company .
Consie:11 ee.
�FORM 370- VA .
Revised Jun e, 1918
SS COMPA NY
SOUTH ERN EXPRE
r a t ed)
{[n corpo
SPECIA L LIQUO R RECOR D
...,..---.,.....,,_____---,,_ _ _ _ Date
2- / ')..,--"
<J
EXPRESS CHARGES
P REPA ID
~((: _
19'?__ Affid avit No._ _ _ _ __
COLLECT
WarTu
Collect
Add
Unde rc ha rge
To Sh ipper _ _ __ __ _ _ _ _ _ _ _ __
(OVER)
�"
I, --'"-''--\-_,._-'-_
=_,.,,:---==,._~..£__,,"-- - - -- , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified oh other side of this form , this day
_ i_
_
delivered to me by the Southern Express Company, from _ _____~ · - - - - - - - i that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatEoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved Marc~9, 1918, or co.,ntrary to law, and that.the ardent spirits so received by me are to be used
by me for
d'll L -
, ,' ,.
_;
(State whether for Scientific, Sacramental, )l(edicinal or Mechanical)
formity with law.
purposes at my own home, and in con-
_,.,..
l'v /. //J;
Cousi2nee.
Sworn to and subscribed before me,
ihis _ _ day of _
_ _ _ , 191_
.
I
Airent for Southern Express Company.
�FORM 370- VA .
Revised J une, 1918
SOUTHER N EXPRESS COMPANY
(Incorporated )
SPECIAL LIQU
I
.Advan ces to
Collect
_To Shipper _ _ _ __
(on&)
�\
;
STATE OF Vr,t\UN1-A 1
/ ,
COUNTY OF- ~ - - - -- - - --
I ,'
I, _____ ______.___________,,,._, being duly sworn, depose and say that I am
the consignee of a certain shipment of a1·dent spirits, as specified on other side of this form, this day
lirottoes, v~.
delivered to me by the Southern Express Company, from _ ______________ ; that I am not
student or minor, and, if a female, I am the head of a family; that the ardent spjrits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the..qnantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 197 HHS, or contra,ry1 to law, and that the ardent spirits so received by me are to be used
a
.,,'/
:1/
I
.
!
by me for _ _ _ _ _ _ _________ ___________ purposes at my own home, and in con-
7Jc
. (State whether for Scientific , Sacramental, Medicinal or Mechanical)
formity with law.
.(
Sworn.to and,subscri'bed 'before me,
Ae,ent for Southern Express Company.
Consh:Dee.
�FORM 370- VA .
Revised June , 1918
SOUTHERN EXPRESS COMPANY
(In co rporated)
RECORD
,I
.Advan ces to
Co ll ect
I
Add
Unde r c ha rge
To Shipper _ _ _ _ _ _ __________
•
(o n&)
�.,
I, - +----\---'"""'-- --__.___,.,_,,___.,,.,:.=,e:_-=--- -- - -~ - , being duly sworn, depose and say that
I am
the consignee of a certain shipment of ar-d ent spirits, as specified on other..side- of thi; ·-form
; thrS-day- delivered to me by the Southern Express Company, from _ _
• ; th at I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place
whatrnever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia ,
approved March 1 1918, or co rar:\ to law, and that the ardent spirits so received by me are
to be used
,
L_,1,v"A
by me for
/
., {_
'
,'
L
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
purposes at my own home, and in con-
formity with law.
s
J:' a2i,
b
~f
Consi e:llee.
before me,
'£'9~7C ··~ iQ ~
l 1
Agent for Southlrn Express Comp3ny.
�FORM 370-VA .
Revised June, 1917
SOUTH ERN EXPRE SS COMP ANY
(Incorporate d)
LIQUO R RECOR D
Way-Bill_No,, _ _ _ _ _ _ __ _
TO - - ~ - -- - - - - -- - - ~- - - -
Advances to
Coll ect
EXPRESS CHARGES
PREP.AID
COLLECT
Add
Underchnrge
Shipper - ~ - -- - - - - - - - -- - - . /
P. 0. Address - - - - - - - -- - - ------- -=~ ,..__ ___._ _........_ _..__
_ _.__ __.__---'-_ _....__ _,
RECORD OF NOTICES
To Consig nee
To Shipper
(OVER)
�Vf'\
1
1
I,---'--""''----------=:,e__---'"""-- = =--"'"----'= "-----'-- = ,,__--_
.,_~ being duly sworn, depose and sa.y that I am
the consig nee of a certain shipme nt of ardent spirits
, as specifi ed on other side of this form, thi s day
deliver ed to me by the Southe rn Expres s Compa ny,
f r o = - - - - - - - - ~ ~ - - - - i that I am not
a studen t or minor, and, if a female , I am the head
of a family ; th at the ardent spirits so r eceived by
me
were brough t into the State on my written order,
and thai I have not, within the th.i rty days previo
us
hereto, receive d any ardent spirits of any kind wh
atsoeve r, from any person or from any place whatso
ever, in excess of the quanti ty allo'we d by the provisi
ons of th e Act of the Genera l Assem bly of Virgin ia,
approv ed
!}JO, 1916, o contra ry to law, and th at the ardent
spirits so receive d by me are to be used
Mr
by me for
7I
t,
~
~
.....
·
·
•~~
~
(State whether fo r Scien t ific, S acram ental, Medicin
al or Mechan ical)
I
·
J. t
...
,,, '
t,
Sworn to and subscr ibed before me,
this _ _ day of_ _ _ _ _ l9l_,
Aeent for Souther n Exi)ress Compan y,
,
purpos es.
Conslen ee.
�SOUTHERN EXPRESS COMPANY
f"ORM 370-VA .
(I ncorpo rnte d)
Revised June, 1917
GR
OE .
y
PECIAL LIQUOR RECORD
I
Consignee, _ _ _ _ _ _---''---'---=..,,:__-'-----'----=-------
-
~
P. 0. Addr_
ess_:.:c..:;'-'---'-"--+"'-+.k--"--"--''---
Kind of Ardent Spirits,_ __ --=----- -'---'·-'------'--Ouantity,_ -'-l_
' _ __ _____ Weight
Way-Bill No,_ _ _ __,._."'--",___ _
_ _ _ _ _ _ _ _ _ _ _ 191_
To _- _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ __
Advance s to
Coll ect
RECORD OF"
To Consign ee
To Shipp er
(OVE R)
.
'
f
lbs.
From, _ _ _ __ _ _ _ _ __
E X PRESS CHARGES
P R E P AID
COL L ECT
Add
Unde rch arge
�COUNT Y 0
I , - - --""'--" "--~. .L.-- -'----'---"""'----"'"---"'"-=--- , being duly sworn , depose and say that I am
the consig nee of a certai n shipm ent of ardent
spirits ,
of this form, thi s day
delive red to m e by t he South ern Expre ss Comp
any, f r o = - - - - - - - - - - - - - - i that
I am not
a studen t or minor , and , if a female , I am the
head of a family ; that the ardent spirits so receiv
ed by me
were broug ht into the State on my writte n order,
and that I have not, within the thirty days previo
us
hereto , receiv ed any ardent spirits of any kind
whatso ever, from any person or from any place
whats oever, in excess of the qnant i~ allowe d by the
provis ions of the Act of the Gener al Assem bly
of Virgin ia,
app rov ed~ 10 ,,..1916,} r ~ontra ry tQ law, and
th at the ardent spirits so receiv ed by me are to
be used
by me
purpos es.
(Sta te whethe r fo r Scientifi c
f: / / ' ~~A ._ ~
, Sacram ental . Medidn al or Mechan ical)
,1
~l '
. ,.:11~
Sworn to and subscr ibed before me,
this _ _ day of_ _ _ _ _ l91_ .
Ai:ent for Southe rn Expres s Compan y .
'
l
· Consi2nee.
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 05
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Grottoes in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
grottoes
virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
1918
1919
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box10-041
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Grottoes, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/c682d45597ee923cadb35753db496029.pdf
6143cc0f30e0e1c63e7062e1876790d6
PDF Text
Text
SOUTHERN EXPRESS COMPANY
FORM 370-VA.
(I nco rpo rated)
SPECIAL LIQUOR
Received at _lsland
_ _ _ _Ford,
_ _ _ Va.
_ _ _ __ _ _
Consign ee
l
'i
'-
.
Kind of Ard ent Spirits
1
I
1 •
-
,,
~
~ •...,Ji
J-/--- ) 1 /
\sland Ford, Va.
Way-Bill No.
(,\
f
Date
RECORD
" 1 n
1-_j_
191
Affidavit No .~
:;t
I
Am ount,_ '/--"('--'1_i__
,_
_ _,
_ _ _ _ Wei ohtL_ _ _
lbs.
1
ate___.~J'---(~ t'---'1'--5
-=-.."
_ _ _ _ 191~
To - - - - - - ~ - - - - -- - - - -
Ad vnnce s to
Collect
F O!)l _ __ ,.__
, '/--'-/--'/"EXPRESS CHARGES
PREPA I D
---"'---'Add
Unde r charg e
Shipp'<!r.--Jb.-.,----'l-"=-..:;..,,.Z..::
v4
:_;....!="-"-=--'--~'--==--
7
°
/
RECORD OF NOTICES
To Consignee _ __ _ _ _ _ _ _ _ _ _ _ _ __
To Ship pe r _ _ _ __ _ _ ___,__ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVE R )
�FO,=t ARD ENT SPIR ITS FOR
PERS ONA L USE
STATE OF VIRGI N!
COU NTY OF _ ~ - - ~-'-':e....!.-'--'e__.e....;C-"'-
..i
being duly sworn , depos e and say that I am
I, - =
{~------'---}~l---- ---------'-----"------- - ,<~---,pecifi
ed on other side o this form, this day
t
the consig nee of a certai n shipm ent of arden
; , •; that l am not 11
I
any, fr
delive red to me by the Southe1·n Expre ss Comp
receiv ed by me
head of a famil y ; that the ard ent spirit s so
stude nt or minor , and, if a femal e , I am the
days previo us
thirty
the
within
,
not
have
order, and that I
were broug ht into the State on my writte n
any place whats oever , in
from
or
n
perso
any
from
,
oever
whats
kind
hereto , rece ived any_ar dent spirH s of any
Virgin ia, appro ved
ions of the Act of the Gener al Assem bly of
exces s of the quant ity allowe d by the provis
me are for my own use, at
by
ed
receiv
so
s
spirit
t
arden
the
that
March 10, 1916, or contra ry to law, and
s will not be u sed in violat ion of law.
my own home , at!d that the said arden t spirit
d before m e,
)UJ<•--=c:::....=_ _ ,
191
7
/
/
�FORM 370•VA.
SOUTHERN EXPRESS COMPANY
( lucorporat.e d)
LIQUO ~
Received 8)1---"-'--'.J~'--"-""-''---'~'c"--'~-=:;:..--,--c------,--c --
Date
RECORD
,,j
191_
Affidavit No,_ _ __ _
Consione..,___-"---_~'---'----=----=---'---"-'-"·c..c'--'---"----'--------------- ----- - - -- - - - -- - -"'---'--=-""'-- - ---=-...!....:.....c.'---'--==-- Am ount _ _ __ _ _ _ _ _ _ Weio ht
Fro~ J,l~ (
A d vn nce e t o
Collect
!
l' llE P A JD
/QI')
lbs.
h / I'
Add
Uud e r c harge
C O L L ECT
~
To Consignee
,I'
EXP l! l!:S S CHARG ES
J_ /.,
I
To Sh ipper _ _ _ __ _ __ __ __ __ _ __ _
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE .
(OVER)
�ARDENT SPIRITS FOR
COUNTY 0 ~'-~--'-'---- '-
- - ~ --
I
/
Ir
l,
\.I '
the consignee of a certain shipm ent of a tlent spirit s, a~
'
PERSONA L USE
being duly s worn, depQSe and say that I am
: ter
r;
· e of thi s form, this day
t
I
•
,
deliver ed to me by the Southern Express Company , from
_,......,~- - - -·i that l am not a
student or minor, and, if a fem ale , I am th e h ead of a family; that the ardent spirits so received
by m e
were brought into the State on my written order , and that I have not , within the thirty days
previous
hereto, received a ny ardent spirits of any kind whatsoever, from any person or from any place whats.
o ever, in
excess of the quantity allowed by the provisions of the Act of the General Assembl y of Virginia,
approved
March 10, 1916, or cont rary to law, and t hat t he ardent spirits so received by me a re .f or my
own u se, at
my own home, and that the said ardent spirits will not be used in violation of law .
R (("') )'
(.)onsi6CU80 •
•
�FORM 3 7 0•VA.
SOUTH ERN EXPRES S COMPA NY
(lu(·orpo
t otod
Received at _...,___ _ _ _
Consignee
~-~~ -
LIQUOR
--.-1- --
Da'te _ _ _ _~--"- l!l l
__l
Affidavit No,_ _2(..,__,,,{'----
/- -------"---~-=~=Y
=------'tc.'--==----=--~-_,__-----"-_ ____ ____ _____;j:__,'------
Kind of Arde n_t_S-p~i~
rit_s,__~~
,
~--
•a'.,
'¥
IJ
I )
V
' ,.
is '"'-·-'/_~,_,_--= ---~-+- ---Weioht
,r ,
lbs.
19 1
Ailvnnf' c a to
Collect
EX.PRESS CHARGES
! 'REPA ID
COLL ECT
Add
Umlerchnrge
{
RECORD OF NOTICES
To Consignee ____ ____ ____ __ _ __
To Shipper _ _ _ _ ____ ____ _____
AFFIDAV I T FOR ARDENT SPIRITS FOR PERSON AL
USE .
(OVER)
�\,
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(lucorporoted)
SPECIAL LIQUOR
Received at
ls~and Fo rd1 Vij.._____ Dat l
~+
--\cc--',---"-+-~~-+-- - -~,--,------
C
RECORD
Am oun ~ - '---rc...+-~-- Weioht /. -1·
)/ I
Ad vnnccs to
Coll ect
RECORD OF NOTICES
To Consignee
Add
l'REPAID
To Shipper _ _ _ __ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVl<R)
lbs.
J
U u<le r chru-ge
_ __ _ _ _ __ _
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
"j
STATE OF VIR GINIA /
r
COUNTY Ot,.--L:IL -_,__
__:_::.::.__::~:c..:...:...;..
•u
I,
the consignee of a certain shipm ent
::)being duly sworn, depose and say t hat I am
sp cified1 on ot her siq-e ' f this form, this day
f7
C cl.J?
not a
j,,. ha
d ~- ( {_
delivered to me by the Southern Express Company' rom
student or minor, and, if a fem ale, I am the head of a family; th at th e ard ent spirits so r eceived by m e
were brought into t h e State on my written order, and that I h ave not , within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever , from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or cont r ary to law, and that the ardent spiri1.s so received by me are for my own use, at
my own home , and th at the said ardent spirits will not be used in violation of law.
/t e ~ ~ ~ - F - - F -~
~~
A~ent for Sout hern Express Company .
�SOUTHE RN EXPRESS COMPAN Y
FORM 370-VA.
( l uco rpo r: t ed}
SPECIAL
Affidavit
No,__?---y--
- - -- ---+- ~- -'----c-"'--_;_--'---'--- - - - - - - - -;:;t:.'::.::.=.:..- - -- - - -__,_---'-'-~ - ' - ~---'---'---" c,----,.,..-,i----;-'----
Am oun
~--- .·j
c. ____, __
7
/
FrOl1)1--- ---_,__, __-'-'--I
Ad vrmces t,o
Collect
EXPRESS Ct1ARGES
Add
Undercharge
RECORD OF NOTICES
To Consign ee _ _ __ __ _._ _ __ _ _ __
To Shi ppe r _ _ _ __ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
(OVER)
_ __ _ _ _ __
�AFFIDA VIT FOR ARDEN T S PIRITS FOR
PERSO NAL US'E
/'
being duly sworn, depose a d say that I am
l, on other side of this form, this day
specified
a
spirits,
the con-signe e of a certain shipment of ardent
that 1 am not a
.....i
delivered to me by the Souihern Express Company , frof
so received by me
spirits
ardent
the
that
family
a
of
head
e
th
am
I
female,
a
if
and,
student or minor,
, wit hin the thirty days previous
were brought into t he Stat e on my written order, and that I have not
or from any place whatsoev er, in
person
any
from
er,
whatsoev
kind
any
of
spirits
ardent
any
hereto, received
of Virginia, approved
Assembly
General
the
of
Act
the
of
excess of the quantity allowed by the provision s
are for my own use, at
me
by
received
so
spirit.a
ardent
he
t
hat
t
and
law,
to
rary
cont
or
March 10, 1916,
of Jaw .
my own home, and that the said ardent spirits will not e used iu violation
+-,
- ~" r - ----L-----"- -"'- -~----"' ---------1- ~ ~ -
f~
r
/
Sworn :o/nd su:,t 1be before me,
thi
_#_! )w / ,~✓/
\ ;1~ /7
,9.y-nf
'-'
•
1
,I°'-
Aa«nt for Southern Exvress CompaJ y.
V
1
~e )d
/7 / ·;
,_.,(f-/.
~
/I
Uonsiinee.
�FORM 370•V A.
SOU THE RN EXP RES S COM
PAN Y
(loc orpo
ral.ed)
Recei ved at
Island Ford, Va.
sPE ctA L uQ u~
_ __ _ _ _ Oa'ie'
Consignee _ _ _ _---'-'C---"'.:--+'-:
.+--~~~~ ~-
REc oRo
(
t
'7,,, 1.,_.,.,lDLL
'-.....,/ f-"
- - -- - - - - -...,• ~ -
Kind of Ardent Spirits- - ~ ~ ~'""""__,.~
, -~ ~ ~ -Way-Bill No. '), - /
--<.J_q.i--_-L/_....-,
_
Amou ntL
._ __,___ _
To _ Isla
nd _ _ __ _ __ __ _ _ __
_ __
S.hipper _ _
1
~J~~~~~~ ---=.---=.--=__::--=::.=
Arlv n n ce s to
Co ll ect
Affid avi t N·o?
· - - -- - -- - --
_c__ _ _
1917--
7.---
Weioht
J
lbs.
From, _..1.l-<1_,___ ____,;~:.:.__-t =•:.il
EXPR E S S CHAR GES
P RE PAJD
COLL EC T
Add
Ulld t: r c h n rgo
REC ORD OF NOT ICES
To Consignee _ _ _ _ __ ___
_ __
_ _ __
To Shipper _ _ _ __ _ __ __
_ _ _ __ _
AFFI DAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
(OVER )
�AFFIDA V IT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
/j
STATE 0~'
COUNTY
Vrno
NIA ,
o.~~- -~----,----'--~ -~-
/,j~.
J
duly sworn, depose and say that I am
1, ~ -....,.. ..~~~~ ~~---- -~~ - ~- - -- - , being
on other si b of this form, this day
specified
as
s,
spirit
the consign ee of a certain shipmen t of ard~nt
ot a
7 \ that
' < +
delivere d to me by the Souther n Express ; ompan , rom
me
by
received
so
spirits
that th e ardent
student or minor, and, if a femal e , I am the head of a family;
previous
days
thirty
the
within
,
not
have
I
that
and
were brought into the State on my written order,
any person or from any place whatsoe ver, in
hereto, received any ardent spirit s of any kind what soever, from
Gener.iii Assemb ly of Virginia , approve d
the
of
Act
the
of
ns
excess of the quantity allowed by the provisio
m e are for my own use , at
rece'ved
so
s
spirit
ardent
the
that
and
law,
to
contrary
or
March 10, 1916,
flaw.
lation
~
sed
u
be
ot
w\n
my own home, and that t he said ardent spirits
(.
' ~ .c
~
+IiL:.
--
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(Incorporated )
SPECIAL LIQUOR
RECORD
Affida vit No,_,),__i_ _,_,__ _
To
Advnnces to
Collect
/
EXPRESS CHARGES
PREPAID
COLLECT
Add
Oude r cbarge
Shi pp~...:.,__==-=~-----'----'---_c_---'--~~ - - - -
RE C ORD Of" NOTICES
To Consig nee ____ __ ___________ __
To Shipper ______ _ _ __ _ _ _ _ _ _ __
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE .
(ovxa)
�AFFIDAVIT FOR ARDENT ' SPIRITS FOR
STATE OF
PERSONAL USE
vlu0rnrA,
COUNTY Ow_ _:._
{ _ __ ..c,___..:...c..,.__-'---'~
~
I,
..._
, being duly sworn, depose and say that I am
.the consignee of a certain shipment of ard'e nt spirits, as specified on o.t her side of this form, thi s day
depvered to me' hy the Southern Express Company, from
1
; that l am not a
student or minor, and, if a female, I am the head of a family; th at the ardent spirits so received by me ,
were brought into the State on my writt en order, and that I have not , within th e thirty days previous
hereto, received any ardent spirh s of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March IO, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
·
( 7(/? 7. /
i!,IY.~!,,..-,h-==--- ,
191
l
Agent for Southern Express Company.
j
J ~
�SOUTHERN EXPRESS COMPANY
FORM 370-VA.
( lo(·orporated)
SPECIAL LIQUO
Received at _ _~ ~ - - -- -
To - ---'-- - - -- ~~•-'-,------ -Shipp er _ _~ ~ ~ -__.__
/RECORD
_ _ __ _ _ Date r, I •
l
l!)J_
Advn nC"eS to
Collec.t
\R..(
_~ ~Jt. . . ~J q--__,,i---:--_
_
Add
COLLECT
Uude rchllrge
-§ {
J
RECORD OF NOTICES
To Consignee _____~ - - - -- - - - -- -
To Shipper _ __ _ _ _ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVXR)
�ARDE NT SPIRI TS FOR
PERSO NAL USE
STA'.rE 01'' VI
COUNTY 01''- -- -~ ~ ~- ~ -~
1
1,
, being duly sworn, depose and say
that I am
th e consign ee of a certiiiu shipme nt of ardent spirits,
as specifie d on oth er side of this form, this day
deliver ed to me by th e Southe rµ Express Compan y, from
_ _ _~ - - -- - - - -- - ; that 1 am not a
student or minor , and, if a femal e, I am the head of a
family; th at the a rdent spirits so r eceived by me
were brough t into t he State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirit s of any kind whatso ever,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisi ons of the
Act of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and that t he ardent
spirHs so receive d by me are for my own use , at
my own hom e, and th at the said ardent spirits will not
be used in violatio n of law .
,&lJ --J / ~
( A gent for Sop thern Express Com1>auy .
�,.
SOUTHERN EXPRESS COMPANY
FORM 370-VA,
( l.ucorpo rat ed )
SPECIAL LIQUO J
Received at _
Consignee
r
__c:..::....c:..__.:._....:..__ __
'
I
_
__
_ _ _ __
Nn.l ~
r
19 1~
Amount / < I
Kin d of Ard ent Spirits_.;Lc....,.
,(, _ ___,__-==='----4'------'---'c,----,'-c:::---''-----
Way-Bill
RE C ORD
'""...-T/ '
Date /
l
Wei oh /
191-/-
To _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ __
Advnnce a to
Collect
j.
lbs.
From, _ _ __ _ _ __ _
EXPRESS CHARGES
PREPAID
COLL EC T
Add
Unde r c harge
Shipper_ L
}----''-----'='--.:......:-'----'---'~= ----'-- - -- - -
r
/}
RECORD OF' NOTICES
To Consignee _ __ _ _ _ __ __ _ _ _ _ _ _ __
To Ship per _ _ _ __ ___ _______ __ _
AFFIDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(OVXR)
�AFFIDAVIT FOR ARDENT SPIRI T S
FOR
PERSONAL USE
: being duly sworn, depose and say t hat I am
:J
l,
is form , t his day
the consignee of a certain shipment bf ardent spirits, s pecified on .o1her side
fl.{
that lam not a
J.. (1 ,/1 J::..._
delivered to me by the Southern Express Company, fro
by me
student or minor, and, if a female, I am the head of a family; that the /ardent spirits so rece1
were brought into t he State on my written order, and that I have no t( wifain the t hirty days pre ious
hereto, received any ardent spirHs of any kind whatsoever, from any per's on or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or cont rary to law, and t hat t he ardent spirits so received by me are for my own use , at
,,.
my own home, and that the said ardent spirits will not be sed in violation of law .
\.
)
(Jonsi1:nee.
- - - - - -- , 191_ .
I ,r... I//
I I
V
C
I
A11ent for Southern Express Uomi,any .
�SOUTHERN EXPRES
FORM 370•VA.
(ln <'o r~
e
I
SPECIAL LIQU
ord, Va.
COMPANY
"•9!!:t f,,,t
RECORD Of" NOTICES
To Consi gnee _______ _____~ - - AFFIDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE .
( OVER)
�SPIRITS FOR
PERSONAL USE
delivered to me by the Southern Express Company,
student or minor, and, if p. femal e, I am the hekd
~
sir:nee.
�FORM 3TO•VA ,
Affidavit No ., _ _
.~/-=!l_,,_____
p ___
Ac1Vftllf' C 8
Coll ect
to
EXPltESS CHARGES
PREPA ID
c..___
_
_
WeiohtL'--- - lbs.
Add
Uucl e r c bar ge
RECORD OF NOTICES
To Consignee _ _ __ __ _ ________ __
To Shipper _ __ _ _ _ _ _ _ _ _ _ __ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(ovKR)
�AFFIDAV I T FOR ARDENT SPIRITS FOR
PERSON AL USE
/
STATE OF Vp wrnrA,
,....
COUNTY 01'---.:::-- - . ---;-:----:--:----'+-.....-:
and say that I am
1, - - - -- - - - - - - - - - - - -- - ~ - - , being duly sworn, depose
of this form, t his day
side
other
on
specified
as
spirits,
ardent
of
shipment
certain
a
of
consignee
the
/
,,.r
; that l am not a
;
from
Company,
Express
Southern
the
by
me
to
delivered
spirits so received by me
student or minor, and, if a female, I am the head of a family; that the ardent
the thirty days previous
within
,
not
have
I
that
and
order,
written
my
on
State
he
t
into
were brought
any place whatsoeve r, in
from
or
person
any
m
fro
r,
whatsoeve
hereto, received any ardent spirits of any kind
of Virginia, approved
Assembly
General
he
t
of
Act
he
t
of
provisions
the
by
allowed
ity
quant
the
of
excess
for my own use , at
are
me
by
received
so
s
spirit
tlent
he
March 10, 1916, or cont rary to law, and t hat t
my own homo, ond th.t lh• ..,. -.d,nt spidt, wi'J'r x1 in
t:"o:JI; wNY ,
f-;(J/tU :•:~
-f'J---'\;;:~tf (,
9
• ·
I r:_e,,-.---::-,
f~_r:~----::-/ ~---.-~,; • _b~_;;,_::_
: ---:-:-_o _: :
:_h:_:r---'r-1/
V /
Ai:Mt for Souther11 Exvre s Com
I
v
�FORM 370•VA .
SOUT HERN EXPR ESS COM PANY
•
(lucorpo
rate d)
SPEC IAL
n.
Received at _ _ _ _ _ _ _-'---'"-'- - - ~ - - -- Dat., '-''---'- --'--"- ---=-- - JQ l _
~ ~ ~ - - - - ~ - - --=-- - ' - - Amount
a f
/
1:__
_.;_;._.i...::c== --- - - - - - ; D
A dvnnc c e to
Co l lect
Affidavit No.
7
Jlo
Weio hL/:..____ Jbs.
Fr(u.111~_ ~
: ~,;!.l___ __ ~ - -
EXP1!1£ S S C HARGE S
Add
Und c Tc hnrge
l ' R E PAID
(
RECO RD OF NOT I CES
\..,
To Consignee ___ ___ ___ ___ ___ __
_
To Shipper _ _ _ ___ ___ ___ __ _ _ _
_
AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE .
(OVER)
�AF-FID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
8TA'l'E OF VIRGIN IA,
COUNTY OF _ _ _ _~_-=:..._ _ ___.__:-
/""'
I,
/
, being duly sworf , depose and say th at I am
th e consign ee of a certain sh ipment of ,a rdent spirits,
as ~pec ifi.ed on other sfde of this form, this day
1
deliver ed to me by the Southe rn Expres s Compan y, from
"
t
'- (
t i / ; t.ha
m not a
student or minor, and , if a female, I am the h ead of a
family; th at the ardent spirits so r eceived by me
were brough t into t he State on my written order, and
that I have not , within th e thirty days previou s
hereto, receive d any ardent spirits of any kind wh'a tsoever
, from any person or from any place whatso ever, in
excess of the qu antity allowed by the provisio ns of thii
Act of the Genera l Assemb ly of Virgini a, approve d
March 10, 1916, or contrar y to law, and that the ardent
spirits so receive d by me are for my own use , at
mY. own hom e, and that th e said ardent spirits will not
be used in violatio n of law .
j
{,
(Jousiieuee.
Exl)r d
mpany.
�FORM 370• VA.
SOUTH ERN EXPRE SS COMPA NY
(Inco rpo rate d}
SPECIA L LIQUO-;;I RECOR D
~"'-'--:c= "-----'--- ~---'---- _ _ __ _ _
_
_
d(
J Hi12
I-
Dated
Affidavit No
I
Co nsig nee - - - - -- ~ - - + - - = - ~ - - - - - - - - - -- -,_j____ ____ :.___,___ _
Advnn cc e to
Coll ect
l!j.l(Plrn:SS CHARGES
PREPAID
COLLE CT
Add
Utu1erc barge
RECORD OF NOTICE S
To Consign ee _____ ____ ____ __ _ __
To Shipper _____ _ ____ __ _ _ _ _ __
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL USE .
(OVER)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
STA'£E OF VIRGINIA ,
COUNTY OF- ~ - - - - - ~ - 7 ' - - -~l,
I
!
depose and say that I am
1, - - -- - - - ~ ~ - -~ ~ ~ - - -- - - - - , being duly sworn,
on other sip.e ' f this form, this day
the consigne e of a certain shipment of ardent sp irits, as specif!ed
l
(
•
'//71,
,
<IC:
A
ro
delivered to me by the Soufoern Express Comp~
received by me
so
spirits
ardent
the
that
y;
famil
a
of
head
the
am
I
,
student or minor, and, if a femal e
not , within the thirty days previous
have
.
I
that
and
order,
w1·itten
my
on
State
the
into
brought
were
person or from any place whatsoev er, in
hereto, received any ardent spirits of any kind whatsoev er, from any
Assembly of Virginia, approved
excess of the quantity allowed by the provision s of the Act of the General
by me are for my own use, at
received
so
spiri1.s
ardent
the
that
and
law,
March 10, 1916, or contrary to
law.
of
my own home, and that the said ardent spirits will not be used in violation
Ir
ibed before me,
~
Sworn to an
('
day o ,-,
1
/
Tl V"
'--"' I
.r
f ,19; } .
/
A~ent for S outhern Express Company .
Uonsie:ne.e.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
( Inc orporated)
SPECIAL LIQUOR/ RECORD
- F ~ - - - -- - + - - - -- --
Date '
_
J
191_
Affidavit N
Kind of Ardent Spirits_ ~~-F~ ~~f ~ •-' ~' - - ~ - ~ ~ - Amoun ~_/_l':.
_'1_ ~,
-~
--+ - -Way-Bill No. /
fV
Weioht4 -lbs.
Date _~r~?~""'~t~ / _{.. __,. ,.,_
. _ _ _ _ 191
•
To
27----'\
, - - - - - - - , - - -E- X-.P-R_E_S_S _C_H_
A_R_G _E S
- - - , - - - - - - ,~
Advnn<' es to
t
Coll ~ct
f '
Add
l'REPA1D
COLLECT
Ship11er_ --==---=---'--'--:c...z.s ::--='--"'----'--=,,, ----,.-~~-
Underc harge
,I
RECORD OF NOTICES
To Consignee_ _ _ __ ___ _________
To Shipper _ _ _ __ _____ _ __ __ _ _
~FFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
STATE OF VIRGINIA,
/,
/
0
COUNTY OF
PERSONAL USE
~
/
'j)
, being duly sworn, depose and say that I am
' ,
1
I,
on ot her side of/ this form, this day
specified
as_
spirits,
ardent
of
shipment
certain
a
of
the consignee
· ; that' l am not a
/", I
I
delivered to me by the South~rn Exp~ess Company, from
student or minor, and, if a femal e, I am the head of a family; that the ard ent spirits so1 received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatso·e ver, frohl any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirit.a so received by me are for my own use , at
my own home, and that t he said ardent spirits will not be used in violation of law .
efore me ,
U'l....U:C....::;..c__ _ ,
;
191_,
/
I /~
'" Agent for Southern Ex i : ~va~··
'
�SOUTHERN EXPRESS COMPANY
_f ORM 370: VA.
(lurorpor.ated)
SPECIAL LIQUm
Rece ived at.-">-..:;.J.~ .!-'-"-----=---"-'~"-'---
/
t
RECO
- ~ -- - - Da'Z_.,J (
J
19 L:__
Affidavit No.d -----f- __
AdvrW<'C8 W
Collect
PREPAID
COLLECT/ /
Add
Uude rc bo.rge
\V
RECORD OF NOTICES
To Consign ee _ __ _ _ _ __ ____ _ _ _ _ _
To Shi ppe r _ _ _ __ _ _ _ _ _ _ _ _ __ _
AF.FIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
;
PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF ~
'
, being duly sworn, depose and say that I am
/
~I,
the consigne e of a certain shipment of ardent spirits, as specified on other side of th is form, this day
I \ , ) / ; , ; that l am not a
I
delivered to me by the Southern Express Comp~ny, from ,
student or minor, and, if a female, I am the bead of a family; that the ardent spirits ,so 1· ceived by me
were brought into t he State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
aw. ~
my own home, and that the said a_rdent spirits w1 Ze used in violatio,
Uousieuee.
�SOUTHERN EXPRESS COMPANY
FOR M 370•VA.
( lu corpQfated )
Affi davit No.
Consignee
~
- ----'~- -----''--- ~ ~ - -~ - -- -- -- - -- - -p+ --- - -- - - - -J..f--_,_~ _
·- - ~~--+--~-"-:::::.- ----:-~-,..,,_- Amoun t._,-._:.~----;'------ -- Weio hL.___.:__ _ lbs.
From ___ _~_ __,/1
'----'._1
_ _
Ad vn n cc s to
Coll ect
EX PR ES S CH ARG ES
l'REPA1D
A dd I
U nde r c harge
RECORD OF NOTICES
To Consignee _ _ _ __ _ _ _ _ _ __ __ _ __
To Sh ipp er _ _ _ __ __ _ ___ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVER)
�AFFIDAVIT FOR ARDEN T SPIRITS FOR
PERSONAL USE
I, - -- - - - - -- - -- - - - - -- - - -- , being duly swor)l, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified 1 on other side o this form, this day
1
/;
delivered to me by the Sout hern Express Company, from •
that l am not a
student or minor, and, if a female, I am the head of a family;
e ardent spirits
eived by me
were brought into t he Stat e on my written order, and that I h ave ot, within t he
irty days previous
hereto, received any ardent spirit s of any kind what soever, from an j person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly f Virginia, approved
March 10, 1916, or cont rary t o Jaw, and t hat t he ardent spiri1s so received by me are for my own use, at
my own home, and t hat t he said ardent spirits will not be used in violation of law .
/) J
u
Oonsi2ueo.
·;
Sworn to and subscr bed lfefore me,
this
day t''::r--"'----....:::..-
, 191_.
I-I - -- -- ~
~
,
Acent for Southern
Express
ompauy.
�SOUTH ERN EXPRE SS COMP ANY
( l u corporate d}
Affid avit No.
To
J/-3
- I.
Shipper: B '
t..-1..A
RECOR D OF NOTICE S
To Consign ee _ _ _ _ _ _ ___ ___ ___ __
To Shi pper _ _ _ __ _ _ _ _ _ _ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE .
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
STATE 0~'
COUN'fY
PERSONAL USE
i
V RGINIA,
F__,_ _ _
......._-====--=:...::---=-
, bein g duly sworn, .depose and say that I am
rr--z.-tl- h .
1,
specified
as
the consignee of a certain shipment of ardent spirits,
. on oilier side of this form, this day
.
__:_./ 1
h
·
that 1 am not a
°rrl
deliv.e11ed to me by the Southern Express Company, from
ceived by me
so
splrits
ardent
the
that
;
/
famil
a
of
he~d
the
am
I
female,
a
if
and,
student or minor,
evio s
were brought into the State on my written order, and that " I have no t , within the thirty days
i
whatsoever,
place
any
from
or
person
any
from
whatsoever,
kind
any
of
s
spirit
ardent
any
hereto, received
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or cont rary to law, and that the ardent spiril.s so received by me are for my own use, at
my own home, and that t he said ardent spirit s will not be used in violation o·f law.
J1
/
Sworn to and subs ribel before me,
this
/C, dayor'
,_/
{ J
, 191_
,
I Ae-ent for Southern Expres~ Comi,any.
vr v
fr>-n-:i e--11
Consienee.
�FORM 370•V A.
SOU THE RN EXP RES S COM
PAN Y
(lucorp
ornt.ed )
,m,~;,,.2$
SPE CIA L LIQ (J' R
Consign ee - --"< ~,,., ,,'--- '--"- -',-,.
""--' -..,_ _.,~
~~., _'-0 .._,_ ___ ___ ___ __
/
'---1 --~ ---- --"-- - Wei oht
~I
JL
lbs.
Fro m,..,__ _ -'-- ----"-'- ~
..,1'-'--'
' '-'-f--=,
A<lv:rnc: c s to
Coll ect
EXPH E S S CHAR GES
REC ORD OF" NOT ICES
To Consignee _ _ _ __ __ __ __
__ _ _ _~
Add
PREP AID
U ud e r c hurgo
I
To Sh ipper _ _ _ __ _ _ _ __
_ __ _ _ _
AF"f" IDAV IT F"OR ARD ENT SP
I RITS F"OR PER SON AL USE
.
(OVER )
�2
,
·
/
0•! ! ~,•:t,~dt~r
AFFIDAV IT FOR ARDENT SPIRITS FOR
)
PERSON AL USE
STA'J'E OE' V1 ' GINIA,
COUNTlY
1
-~~--C~__(l
~ ~-----1-.. .-'L
-----~l/L
-...~ ~
:~ _,_
/~i ~ !a.~_ - - - - - , being duly sworn, depose an
ay that I am
other side of this form, this day
th e consignee of a certain shipment of ardent spirits,
,k; ~ )J/c,
1
delivered to me by the Southern Express Company, fro
?
/,,
hat l am not a
student or minor, and, if a female, I am the head of a famil / ; that the ardent
spirits so r eived by me
were brought into the State on my written order, and that I h ave not, within
the thirty
s previous
hereto, received any ardent spirits of any kind whatsoeve r, 'from any person or from
any place wh tsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
March 10, 1916, or contrary to law, and that the ardent spiri1.s so received by
me a re for my o
my own home, and that the said ardent spirits will not be used in violatiou of
law.
/q,1
I
Uonsi2uee.
efore me ,
~'----
-t:--- , 191/ /
7
I
J
Al:ent for South: ra
)
Efpress Com1>auy.
�SOUTHER N EXPRESS COMPANY
FORM 370•VA,
( l u('o rpo raLcd}
SPECIAL LIQUOR
RECO
_ _,.,,__ 1!l
'v
Rece ived at _ _ _ _ _ _ _~ ~ -- - - - - - Date,--'-/_ _ _
12
Kind of Ard ent Spirits,_ c,--1----"-- -'--~-~-~ ~ - - - ,~ ~~ ~ - Dat/
c3 f f
't,,
Advnnccs to
Collect,
To -- + - - - - - - ~ ~ - ~ -- - - - - - -
EXl'l!ESS CHARGES
l'REl'Al D
Add
Uud e r chnrge
J ---'-_,_~--- -----,~-'-~,;o ,.Shipper.-......-~~JC. ..-"'-
RECORD OF NOTICES
To Consign ee _ _ _ _______ _ __ _ _ __
To Shi pper _ _ _ _ __ _ _ _ __ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER)
�FOR ARD ENT SPIR ITS FOR
1,
-
v"'--"'- "'-----f .-f---= -- =--'--"-J'-'--""
PERS ONA L USE
'----'== =----- ---,---, -,
being duly sworn , depos e an say that I am
specif ied
other side of this fdrm, this day
------->;'l'l-r.:'t7 J
}J
J ; that l am not a
stude nt or minor , and, if a femal e, I am the
I 7 I
head of a famil ; that the arden t spirit
s so r ceived by me
were broug ht into t he State on my writte n
order, and that I have not, within the thirty
s previo us
hereto , receiv ed any arden t spirit s of any kind
whats oever , from any perso n or from any place
wha ever, in
exces s of the quant ity allowe d by the provis
ions of the Act of the Gener al Assem bly of
Virgin ia, ap ·oved
March 10, 1916, or contra ry to law, and that
the arden t spirit.a so receiv ed by me are for
my own us , at
my owu home , and that t he said arden t spirit
s
not be used in violat ion of law.
will
j
Oonsie:nee.
�FORM 370•VA.
)
l!ll _
Consignee - - ----=-'--''- --_e__c'----='-"-...-=-.=c='-'-- - - - - - - -+---=--c,----- -
- - -- -- -.t---
Kind of Ardent Spirits, _ _ ~~_.c....~- ~~'-T--' ~~-,.-'-- - Amo un.__ _ _
_ _ _ __ __ Wei ati<-- L - - lbs.
Way-Bill Np.
)
To
, .
c~,f
~
,,v
..
✓
-
Advonces t o
Collect
~
LvvO
EXPRESS CHARGES
l 'REPAID
COLL EC T
~
J. /c...,J'+
,
;
- -'----=- ------~- T- - -- ~ - -- - -
Shipper
1
___:l___:,_IJ
c:.;=-_1-,lu )~
i
i
Add
Unde r c harg e
I
RECORD Of" NOTICES
V
To Consignee _ _ _ _ _ _ _ _ ___~ - - - - - -
To Ship pe r _ _ _ _ _____ _____ ____
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONA L USE.
( OV ER)
-
�AFFIDAV IT FOR ARDENT ' SPIRITS FOR
STA'rE OF VIRGINIA,
COUNTYOF _ _~•-
Jl
PERSON AL USE
•
~ -{,--:-c'--'=-;--=-{....,--~
j
,,
,
· l,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on ol her side
of tqJs form, this day
· delivered to me by the Southern Express Company, from ,
I i.!
; that 1 am not a
student or minor, and, if a femal e, I am the head of a family ; that the ardent
spirits so re eived by me
1
were brought into I.he State on my written order, and that I have
not , within the thirty day previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from'
_a ny place what s ever, in
excess of the quantity allowed by th e provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiril.s so received by
me are for my own use, at
my own home, and that t he said ardent spirits will ot be ut
~n violation of law .
'~
I
~
~irl!Po/~
I
A!lent for Southern Exvre
~~
omi,any .
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 08
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Island Ford in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
island ford
virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-003
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Island Ford, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/5e416830b055187760b0309e03066519.pdf
1994dd931738c132d77f20f4a44d99d0
PDF Text
Text
DELIV ERY FORM 60
ADA MS EXPR ESS COM P ANY
SPEC IAL LIQU OR RECO RD
/,
- - ~ - ~ - -- 191 _
/
Cons ignee _ -----'--'----------:.,_ ---''-'F ~-'-'-~--"-- --'c-:- z----- '-----' ----"--
Affidavit No. _ _ __
'-c;--- --.,c--:--::-- -:--- '---- ----- -- ~ ~ ~ - -~ -.--'- '~- .........,._-A mou
nt-----./~ ~ ~ - - -- Weig ht~~ - -lbs.
Advan ces to
Collec t
I
RECO RD OF NOTI CES
To Co nsign ee _ _ _ __ _ _ _ _
_ _ _ _ __
' EXPR ESS CHARGES
PREP AID
COLL ECT
I
To Shi pper
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE.
( OVER )
~- ,
Add
Under charge
-
I
�~-----~~---------------~---- --~-ARDENT SPIRITS FOR PERSONA L USE
I
,I
/
I, - - - - - - ~ - - - - - - ~ - - - ~ - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this
day
~
delivered to me by the Adams Express Company, from :' _I
,
; that I am, riot a
- student or minor, and, if a female, I am the head of a family; that the ardent spirits so receive
me
were brought into the State on my written order, a1,d that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever , from any person or from any place whaJso1
ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are
for
my own use, at my own home, and that the said ardent spirits will not be used in violation of
law.
.
A g ent for Adams E x pre ss Comoany.
-
�ADAMS EXPRESS COMPANY
SPECIAL LIQUOR RECORD
,I
- - ---==-:-:----:;- -;----- - , - - - - -Date~- ----r_
,, _
____ 19;2-
Affidavit No. _ # _ __
Consignee _ :s,,,____,_---''----,- -"-~~- -""'"''--·+.-L ,-C~~,"---"c----'C......~L"----- ~ -- - - - - - --Way-B·ill No· -
/
~ -~-"--
To_-'--- - - - ' -~~~r(a.--+--~- --Shi pper
Ad vances to
Collect
Add
Unde rcha r g e
....,,__,r:.--i'-'--,c.......,--1.r.....,__=:;;_, 1-,;e;c:~=..;..:'- -,,-'--
RECORD OF NOTICES
To Consignee _ _ _ _____ _____ __ _
To Shipper _ _ _ _ _ __ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVER )
�,-.- · --------- -----------.-- --------- -------- --------- -----AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF V1Rf'.}1'1A,
L!"-"//c___ ,L_=:.::.....::.....=..
/
COUNTY OF-,,/'--"-
, being duly sworn, depose and say that I am
.
.
I,
the consignee of a certain shipment ofoirdent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, from _ _ _ _ _ _ _ _ _ _ _ ; that I ar;n not a
student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by me
were brought into the State on my written orde r, atld that I have not, within the thirty days previous
h ereto, received any ardent spirits of any k ind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by t he provisions of the Act of the General Assembly of Virg inia,
approved March 10, 1916, or contrary to law, and that the ar dent spirits so r eceived by me ar e for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
0
_-
(
I
Consignee.
Sworn to and subscribed befor.e me,
thisL
day of
;lu
I
/
'
~
A gent for Adams E xpress Company.
�----------------------------------------- -·- --- --- --- --ADAM S EXPRE SS COMP ANY
D EL I V E R Y F ORM 60
I ,..,
C onsign ee __~ - - ~ ; . , - - - - ' - - - ' ~ - -
..- ,_
Date,:;.,,=--,L----,.-'.,....,...,'---c--19 1 / ' · Affid,avit No. !
=-------- - - - -- - ; --.-,---- r--'-c,... ..,/-,,-~. ._•_-'r<-c-✓
~
..-'""....-~:\.:....,.....,,- I
:t-:":_.=_. ,mou nt _ _~_ _.....,.·- •~ We igh t _;::'_,_
, _ l bs.
l<ind 9f Arden t Spiri ts _ __,..~-o-=--i-.~=-;;r-c,..,...__,,.....:~
Way-B i!l , No. _ __,c.......---=---- -
To
_,
/
.,, •
._.,_
Advanc es to
Collect
i
RECOR D OF N O TICE S
_
To Con si!}l'lee ___ ___ ___ ___ ___
EXPRE S
):'REPAID
CHARG ES
To Shi pper _ _ _ _ _ _ _ _ _ __ _ _ _ __
PE R SONAL USE.
A FFIDAV IT FOR ARDEN T SPIRIT S FOR
(OVEK)
�(
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF ':IR~INI~, ( ; ,
• .•.I
COUNTY OF, , ..: ( /', . .f . f"i·',
....
.
· ·· ' · · , • · ·· - 1~,~eing duly sworn, depose and say that I am
•.
·• '
I,
of this form, this day
of ard~n·t~p~ra!I"specified on other/side
shipment
certain
a
the consi~~e
'
t:r
~
~
delivered to me by the Adams Express Company, from ;- , / .....,;. • -,.,<.· 9 • .,. ,. ~- ,> i, that I •am m1t a
student or minor, and, if a female, I am the head of a famiJy ; that the aroeht !1pitits-s'lS~_e.~i-ved\fur me
were brought into the State on my written order, and that I have not, witrufi the thirty days pre,:"ioushereto, received any ardent spirits of any kind whatsoever, from any persoo or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
\
Sworn to and subscribed before me,
., '
�ADAMS EXPRESS COMP ANY
OEL !VERY FORM 6 0
Received- ..,
..,...--===::....:::..:....=:.c:._-~;__~- -- Consig nee _ _----,--__:.'----'--- _:__--'--_LL--:+--=-:.=--'::..._--,-- 4~,'---------- ,--,.......,~- ---,------ --- -
,.,,,.
- ---=---=----=-----"--': ....:..-~~-- '-----
To _ _~
PREPAID
I
Shipper
RE COR D OF" NOTI CES
T o Co ns ignee _ _ _ _ _ _ _____ _ _ _ __
/
T o Shippe r _ _ _ _ _ __ _ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( O VER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF v15m~u,
COUNTY OF-,i-~-+--e-'-- - -=-'-- . - - -
/ '"
I, - - -- -----'------ '----'--..____ , being duly sworn, depose and say that I am
the consigne'e of a ce!"tain shipment of ardent spirits, as specified on other side of this form, this day
;,.,that_ am not a
n I
.
delivered to me by the Adams Express Company, from ,
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are fo r
my own use, at my own home, and that the said ) ; dent s irits will not be used in iolation of law.
(l (!_ U, (
l }ll,€,) 1
ttl
I
Consig nee.
Sworn to and subscribed before me,
tbis_ _ day of--'.....:-:==-~- , 191T .
I
Agent for Adams Express Company.
�ADA MS EXPR ESS COMPANY
To
';
Ship per -:,:_;}..-4--- '---'- =~__ ._--"""-------""'
--','--"
- f_"'_.'
,__
RECO RD OF NOT1 c i: s
1
Advan ces to
Collec t
I '
~..: ., :// ;
~- ~- -~ --~ -~ --~ -~ ~- ~- ~
To Co nsign ee _ _ _ _•·_ _ ___ ___
___ _
To Sh ippe r ·
AFFID AVIT FOR ARDE NT SPIR
ITS FOR PERS ONAL USE.
( OVER )
l
�___ _______________ ___ ____________________________________,
___,..
AFFID AVIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE
STATE OF VII>f!
COUNT Y OF+(_, -:,,_ _ __ _ ___,,.....,,..
J_
,✓
'J'
I,
"
', being duly sworn, depose and say that I am
the consign ee of a certain shipme nt of ardent spirits, as
~.ge_9ffied on Q,ther ,;tide1'f> this.ff;lrm, Jl)is day
deliver ed to me by the Adams Expres s Compa ny, from ?Jf
"1"' ~~ · , __✓,-.,.,<-/4!/~t a
studen t or minor, and, if a female , I am the head of a family
; thlttiie a:rden t spirits so receive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previous
hereto, receive d any ar dent spirits of any kind whatso ever,
from any person or from any place wh1J,tsoev_e r, in excess of the quantit y allowed by the provisi ons of
the Act of t he Genera l Assem bly of Virgini a,
approv ed March 10, 1916, or contrar y to law, and that the
ardent spirits so receive d by me are for
my own use, at my own home, and that the said ardent
spirits will not be used in violati
of law.
,,
, °I
I _:.,. (
,,
;,
'.
'i ,~.;, il,fl
-~-
·'(Ir"'."~ , ..
"'l < & / f
Consigne e.
l
A gent for Adams Express Company .
�ADAMS EXPRESS COMP ANY
LI QUOR RE.C OR D
SPECIAL
,
Received_ _ _ _~-'----=------=--:..:.....-'-- - -- -C onsign ee _ _+-- -- --,--rc-- - --==--i==--------,--'-- -f-- ---'---'-----=:--:--;--".:a...--..,..,....~ - - - - -- -
~ - -
1.bs.
W ay-Bill No. _ -c-:---:-c==,-,--To '
/1
A dvances to
Collect
/
E XPRESS CHARGES
PREPAID
Add
U nd e rch a r ge
RECO RD OF N O TICES
To Consignee
T o Ship per _______ _ ________
A F FIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVER)
�--------- -------- -- -AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _,,,_
J _ __ _I~
f./·
1/
/_/_ __
I
,I
,,
I,
I
, 1 ,·
/
, oein~ d uly sworn, depose and say that I am
the consigni e of a certain shipment of ardent spirits, as specified on other side of this form, this day
J
delivered to me by the Adams Express Company, from
; ./ 1
( that I am· not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and tha t I have not, within the thirty days previous
hereto, received any ard en t spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for
my own use, at my own home, and that the said ardent spirits will not be u sed in violation of law.
Sworn to and subscribed before me,
this _ _ day of_ _ _~ ~•• 191___,(.
~
I /
A gent for Adams Express Company.
�- ---- · -- - - - - -- --- - -- --- ---- ---- - -- - --- --DEL I VERY FORM 60
ADAMS
EXPRESS COMP ANY
SPECIA L LIQUOR R::::co D
--+-.......,,;;,,,...-.,...:....-=-'-'--=--- - -- -Date _: _-+---- ,,.,_--
191_ Affidavit No.- - b - -
S~ipper
REC OR D OF' NOTICE S
To Consign ee ____ ____ _____ ____
To Shipper
AF'FIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL USE.
( OVER )
�AFFIDA VIT FOR ARDENT SPIRITS FOR PERSON AL USE
STATE OF VIRGINIA ,
COUNTY OF----:-:----::: - - ~---.=:c-:- ---=.7.A
I, "-------"----- ~~- -',,- - ---"--- ---.:... ----, being duly sworn, depose
and say that I am
the consigne e of a certain shipmen t of ardent spirits, as specified on other
side of this form, this day
delivered to me by the Adams Express Company , f r o m - - - - - - - - ~ - - ; that1 am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and tha t I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or f rom any place whatsoever, in excess of the quantity allowed by the provision s of the Act of the
General Assembl y of Virg inia,
approved March 10, 1916, or contrary to law, and that the ardent spirits
so r eceived by me ar e fo r
my own use, at my own home, and that the said ardent spirits wilLnot
be used in.Niolati on of law.
Consignee.
A gent for Adams Expres s ComDany.
�ADAMS EXPRESS
DELIVERY FORM 60
COMPANY
SPECIAL LIQUOR RECORD
Received _ _ _-----::--=--==;-;:c....;~';--=--=+~ ~ ~-
- - --"--- ~- -- 191 _
Affidavit No. _ _/_ __
Consignee _ _~ - - - ~---=--- ~ -------::~- ~------.------, ,-:~-----:;;e-- -------- - --
Advances to
Collect
I
E XPRESS CHARGES
PREPAID
COLLECT
I
RECORD OF NOTIC ES
To Consignee _ ________ _______
To Shipp er
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVER )
I
Add
Undercharge
I
�- --- --~-- ----- - --
- - - ·--··· ------- ------
--
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE
, 'being duly sworn, depose and say that I am
....
I,
this form, this day
the consignee of a certain shipment of ardent spirits, as specified on other side of
_,/
that I a m not a
delivered to me by the Adams Express Company, from----'" -------...., __ _ _.__~;
received by me
so
spirits
ardent
the
that
family;
a
of
head
the
am
I
female,
a
if
student or minor, and,
days previous
thirty
the
within
not,
have
I
were brought into the State on my written order, and that
whatsoplace
any
from
or
person
any
from
er,
whatsoev
kind
any
of
spirits
ardent
hereto, received any
ofVirg.foi a,
ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
by me are for
approved March 10, 1916, or contrary to -law, and that the ardent spirits so received
of law.
violation
in
used
be
not
will
spirits
my own use, at my own home, and that the said ardent
\
Conei~nee.
Sworn to a d subscribe d before me,
rt.
"'---"~- , 191...:J.
thi!<_J_day of_ ...==c(,
I
A g ent for Adams Express Company.
�~----- -------------ADAMS
DELIVERY FORM 60
.
EXPRESS
{ OMPA!ff
Reoeived_'-'----"-=-::::,;c..:=_~-==-'-="'-'-_:__::::..___.:c-'----"--Date_~~- - - - -191_ Affidavit No,_1_ __ _
Consignee _ _ _ _---.::-r------=--::c----cc--::-;::--;----::::::=-- -- --
/
-----=--:-:----:------ - -- --
-
- ~--~ ~ -~ - ~~~~- - ~moun t _~/_ _ _ _ __ Weigh ~ ___ Jbs.
Way-Bill No. -+---~ - -- -
To _~___________=--:"- --
-
-
-
Advances to ·
Collect
EXPRESS CHARGES
PREPAII)
COLLECT
Add
Underc ha r ge
Shipper
I
I
RECORD OF NOTICES
To Consignee _ _______________ _ To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER)
I
I
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRGINIA,
COUNTY OF _ _ _ __ _ _ _ __
I, - -- - - - -- - - - -- - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, f r o m - ~ - - - - - - - - - - ; that I am not a
student or minor, and, if a female, I am the head of a family ; that the ardent spirits so received by me
were brought into the State on my written order, and t hat I have not, within t he thir ty days pre¥ious
h ereto, received any ardent 2pirits of any kind whatsoever, from any person or from any place wh at soever, in excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Virginia,
approved March 10, 1916, or contrar y to law, and that t he ardent spirits so r eceived by me a re for
my own use, at my own home, and that the sa~
t spirits w~ll not be used in violation of law.
Consignee.
Sworn to and subscribed before me,
tb;;;l-c dfy of
~
{~ Z7 / '
91
' J.
.
I
A g ent for Adams E x press Company.
�l bs.
Add
U ndercharge
Sh i pper
RECORD OF NOTIC ES
To Consignee _ ______ _____ _ __ _
To Shi ppe r _ _ _ _ _ _ _ __ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRG NIA,
i
I
, - -- -f----COUNTY OF-.-- ' ,_
f
I
--"-- -
, being duly sworn, depose and say that I am
_,t,_,.
I, .
the consignee of a certain shipment of a rdent spirits, as s ' cified on ot r side of this fo:r.w, this day
/_,-,f~ ;
r:. '/_,.;.- '"':,
•'/'.
~
at I am not a
,!: ,.,, · · ' ' 't,- ,'-,;
delivered to me by the Adams Express Company, from 1
student or m inor, and, if a f ema,le, I am the head of a family ;{ hat the ardent spirits so received.by me
were broug ht into the State on my w ri tten order, a11d that I have not, within the thirty days previous
hereto, received any ar dent spirits of any k ind whatsoever, from any p er son or from any place wh11tsoever, in ex cess of the quantity allowed by the provisions of the A ct of the General Assembly of Virginia,
approved March 10,' 1916, or contrary to law, and t~at t he ardent s pirits so re ceived by me are fo r
my own use, at my own home, and tha t the said ar~ t spirits will not be used in violation of law.
.
,
/,;
//
· ;. '_. . · ~· ;_ ,,.., -;, ·
l_ /,, I .
/
.!,/
.
.
Consignee.
J
A g en t for Ada m s Express Company.
�~-- --~-- --- ---- --- ----- --- -DEL I VERY FORM 60
ADAMS
EXPRES S
COMP ANY
SPECIA L LIQUOR RECORD
Add
Under ch a r ge
R ECO RD OF NOTICE S
To C on signee _ _ _ _ _ __ ____ _ _ _ __
To Shipper
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL USE,
( OVE R )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF
/ /1
Vr~~L\~-')
1 :•
COUNTY OF
~ ,
J , .' '-
,
~ ~
,
~
~
I,
' , ,
<
,,- r ,.
, being duly sworn, depose and say that I am
the consig'iiee o a cert ·m sh ment of ar'dents\,w-.its-, as specified on other side of this form, this day
1
delivered to me by the Adams Express Company, from
~
; that I arh not a
student or minor, and, if a female, I am the head of a fanfify; thftfiiearde ~pirl\:s so received by me
were brought into the State on my written order, and tha t I have not, within the thirty days previous
hereto, received any ard ent spirits of any kind whatsoever, from any person or from any place wh.at soever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved Mar ch 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
?f's' .
4':::t;t
<- ,
;
Sworn to and subscribed before me,
,/
-✓.: ,,~
thi~day of pi;,':,,
19L'/'
i ,
, -'f=(f /,-- I,__..,._ -- "
-{l- f~_,T
~ k ~ ~-Comuany,
:;...-
I
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l
~
;"
/r
..
/
~
'l '
i
'.,,
'-
.
.,,
-~1· l,,,KlI : •,•- . .
Consignee.
�------- ----------------------- - -
- - ~-
-
_
,._.._.
_____ - ----- -- - ---- ---- ---- ---- ----.
COMP ANY
ADAMS EXPRES S
DEL I VERY FORM 60
SPECIAL LIQUOR RECORD
Way-Bil l No. _ _ _ __ __
To _ _ _ _ _
Advances to
__:...__.:::__..:_ __:c:....: :...~~---+ ~--
Co11ect
EXPRESS CHARGES
PREPAID
COLLECT
S hipper - -- - - ~ -- - - - - - -
RE CORD OF N OT I CES
T o Consigne e ____ ____ ____ ____
To Shipper
USE.
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
( OVER }
Add
UndeTc harg e
�I, - - -~ - - - +------,-'~--- ,c-'-------- --, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as s ecified on other side of thi , form, this day
. Adams Express
~ I a m not
delivered to me by the
Company, from l
1 '".
r
, tli
a
student or minor, and, if a femal e, I am the head of a family; t hat the ardent 1rits so ceived by me
were brought into the State on my written order, a nd th a t I have not, withi the thirty days previous
h ereto, received any ardent spirits of any kind whatsoever, from any person or from any place wh.atsoever, in excess of t he quantity allowed by the provisions of t he Act of the General Assembly of Virg inia,
approved March 10, 1916, or contrary to la w, and that the ardent spirits so r eceived by m e are for
my own use, at my own home, and that the said ardent spirits will not be u sed in violation of law.
I
Sworn to and subscribed before me,
A g ent for Adams Expre ss Comoany.
·~ --
Consignee.
�- - --·- - -- - ---- --~--- --- - - - -- ---
------ ---- ----
ADAMS EXPRESS COMPANY
COLLECT
REC ORD OF NOTICES
T o C onsignee ________ ___ _ __ _ __ To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVER )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I
I, _ .,._:,__ _,--,_ _ __.__:::c..._-=:..__..c....;:..__~ ~ - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Adams Express Company, from--~ ---'------ ---; that I am not a
student or minor, and, if a female, I am the head of a family ; t hat the ardent spirits so received. by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from a ny place whatsoever , in excess of the quantity allowed by the provisions of the Act of the General Asse mbly of Virg inia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for
my own use, at my own home, and that the said ardent spirits will not be used in violation· of law.
Sworn to and subscribed before me,
this+
day of_ _ --,,__
/
A gent f or Adams Express Compan y.
Consignee.
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 09
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Keezletown in Rockingham County Virginia for personal use.
Subject
The topic of the resource
affidavits
ardent spirits
personal use
keezletown
virginia
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-004
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Spatial Coverage
Spatial characteristics of the resource.
Keezletown, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/bf553a51729eecd95698630bd7365264.pdf
0d31613fd8dd28a83ffb55f901100a33
PDF Text
Text
G. s.
H.H.ALDHIZER, PH. G .
ALDHIZER
ALDHIZEH & SON
THE·DOWN·TO·DATE·DRU GGISTS
BROAD-W-AY, VA.
ir
. .. t a t e o ·
7'
in i
ou t y
f
o t c..ry pu l i e i n ~ n i
I , J . J . P nr yba k r ,
0
otd.t ~
f or~s a i :i , o c~ r ti
ni- , H . H .
.a
~
/> l ,ihi zer
aff i a ri
hu t
o f J· lcohol a n ~ t a t
of
u iJ.o u n ,_
1 t -1 9 1 , 76
t a t t is day p "' rs c rw.ll
h~ , h . 1 o n han::1 on J a nuar ,
uri n~ th
th , , ounty a n::l
a.Pf'
"r~
b ~ or ~
134 F l u i
l , ,.
ov . 2 t h-1 () 20 .
o
1st- 19 18 , 294 F l uiiou
u c es, ~~vin : on h a n
1 oh 1 •
.x ir~ s
'ba
a., '
n:ont.. o f J an,{u ry th ~y r c , iv~
u
u nc ~s of
},zy co .. r:. i s i o
11 iv .n u n
r
or
of th~ f i r ri 1 o . .A li11. i z e r & ~o , ::Br oa 'W Y ,
l coh o l a n
l ui
o c in h am , t o - i t :
60
~ ~b r u a r
s
��G. S .
ALDH I ZER
H. H.AL DHIZ ER, P:x. G .
AL DH IZ EH & SO N
THE- DOW N-TO -DAT E-DR U GGIS
TS
!r.lte
~~ Store
BRO AD-W AY, VA.
, t
~
of
i r in
Cou ty of Po
I,
c n t_r · n
St t e
f
l' ;i ,
~
un
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V
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y
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l
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~
on
the
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on
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o.
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1 t - 1'j1 8 , 76
r 1~ r y t •~Y u .
1i -1 9 1
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. y co ·r1· " i n
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.-ry p ub i
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V
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cf P l h iz ~r &
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· ncrh a
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c•
flu · '
��G. S. ALDH IZER
H. H.ALD HIZER ,P:H. G .
AL DH IZ EH & SO N
THE- DOW N-TO -DAT E-DR UGGI STS
T'lte
~~ ft
Store
BRO ADW -AY, VA.
Stat e of Virg inia ., Cou nty of Rock ingh am to-w
it:
I, J. J. Penn ybac ker, a nota ry pub lic in and
for the coun ty
and stat e afor esai d,do cert ify that H. H.
Ald hize r of the firm of
.Ald hize r & Son, Broa dway , Va., did this day
pers ona lly a ppea r befo re me
and n~ke affi dav it that the said Ald hize r
& Son had on hand on Marc h 1st1918, 629 Flui dou nces of Alco hol and that duri
ng the mon th of Marc h tmey
used 101 Flui dou nces of Alc oho l,l e avin g on
hand on Apr il 1at- 1918 ,
528 Flui dou noes of Alco hol, and that duri ng
the n1onth of Marc h they dtid
not rece ive any Alco hol.
~
'
.
com miss ion exp ir es Nov. 28th '!"19 20.
Give n und er my hand , th i s 1st day of Apr il1918 .
!
- }-(/ ~--. --- -~-- -- -- -- -N •
P
0
��G. s.
A.LnHIZER
H.H.ALDHIZER,PH. G.
ALDHIZEH & SON
THE·DOWN·TO·DATE·DRUGGISTS
'Y.ne
~e1CafL Store
BROAD-W-AY, VA.
St ate of Virginia, County of Rockingham, to-wit:
I, J. J. Pe nnylJacker,a notary public in and for the county and
stat e aforesaid , do certify that H. H • .Aldh i zer of the f inn of Aldhizer
& Son, Broadwa y, Va., did this day personally app ear before me and
n~ke affid~vit that Aldhizer & Son had on ha.ad on Ap r il 1st-1918,
528 Fluido un ces of Alcohol a nd t hat dur i ng the month of Apr i l they
used 164½ Flui dounces of Alcohol,lea v i ng on haad May 1st-1918,
363½ Fluidounces a nd t hat
ur ing the month of .April they did not rece i v ~
a ny Alcohi> l .
My cornmi ssion ,~xpires Nov. 2 8th- 1920.
Given under my
da.y of May, 1918.
��G. s. ALDHIZER
H.H.ALDHI.ZER,P:11. G .
ALDHIZEH & SON
THE-DOWN-TO-DATE-DRUGGISTS
BROAD-W-AY, VA.
St.a . , e of Virginia , Cpunt y of Ro ck· ngham , to-wit :I ,_
h- 12. auU#
,a
no t ary pub lic in an
fo r t he
county ad state afo resaid , do cert i fy that H. H• .Aldhizer , of Aldhi.,r
&
Son , Broadway, Va., did this day perso nally appear before me and make
affidavit that they h a d on hand on May 1 t -191 8 , 363½ Fluidounces of
Alcohol and that during the month of May they us ed 204½ Fluid~unces of
Alcohol, lea.v i ng on hand on June 1st-1918, 159 Flu i dounce s of Alcohol
a nd that during the month of May they did not receive any Alcohol .
Given under my hand , t hli.o
c3
day of June , 19 18.
- - -~~·---~----a_e/1.~____
My con.rnission expires
/d ,_,,..../_, _/ f.~L .
N. P.
��G. s.
ALD HIZE R
H.H. A.LD HIZE R,P.u .. G .
A. LD HI ZE H & SO N
THE ·DO WN ·TO -DA TE·D RUG
GIS TS
'rlt~ ~~ Store
BRO AD- W-A Y , VA .
Sta e of Vir gi ni~ , Cpu n t y of Roc
kin ha ., o- .it :I , J. J . Pen nyb cke r , a ota ry Pub
ic in an for the c oun ty and sta
te
~fo re aid , do cer ti fy tha t H.
H. J..ld hiz er of the firm of Ald hiz
e r & Son ,
Br o;..dway , Va ., did thi d y per son
all y ppe r bef ore me and m ke
ff i
vi t
tha t Ald hiz er & Son had on han d
on Jun e 1~t -19 18, 159 Flu ido unc
es of
Alc oho l a nd tha t dur ing the mo
nth of Jun e the y r ece ive d 608 Fl
ido une es
of ./llc oho
nd u ed 195 Flu idc uno e , lea vin
g on hand on Jul y 1 t .1 918 ,
572 Fl1 ido unc ea o f Alc ol). ol o
My conm,i s ion exp ire s Nov.
28_th-1 920 .
Gjv en und e
my han d , thi& 1 t day of
, -7-~
1 - 91 8.
N tar y Pub l:tc .
��G . S . A.LilHI ZER
H.H.AL DHIZE R, Px. G .
AL DH I~E H & SO N
THE-D OWN-T O-DAT E-DRU GGIST S
T./z.e
:R ~ Store
BRO. AD-W AY, VA.
t· ~ __, 0.1.
f'r
n
I:
ta
r
.:i izer
0
aunty
.
enn ·b&c
f ore..; - .
5
FluL...o
r , a No ary
o cert i f
on > :B ro~
ke a
oc in. an1 to-w it :
O-
·av
.,, , V·
i - it t
.......
,lco
101
r
.'
tha
b ic
• A . '-'--' izer 0.1.
0
iu.. t is
vin 0
h t
on hb.n
h
~~
n
0.1.
.A co
t
oun
irm o
u
n
anu.
n
u:rir\.;, the
g . 'hi -
9i
:o nth o
3
lu i oun
not r.ce· ve
O
0
cowr nissio n
Gi • ...
or t e
a;y .,,,.-:-- ona ly
on ha
~.n
n an,
er
1
;._ ir .s lfov.
n
~
�1. ".d
�G . S . ALDHI ZER
H . H.A.LD HXZER , PC>J.. G .
AL DH IZE H & SO N
T HE · D O WN-TO ·DA T E -D RUGG I S T S
'rit,e
~~
Store
BRO A D'WA Y, VA .
t· t e o
>ta e
Son ,
Virg ini , Coun ty o
.
•
ore
i
nnyb ac.er ,
, d.o cert i y
oa wa y , V
i avit t .at
oun1.,;eH, o
6
]
an
no ar
t
t ' t
~r on-.1 y
y
0
~iven un d r ru
n
u e
i es ' v .
han
han
8
ug, t
on
ugus
Flui ounc e
un
or the
e
fi .cm
1 · t -1)
n
/
ay o f
t
n
Al hiz
0
m
,
~n
m
e
361 Flu i
of )lco nl , le ving
of Ale hml .•
~
unty
they rec~ ive
8 h-192 0 .
this
IY"I
n
pear befo r
uring the mont h o
t -191 , 740- Flu i
on
blic in
E. H. Al hize r of t
t i
i
of ~lco hol
on Set .
con uis
.,
n
'--h izer & Son h
lco o
lui ounc e
on h · n
Ro kingh ;i,,m o-wi
ber -1 9 8 0
��G.S .
A.LDH IZER
H . H . .ALDH IZER., P:B . G.
AL DH IZ EH & SON
THE -DOW N-TO -DA T E-D RUGG I S T
S
'Ylte
~ ~ t,
Store
BRO AD-W AY, VA.
Sta t e of
i r gini a
Cou nt , o
.o C k l. ng 'n
I , J.
t t
an j_
0
;:. l hize r
an
n~
nia
~
i
r-
u.
13 F ui oun c~ a
i
not r ,,cei v
t hi
vi, t hat Aljh izer
lui dou c e
627 ... Flui oun~
.,i i
Al e ho
0
-0
of
t
ol , a n
lcoh o
an
- T on,. ~r ctp
on h n - on
on h
" t
on
D, n ·
0
i rm o
e qr bl'!f ore
'!
t. 1
r_ 3
, e t~n, ,r t e y
8t .- 9 0 .,
~r ,
J
._.
9
~a-- ,/
t .~
ct . 1 t - 19 8 ,
urin g th- mon th o
.0 .
t - ,9 8 ,
s~, v"m ~r
.
My conu1tiss ion ex
Gi y ._ n un . r nq
d
h"'!
u rin 5 t e mon t
cl
fo r the co ·nty
l Jhiz ~r o
coho 1 , ~avi ng on
0
0
~nv
n
:-
ub io in an
c , rt .i y t at H. H .
74 0
,
t o- . l.
no t ar
on , Bro .. :i;.r y ,
...
DI i
0
,
��G. S . A.LDHXZER
H.H . ALDHXZER,PH. G .
ALDHI ZER & SON
THE·DOWN·T O·DA T E·D RUGGIST S
~he
~~tt Store
BROAD-W-A Y, VA .
tate
f
un t · o :'
rgini· ,
•
c er , - Not r· ~u lie in
. enn ·
erti y t
, jo
,
on ,
-.~
V ..
,ockingh n , to - -.7 · t :
•
... . j
t H•
or t1
• .. 1 rt · L.~r o f t . e
j a_ .
t his
n
P"'T on·
')
ount·
i rn1 o
r be f or ~
"'
.A l hizer
n · r11e.
T•l -
·tt th . the· a. on
,n· on cto'ber
~t- 19 1 , 627½ l ui
"
Al co 0 an th· t t y r .,c.__i'fel , uring t v mo nt o f atob ,r 6
0
u
l c oh
0
no,
an
~e ·
uring t
, .,~,vi ng on han :i
v
on
of
n _ venib~r 1 t -19 1
?:ily conrn1L , ion ex ir.., ~ Nov .. 28th - 92
n ~r
ctob"r
,
'74
4
t
91
lu i : oun c~ o
o
~
lo
.,:;i
.1,lui ounc,
er- 1? D.
e
OU
0
J.lco. o .
�L -
�G. S.
ALDHIZ ER
ll. ll. ALDHIZ ER, PH. G.
A LDH IZE H & SON
THE -DOWN-TO-DA TE-D RUGGI STS
T'lze
~e,ca2f-
Store
BR O AD"W" AY, VA .
. t .... te o
- '1 1
Vir~i ni
I'
.
J. p
,Le.. t ~
cl
o r,3o i
.1 hiz r &
·· tr
,
>- 0
on , :Broa
t.,
"c -. ntber
ruon vh
C.1.
~
t -191
N vewb ~r th ~Y
., ,
L
...
1·
1c1 fl
,
L
l,
1-
~-
t ·•
1J·::r
of .Alco
OU!l 1
.
, n.1
0
,
~'">
t
lG. t
o f .Alcoh
:Alco
uot r _ce ..i.'l . ~-n~-
92
O "
o n·
1
on
-n
urin..:: ,
,
-Gl V
int3
n,... t _ct t
lcoho
t~
CIT
i ..:..,r
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lui ounc~
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Al
_Al hiz•r ?. . ,·, n h,
"th -
i1· · e n un e.r 1c
·bli.~ , i n en
th ...v H.
"' .,
Flui
, 57
ot r ,
0
..
t
-~
__QC i. ghti.lli, to - Nit :
.r t, l
•,·6 • l
47
u e
r,
C
8 , 744 :Fl i:ioun
...
I .b~r
~- o f
nn ·b· . . k
c,n.1 n.a.k_ a._ '"' i l ~vi t
.. l~
:JO
OU
G
o
~c"n1 er- 91 u ..
...
.,
t.,
'}!f
on
ount
fi rm
0
e r b" _o.r"
ov~nib er
~
lltO TI
th 0
n
<JI
o:r
ri n...., t . e
��HENRY'S BLUE CO.
MANUFACTURERS OF
II
HENRY'S
BLUE
· CHEAPEST AND MOST ECONOMICAL
Full Quart of Best Liquid Blueing for 5c.
Broadway,
(TRADE i\lARK)
V a .~ · · · ·· ·· ··· · · ·· · ···· · · · · ·· · ·· ·· · ·· · · · · · · · ·· · · · · ··-· ·-
f o r t _e Co iJ ·1 t
n.:! S t· t e ·, ore .... i ,i , J. o
So n ,
roa w&,y ,
, .L't .i.f,
th""t
ljhize r oJ' t ~ firn 1
. • H.
i
'l hiz.-. r
.,
t-191 , 597
2 53½ F l i,
u
1.rnc~ ' , l e.:: vine o t1 hc1. i on J ~m r
.l•oho , t..n .... that Ju.ring th . ,
i.....
on t;" of
1
- !) 1 ,
343-.:
?1 j.U .o nc~
ecemt~r tJ-Ly .lid. n t rec eiv.,
nJ Ale ho ..
- Gi v2:n un ,.,r ray
... n , t1i .i 1 t
ay of
an.urry - 1919 .
•
a
��G. s. ALDHIZER
11. H.ALDHIZER,P: tr. G .
ALDHI ZEH & SON
THE-DOWN-T O-DATE ·DRUGGISTS
"rne
~~fL Store
BROAD-WA Y, VA .
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ALDH IZER
H. H . .ALDH IZER, PB. G.
AL DH IZ EH & S .O N
T HE ·DOW N"· TO·DA T E ·DRU GGIS TS
The
~~ fL
Store
BRO AD-W AY, VA.
'"' t
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ALnHXZER
II.H.ALDHIZER,PB. G .
ALDHIZ EH & SON
THE·DOWN·TO ·DATE ·D RUGGISTS
"r.lte
~~ft
Store
B R O AD"W"AY, VA.
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��G. S. ALDHIZE R
H. 1-1.ALDHIZ ER,PH. G.
ALD HIZE H &
s ON
THE·D OWN· T O·DATE·D RUGGIST S
T'.lte
3?~1£ Store
BR O AD"W°AY , VA.
State of Virgin ia , County of Rocking ham , to-wit :I, M.
o.
Miller,a Notary Public in and for the County and StaM
~fores aid do c e rtify that H. H. Alihiz er of the firm of Aldhiz er & Son,
Eroaiw ay 1 Va., did this day person ally appear before me and make affida vit
that Aldhiz er & Son had on hand on April 1st-191 9, 133 Fluidou nces of
Alcoho l and that durin g the month of April t h ey receive d 608 Fluiiou nees
and used 92½ Fluido unces, leaving on hand on May 1st-191 9 , 648½ Fluidou ncea
of /l lcohol .
~
M
My commis s i on expi r esmtt tw, .3-...........:.
,4
,_/_L2- 3 •
Gi ven un1er my hand, this 1st da,>;. of May~1 :-p/J.
_/
__m.-.
_____.__tf1._._/____
/~
__·______Notary
~ublic .
��•
G . s. ALD H I.Z.ER
H.H.A LDHI ZER,P H. G.
AL DH IZ EH & SO N
THE -DOW N-TO -DAT E-DR U GGIS TS
The
~~ fL
Store
BRO AD-W AY, VA.
Stat e of Virg inia , Co unty
0 1·
Ro c kingham to - W'i t:
I , M. O. Mil ler , a nota ry pub lic in and f or
the Cou nty and
Stat e afor esa id do cert ify that H. H. Ald hize
r of the firm of Ald hize r
& 8 on 1 Broa dway , Va., did this day
pe r s ona lly appe a r b efor e me and malee
a ffi dav it tha t Ald hize r and Son had on hand
on May J st-1 919 , 648½
Flui dou nces of Al c ohol and that they used
duri n~ the mon th of May
133½ Flui aoun cea , leav ing on hand on June 1st191 9 515 Flui dou nces
1
Alco hol and t ha t duri ng t h e mon th of May they
did not r e c eive any Alc oh ol.
My comm is s ion e x p i r e s ~
, J <!:f
/'/'L . 3 •
Give n u n clilr ID/I h and , th i s
2.m'&
1
~
Nota ry Pub li c .
�•
�G . s.
ALDHIZ ER
H.H.A.L DHIZER , P:11:. G.
ALD HIZ EH & SON
THE·DO WN·TO ·DATE· DRUGG ISTS
':rh e~e dtst ore
BROA D-WA Y, VA.
State of Virgi nia, Count y of Rocki ngham , to-wi t :
I , M. O. Mille r, a Notar y Publ ic,in an;i for the Count y and
Slate afore s1:d cl, do c~:rt i fy that H. H. .Aldh izer , of the
firm of Aldh izP-:t
and Son , Broad way , Va. , did this day pe r sonal ly appea
r ·befor e me and
nake affid aYit that Ald.hi z er & Son had on hand on
June 1a t
-1919 ,
515
Fluid ounce s of Al cohol and th at durin g the month of
J une t hey used
318½
Fluid ounce s , l eavin g on hand on July
iat-19 19, 196½
Fluid ounce s of
Al coho 1 an:i that durin g the month · of Jurie they did not
recei ve
Alcoh ol .
YH
/l
~
My cormi issio n expire s.l'
_/~~ ~ ~- ,-..;;.3_ _ _ ,
/'/7- -3.
Given under my hand , this 1s t $ &u ~
N. P.
any
��G . s. ALD H
IZER
II. II . ALDHI ZER, Pn. G.
AL DH IZE H & SO N
THE·D OWN·T O·DAT E·DRU GGIST S
The
~~ tt Store
BROA D-WA Y, VA .
. . t a te of Virg in ia , Coun t y of Roe.Ki ngham, to - wi t : I , · • o. Mi l ler , a no tary pub l ic in a n f or
tr.e
coun ty and s tate
afo1 e said , do c e r ti f y t hat H. H. Aldh i zer of the f
i r n, of Aldh izer & So n ,
:B r oadwa y , Va ., did th i s d.a.y p e r so nal l y a p e a r b ef
o re me and make aff i davi t
t hat Al dh i zer & Son ha on h nd on J u ly 1st- 1919 ,
196½ Fluid ouno es of
Alco hol a nd tha t dur i ng the mon t h of J uly t hey re ce
ived 608 Fl ui d.ounc e s
and used 160 Flu idoun c e s , l eavin g on h a nd on Augu st
1st- 1919 , 644½ Fluid -
ounc es of Alc ohol .
My
conmd ssion expi r e s March 3rd-1 92 3.
Gi v e n unde r my hand , t his 2nd day o f Augu s~~Y
/J ~ !
-..?22~--.. &;.._-'-a~ <~
~ --- --- -'N. P.
�i::
Filed in the Clerk's Offlce
Rockingham County, Va.
r'iUG2- 19 19
----- -Cle rk
,.
�G. s. ALDHIZER
H. H.ALDHIZER, PH. G.
ALDHIZEH & SON
THE·DOW:N·TO·DATE-DRUGGISTS
T'.he
~~tt Store
BROAD-WAY, VA.
tate o
Tir i n is, , Coun t
I,
o.
•
of Ro c1dngham , to-wit :
ill er , a
otary Pub:. ic in a nd fo r th~ County and S~.te
a fores a id do c e rtify t ha t H. H. Ald.hizer of th .... fi -rn1 o f Alih.izer & So n ,
Broad w y , Va.,
that Aldhize
Alcohol a n
i d. this day p , rsonally a p p ear before m . a!'ld ma k~ affidavit
& Son hai o n h a nd on Au g u st 1 t- 19 19 ,
that dur ing·t the
.o n t
of Augu s t
644½ FL.l ido noe s of
they u ed 21 O-½- OuncP-s l eavi n g
o n h and on S ~ t . 1 s t -1919 , 434 Flu i ounces of Alcohol
ntonth of Augu ·· t
nd. t a t
uri ng lthe
th ey did n o t r ~c e i v e ::1.ny Al c ohc l.
1lY conu:tisai<b n ex i r es
ch. 3r d -1.1 3.,
Gi v n u n e r m
.
�'1
I
f
•
•• •
, ,.
.
• J
f iled 'in 'the 'clerk's Offlc'
R-0cklAgham Couflty~ Va,
AUG301919
___ ___ _Cl
C
�G. s.
ALDHI ZER
H . H . ALDHI ZER, PH. G .
AL DH IZE H & SO N
THE·D OWN·T O-DAT E ·DRUG GISTS
The
~e4afL
Store
BROA D-WA Y, VA .
State of Vi rg inia , Cc unty of Rock i_n gham, t o-wi t :
I, .M:. 0.
H l l '3r ,
No tary Publ ic , in and for the Coun ty and
tate afor esaid , do ce!'t i f y that H. H. Aldh izer of the
f irm of Aldh izer
Son, Broad wa y , Va ., did this day pe r sona l y appe a r
befo re me and
ma e affid avit that Aldh i z r & Son ha on hand on
Septe mbe r 1st-1 919 ,
434 Fluid ou.nc es of .Alco hol and. that uring t he month
of S~p t e}l1ber
&
they
u ed 295 Fluid ounc . , l eavin g on hand on Octo ber 1st-1
919, 139 Flui ounc es
of Alco hol n..i that d11ri ng the mont h of Septe mbe r
they did no t rece ive
\ . ·,
any Alco hol.
My comn tissio n exp ire
arch 3-rd- 1923.
Give n und er my hand , thie 1 t day of Oc t ober - 191 9
0
.._
~222
~,-,..;.._
£ "---'
~ --""~-_ _ _
N. P .
��G. S. ALDHIZ ER
H. H . ALDHIZ ER, P:e:. G .
ALD HIZ EH & SON
THE·DO WN·TO ·DA TE ·DRU G.GIST S
T.lze
~~
Store
BROA D-WAY , VA .
S t.: t
o f Vi r -.:, i n i ., , C unt:y of ·.oc ki ngh im, t o-wit :
I , J. J . P n. bac er
n.3 Saa.ee afore ~a ·
no tar
,lo c --- rt i i ~ that H. H.
l ' hiL.i r & Son , :Eroc:.. wa , V .,
u~ an
n a ke a f iiavi t
139 F l ui 4 ou n c
rec i v e.
10/ 10/ ,
Ji
6Go
C ODtl!ii
6iO
F l µ i oun
~
;;:.n '
t
f /I le
...
av
an l u e
' nunce
ire
a
i ' th i.
f i rnc o
on h n
urin=, the :u1ont
on Oc ob er 1
cf
t - 19 ,
cto' er t e r
on h nJ o n Nov en~er 1 t -
ol .
•' •"'\-
t
~
Cort y
, rso n l] y ap e r b e f or e
156½, l ~avin
ov . 2 ' t - f920 ..
Giv nun ~r nt· h n-i , thi
f or th
:h ize r , of t
thr t A .ihiz r & So n ha
of .Alcoh o
59oi2 , lu i
pub lic i in an
u
,.
..
\
-
Nove nib er , 1919 .
z!!r==1~
O J.
Fu l ie .
�I
�G . s . ALDHIZER
H.ff . A.LDHIZER .,PH. G.
ALD HIZE H & SON
THE·DOW N·TO·DA TE·DRUG GISTS
T.he
~~e _t
Store
BROAD- WAY, VA.
Ba•te of Virgi ni~ , County of 'Rocki ngham, to- wit :
I , M.
o.
Miller ,
&
Notary
Pu•lhi , in
and for the Count y a.nd
e
at e
• ~o r esaid do certify th~t H. H. Aldhiz er , of the f i rm of Aldh i zer & ~on ,
Broadw ay , Va . , did thi& day person ally appear e efor e me a nd na ke af fi davit
that Aldhiz er & Son ha:i on h and. on Septen1(1er 1 a t- 1923, 544 Fl uid ounc e s of
Al cohol and used dur i ng Sep t en~er 125 Fluidcu nee a , leavin~ on hand on
o~to•e r 1at- 1923 1 419 Fluido u noe• of .Alcoh ol a.nd thlil.t duri n~ Sep Unnaer t
he
did not r ec e ive any Alcoho l .
My
commis si on e xpi res Februa ry 2 3rd- 192 7 .
Gi ve n u nde r D~ h~nd , t hi
N. P.
fi"il d In the Clerk' s · ~ ..
Rockingham Cou11ty, vc
/i
JCT l• TW23
rf8_tr,,J~-- ~-cHs r
�•
�G . s . ALDHIZER
H.H . ALDHIZER, PH. G .
ALDHIZEH & SON
THE·DOWN·TO·DATE-DRUGGISTS
T'he
~~fL
Store
BROAD-WAY, VA .
State or· Virgi nia , County of Rockin~«L., tc ~.-.i,:
I, M. O. Mill er ,
ii.
Notary Public , in a nd fo r t he Coun t y and
State a.foreaa id , do certi fy th t H. H. Aldhiz er of th e f i r m of Aldhiz er
& Son , Broadway , Va., did this d.ay paer~onally -.pyear befo re me an:i mak e
affidavi t that Aldhi~er & Son ha~ on hand on Oc to• er 1st , 192 3 1 419 Fluia-
ouncea of Alcoh ol and receive '.1 durin~ Octo1er 640 Fl uid.ouno"a and us ed
202 Fl u i~oinces ,l e.ving on hand on Nove mber 1et , 1923 , 857 Flu i dounces of
Alcohol . My commission e xpires Feb. 23rd ,
1927.
ri ven under my hanj , this 1st day of Novem~er, 192 3.
. ,;~
~ ~.: ;. i~
~ •2&
~ e{!)
~dZ
J
'4~1/_ _
N• P •
��G . s . ALDHIZ ER
H. H.ALDH IZER, PH. G.
ALD HIZ EH & SON
THE·DO WN·TO · DATE ·DRUG GISTS
'rh e~~ Sto re
BROA D-WA Y, VA.
t. te cf Virgi nia. , Coun ty of Roe kin
-.11 1
t o- wi t :
I , M. C. Mil ler , a Notar y Pu blic , in ~ nd f r the Count y
~nd Stat e afore a.id o c ertif y t hr H. H. Ald :izr , of
the fi u of
Aljhi z~r & Son , Bro.d w y , V ,., did th i
ry .: ::- son .... l ly
r,,e ilLnu. n, ke -.ffiJ vi t th .. t Al d.h i zer & Son h~.d om. han
1923 ,
57
Fluil oun -~ cf >lc ohol
n~
IJe a.r ' efore
on Noveq tb er 1 t ,
uring Noven ~er th ey u . ed 22 Pl~ i!-
ounce , le ' ving on bani on Dec . 1et - 1923 , 835 Fluid cunce
1~ coru11ti
ion~ .._.,ir • F ~"b . 2 9 rd-1 ,, 27 .
Given under ru
h nJ , t hia
t
of Plc oh ol .
��G. S.
A.LDH IZER
H.H . .ALDH IZER,P :x.
G.
A.L DH IZE H & SO N
THE- DOW N-TO -DAT E-DR UGGI STS
'r.lte
~&X02t Store
BRO AD-W AY, VA.
Still te of Virg iniii . , Cou nty of ~ock ingh am
, to- wi t :
I,
O. 1'i.il l e r ,
1.
.,_fore · i
,
that
::,·:
0
Not. .ry Pu~ lio ,
, o c e rt if
,
Va ., diJ this d ..y p~r ona1 1y
that
nd for the Cou nty and ,
th-. t H.. H• ..Aldh i zer , of the
ldhi z e r & Son h ·-
Alco hol an
in
on h nd on Deoe
p
1
:;,r
i r n, of J.1 ·hiz .r & ,. o n ,
•for e n,~
c
n.., m ke affi J. ..v i t
r 1 t-19 2 3 , 835 Fl u i ounc e
u.rin t~ t e mo nth of De c e mber they u ed 4
1 .. ving on r..~nd on J anu ... ry 1 t - 1924 , 795
Flu i dmm c ~~ of
My con!rl.i
ion expi r e • Feb ruar y 23rd ~ 1927 .,
Give n unde r n~
aa~e
Ju i
Cl,. n
1 ohol ,.
~n· , thi
Flleo In the Clerk's Office
Rockingham County, Va.
1/\ I 3-1924
of
~
��G. s.
AL.nHIZER
. H.H . .ALDHIZER, PH. G.
ALDH IZEH & SON
THE·DOWN -TO·DATE· DRUGGIST S
The~ edLst ore
BROAD-W AY, VA.
S t a t e of Vi r ,in ia ,C ou nt y of P.ockingh am,to-wi t :_
I , 1.1:. O. ;filler,
Notary Pu ~lie, i !'l and. f o r t ,,,_e County a ni
State a fore~ a i d , o c e~ t i f y t hat H. H. Al h i er of the fi r n cf Al h izer
& . on , Broad.·•:ay , Va. .,
i·
th i s
a ' p er sonal l y
ffi ' ._vi t that Ald rii;t.er & f' cn h ai
Ounoe. of J l a oh 1 an
us l
p p e~. r
n 1 and on J.,_nu~iiy 1 t , 1924 , 79 5 F lui j __
uring January 138
l ui~o uno~ s , le avi n
on Februa ry 1•t , 1924 , 657 Flu i J ouncea cf Alc oh 1 .
My
cmn,i
i on expirea Feb . 2;;ri -1 92 7.
Given u n er my h a n , t~ ia
e f or e n "' a n:! n.~,ke
on : a ni
��.., t .i.te of Virgin ia , Cou .t y of ~oc k i ngh-.m, to -wi t :
I , M. O. Miller ,
fore
i ,
@
~
c;:er t ify t h at H. H . AlJ.h i z ar
~~r
h 1st , 1924 ,
uri n ..., F e"br u a ry
i r ~•
Gi ~r e n unde r n1y h and , thie 1at
75
Feil .
eb ru~r y 1 t,
n
n
k~ ~f f i ~-
1924 , 657 F lu idoun J~
Flui~ o uncea , l e vi n . on h· ..nd.
d a;r
2 3r d.- 1927 ..
f Ma.roh , 19: ~
Z: :Z &= -
Fifed In th Cl rk's
~ ~flt 'v
. I
Mi
e f ore me
0 f ~lQoho l .
582 Flu i dounoe
My ecmmrtii ai @n ex~
n
n h a nd
vit t hat Al&hize r & S n h ad
le ohol a.nd u e i
f t he fir:r.1 cf Al h i z er & ?o n ,
d ay ~ er~ ~al l y a p er
Broadway , V ., di d thi
of
t a te
No t r ' Pu b l i c , i n an d for t he Cou t y ~n
°' ~
i 2
N. P .
n
��t a t e e,f Virginia , Count:r of Rocki g11· r.1, to - wi t :
r,
M. 0 . Mill " r , a. Notary Public , in
t a te a f ore . i d. , ::to
n
for t he Cc,u nty
al!
~
er t i f y t h t H.. H. .A l d.12. i z e r of the f i rru c f ; ldhi ze r
& Son , Brov,dw.y , Va ., id thi
- ay
affi avit t hat Al hizer & ~on ha
er onally a. " e r.r " "fore nl!
on h anj
n March 1s t, 192 4 , 582 Flu i -
urin ~ M.a rch 86 Flu hi ou ce , le vin ,,
ounces of Al coh~ l and u se
rd n:51,ke
n
--~-- d
on A~ril 1at , 1924 , 49 6 Fluidoun~~
M"y com .ii,sion ex ire~ F e~ . 2:,t t -1927 .
Given u nder n:y han , thi:3 1st day o f .A pril , 1924 .
;?;? & # ~ ~-
Filed In t
Rockir g
~
ril
,~.A.
N. 1? ..
�(
'
r
.r
�G. s.
ALDHIZER
H.U:.AL»HIZER ,PH. G.
A.LDH IZEH & SON
THE·DOWN·T O·DATE·DRU GGISTS
T'he
~~fL Store
BROAD-W-A Y, VA.
f Vir i1tia.. , •.i t,..;;i..,.,
I,
t .. te afcre
ti.nJ.
• • O.
d.
~~
:ici i' an , to-wit : -
~ill er , a N t111.ry Pu1l i c , i n a.n
,i~ , o e~rtify tt1
Al hi z er & Sall, Bro ..dw- y , v .. . ,
·i
.t,
thi
..,:;. .,.. ·""•--~~ ar.ff'id.;.vi t t h t Al 'hizer & •
~96
Flui ou ~oee •f Al ch l a n
l e · vi
ha
e:n
t. H.
·' ay
Oll
that
1 hizer of the firm e f
er•cns.lly a 1 - e ii,r
ha:i o n h c-.n
uri
a y 1et-1924, 457 Flui c un e
h y cozrnni
Lo
1• t
e f o r•
39 F l ui
f ~ l oh ol ~n
l oh•l .
e pirea Fe r u -.ry 23rt-1927 .
ay ~ f li!ay , 1 24 ..
P//.r!J
1,
e
en !." r i l 1 •t- 1924 ,
.A1,ril th e y u e
1
urint A ril they ' ii no t rec e ive • n~
f er th°' Cou ty
,..
~
-{
.
tha t
un e
�...
�0. S . ALD HIZB :R
H.H .ALD HlZI Dl,P.K. G.
AL DH IZ EH & SO N
f'
'Ylts
TB.B ·DO" WN" ·TO· DAT E•DR UOO
ISTS
~e.xaft Store
BR( >AU WA Y, VA .
!ta . te
or
Vir 1in hr. , Cou nty of 1'oc:kil'l~h
am, to- wi t :
I, M. o. Ki lle r, a No tary 'Pu
alie , in ani for the Cou nty an&
8t~ te afo res aid , -io cer tJf y tha t
H. H• .Ald hiz er , of the f'i!' m
of ~ld hiz er
!on , Bro adw ay, Va ., 4ia thi s aay
per son all y app e~r aef ore me and
make
aff iia vit tha t Ald hiz er & 3on haj
on han d on Hf fl llay 1•t , 192 4
1 457
Flu ido unc es of ~la o~o l and us~
j aur ing May 125 ~lu ido une es, l~a
vin !, on
han d on Jun e 1st , 192 4, 332 Yl uid
oun eea of Alc oho l ani tha t iur in~
May
the y dia not reo eiv e any Al• oho
l.
&
My con 1m issi on ex:p i!'e a
Giv en und er my h aad , thi s 2nd
1u
,
-~ ~
'
a · ,~
_ .,,
•
:f.'.~~, _2~r ~-1 927 .
"-,"
.
.
.
u?
~
---
N. P•
��l5tatement of ex_pendi tures of H. H. Al dhizer , candL1ate for Mayor of
Town of Broadway, Vir~i nia , a t elect i on h e d JUne 10th- 1924 •
.4moun t spen t : NOT ONI CENT ..
I io so l emnly s we.r t h ~ t the aa ove s t atement embra oes a ll mon~y epent
iy me or in my • eha lf , wi th my knowle,i g e and c ons e n t , •y a ny adh erenta
r
f r i eni : t h at I have not iirect l y or indire t l y ~rran:ei , ~n c oura~ea or
conni T~d a t the spen:i i n f o f any money ; t hat I have no t
ffffl
rep ~id any
:mon ey s o s:,ent or c l aimed to h a ve ,e..,n so s:,en t , ::i.nd tha t I will not do
ao , a nd that I h ave not vio l ate " ,my o f the · revi s i o ns of cha te r
ixt e
o f th e Code of Vi r ginia i n le tter or spi r it .
v'~ Sta. te of 'lrirginia , q ounty of :Rockin,!;ham, to-wit :
u•scr ilt ed a nd swo r n to , efore m~, this 13 t h .ia.y of June , 19 24.
~
'.JI.y
&_ ~
No t · r y
ommissio n expires Fee ruary 23 f!id.-1927 ,i
·-
b i •
,l1
�'l'
I
j
r
�//
_ ~~K'rDN,V~~-9
---- ---- -- -~ ~ ~ . Clerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
..4~b'7/'YA _ ___ _
/2 ~~
~
fro m last mon t h.
Pucchased d u r i n g ~ r
i:
--~
____
191__9'_--- ~ K ~
~ //
~~~it
~ ~ ~ ; q ·-·B a l a n c e ~ ~ -- 191£
,~~ ~
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate state ment of all r eceipts , disburse ments and qn:.ntity
ot' Ardent Spirits on hand at the ahove mention ed d at es .
; M ~
--
STA TE OF VIRGINIA,
COU NTY OF
RocKINGHAM---To -Wrr:
this Sub~cibe:,:n: s ~efor °: : : ~ t:e, Co
1
My Commission exeice, __
j'c7~)_-j-___
l~
~~
, ~---"'--
:;-i-- -.---.-------------
��the Ci c~it Court of
ALCOHOL
_______ 19R--
- -----~/df~
Purchased during ___
Balance on
I hereby certify tha~ the above inventory of Ardent Spirits is a
tru e and accurate statement of all receipts, disburse ments and quantity
of Ardent Spirits on hand at t -- -a~ ~ tes . . ----- -- - -- -- ---- ----
STATE OF VIRGINIA ,
COUNTY OF ROCKINGHA M - TO-WIT :
My Commission exFJires~
_/ J : : ._____ 19 _
h
/
��Clerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
Purchased
I hereby certify tha~ the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursement s and quantity
of Ardent Spi1·its on hand at the above mention ed dates.
S'rATE OF VIRGINIA,
COUN'l.' Y OF ROCIGNGHAM - --To -WI'l.' :
�.
�<TON, V
A~/~_1919
__, Clerk of the Circuit Court of
ALCOHOL
On hand __
Purchased
I h e reby ce rtify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements a nd quantity
of Ardent Spil'its on hand at the above mentioneri dates.
jltt~'-- S'rA TE OF VIRGINIA,
COUNTY OF ROCKIN G HAM ---To-Wrr :
--
��cJ',,/;,? /)
. (J
To_if_~_____
f __
.
~
d ----,
E'.;F,ON, VAc :21~ /c•...... .. t'Jt'./_
j/~ M -~
Clerk of the Circuit Court of
Rockin gham County , Va:·
ALCOHOL
~ ~
Br; / ~..
On h•nd
bala nce from last mon th .
Pu cchased d udn ~
~
. 1™2L
<6.£~ .. .
~. . ... . . . . . .
.. . . . . . .. 1!Jt'."/ . .
~/£
«_
~a-L
________ ____ ___ _
TotaL _________ ____________ ___ __
__/~!H :?,.( __
Balance on hand _~
·~
--------
I hereby certify that the above invento ry of Ardent Spirits is
true and accurat e statem ent of all receipt s, disburs ements and quantit a
y
~~ ... ... . .... . . . ----
of A,·dent Sp;,-; ts on h•nd nt the _
STATE OF VIRGI NIA,
COUNT Y OF ROCKIN GHAM - 'I'O-WIT :
Subscr ibed and swo1· . to efore me, in the Co
this __/ ___ ____ day of_ ---- --- - ----- ---, 19i?/ , b.
~
My Commiss ion exfJires'_Y
~-7-.;_
---:
-- ---------- _J0;;--_--./M
, . .,;. ~___ _'i:,
-__
1t -~______
!:.(_ _
19
2-../
�'iled In the Clerk's Offlce
ockingham County, Va,
r.cB ?- 1[)?
"--Clerk
�ALCOHOL
On haa
~~-:tt:t(n
~~~
~'/~~
;o-d,~~
--~y~~ -'c-~ --
~_..... ,_,._,. _
Purchase d durin ~
--1 ~- ____ , __
~ ~-~
-£e £_
//4
_
_ _-_
- -____
Balance on h a n d ~ & - , ___
I hereby certify tha~ the above inventory of Ardent Spirits is a
true and accurate :a.tate ment of all r eceipts, disbursem e nts and qu a ntity
of ArJent Spirits on hand at the above mention ed dates_
-fl ·~ -
�I
'
�ALCOHOL
----- ---/ ~l l'- P~ ~
~ 7 ---
Bern 2 ba lance fro m Llst mo nth
~
Balance on
--' ~~~
- -
. °: ? -" ~
ha~@41 ~ ,--~ ~
I h e r eby certify tha t the above invento ry of Ard ent Spirits is
tru e and accurat e state ment of all r eceipts , di s burse ments and qu antitya
of Ardent Spirits on hand at the above mention ed dates .
cYf) -~~..... ...... .... .../.. .. .
STA TE OF VIRGI NIA,
COUNT Y OF
RoCKINGHAM- -To-W rr :
. this .~~~~ ~dda: n : / ~~~~-~ ::~.t h~ C~--: ~ ~ ~ h a
,
��I
ALCOHOL
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate 8tatement of all receipts, disbursements and quantity
of A nlent Sp;nt, on hand at
'IVJ,.~--.. .- - -. -...
_
STA'rE OF VIRGINIA,
COUNTY OF RoCKINGHAM - -To-WIT :
Subscribed and sworn to before me, in the C
tbis .. .. /. _____ day of.. ~
.-- , 19
�/ .
// I
I
,,..
,.
�of the Circuit' Court of
Rockingh am .County, Va:
ALCOHOL
Purchase d
I hereby
rtify tha~ the above inventory of Ardent Spirits is a
true and accurate state ment of all receipts, disbursem ents and quantity
of Ardent Spirits on hand at the above mentioned dates.
STATE OF VIRGINI A,
J?~
CouNTY OF RoCKINGH AM - -To•WIT:
- -- -
�C:::J
J:r
I"
i_
j
'1
�() /\. dJ /}
To ____✓--- - ~: _
..,,
,,,yroN, VA, .&4; £-~- ----19)! 0
_ ___ , Clerir/4' the Circuit Court of
Rocking ham County, Va:
ALCOHO L
Balance
I hereby certify
a t the above inventor y of Ardent Spirits is a
true and accurate stateme nt of all receipts , disburse ments and quantity
of Mdent Sph-its on hand
att~j/Z&~-- ------ - ---
STATE OF VIRGIN IA,
COUNTY OF ROCKING HAM ---To-WI T :
��~/7
~
(l
'
~c,CA #~/:z: : ----'~
----'--@~- --------------- ------, Clerk. of the Circmt Court of
·
Rockingham County, Va:
To
ALCOHOL
On
hand_~ #~ / £_
__19t"~
--i'_~ _ -
__ 1\li!R
-~
an ce fro m last mon th.
Pucd~ ,e ~ n ~ -
•rot ___ -~
· C
---
- -- _ ___ ______ ____ __ ______ ___ ____ _
~~
/~£)
Balance on h a n d ~---- ~<---19.! ___ _ ____ ______ _____ ___
---- -- -- -- -
1
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spi1·its on hand at the ove mentioned dates.
#7~
.
- - ~.. C. ---- ------ -- ---- ---- --- ----- -- ·- ·--- -- --
STATE OF VIRGINIA,
COUNTY OF
KINGHAM---To-Wr r:
nd
this_~~-v~:a:
~--~-;,-~_·~ - -
�,
�(J /f>./1) ;J
}P;?'ON,
VA/~c! f ___ rneo
To--c;:>'--'-_O!C.._ j/~ ~ .
Clerk/ the Circuit Court of
Rockingham County, Va :
ALCOHOL
_ _ _ _ _/ft___ _ _ _ _
duri~- --__
ue ini? balance from last mo nth.
Pmhased
~
l~~-- ____
19._?,c> __ ---
.
2/~ - - - - -
+ft&.a.-L---,_
"~~ -fut ~
Balance on hand ___ .,,.,.u'• ..&!4~:-:-£/f[__rn,!(,
,
ft'--
✓~~
I hereby certify th the above inventory of Ardent Spk its is a
true and accurate :;:;tatement of all receipts, disbursements and quantity
of ,Aruent Spil'its on hand at th e a ove mentioned dates.
--------~k ~--- ---------STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM --TO-WIT :
thiss~:.:":ftfor-~-~it}l;;:":h~:m:,:::
_}fVZ(_ _k::~ ___ ______ 19zj '11( ~
My Commission exi1ires _
�led in tne C\.Prl..:' _:, 1 . Ct
ockin ham Lui ;, t;· , Va.
1uL ,~ -
rp-.o
_ __ __ __ Clerk
�ALCOH OL
fle7ce
On h a n d ~ ~/
. V
~
_
from last month.
P u c c h ~ __ .. ... ---, .. .
,
1t47
_~-·-k_
---
__ 1~"1 -
f _
...!?'.d--?>fz-
~ - -1 --- _ _ __ _ __ _-;1___ _-______
Balan ce on hand .
191_ _
'1 __ _~
--- ·- -
1
I hereb y certif t iat the above inven tory of Arden
t1·ue and accur ate s temen t of all receip ts, disbu rseme t Spirit s is a
nts and quant ity
of A>-dent Spid ts no hand at th
:~:z•~"-_.---
~
STATE OF VI RGIN I A,
COUN TY OF RoCKI NGHA M - -To-W rT :
7~
expire£j:i. ::;-;r:_ ;;•~ -
thisS ;r,ib edda :n:/a :;:fo ,~
My tommi ssion
th:?
nty o~ ckingh~
��. 1,
d
......-7'.
l1
" 'ON, VA ., ____ __ -- - -- -- -----~- --19~(:I
'M~~ f _; f _ _ ~ ~-: 0 .\-e
f;ockin gham County, Va:
· of the Circuit Court of
·-~
ALCOHOL
.. --- ------- __ __ rnl:::?.e __-~
--------- - -
I h e r eby certif that the above inventory of Ardent Spirits is a
tru e and accurate state ment of all r eceipts, disburs!:lm ents and qu antity
of A1·dent Spi1·its on hand at the above . ntion ed dates .
ii·---~
�fi\ e in t e r.\f' "'-' Offlc
Rock\n gh
r .
...,,_,
a,
r,
•
1 .t)
- l0L.
_ __ ___ c,ect
�<2£h , ,
E;i,r• VA{lJd7~
_111'£?1
To-z:x-.~-----~-- -( ! . . X . . ~ C l erk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
ota\ ___ ___ ___ __ ___ _____ ___ _ __ ____ __ ___ __ ____ __ __ _____ __ _
Balane,e on hand
@d-./~9t7(!_ .J!f_4&-_
I
_
•
I .hereby certify thab the above inventory of Ardent Spirits is a
true and accurate state ment of all receipts, disburse ments and quantity
of Ardent Spirits on hfrnd at th e above mention ed date s.
~a.~~
- - -- --- -- -- --- --- ------ --- · ---- ----
-- ·---------
STATE OF VIRGINIA,
th;s8 j"he~da:n:/~or~ ::;;':~.co;; o .c....o-.,,,,~-,
Commission ex,ices_~zr::: _:19;;,---77 ----- --- - COUNTY OF
RocKINGHAM- To-Wrr :
1_1f_..,_,t.
My
��ef.'tf_________ J ~
o/}r VA~
,,
/2;-,
~ 0 l e r k of. the Circuit Court of
__ __ _...,_€ _ 4~
R~~~ham County, Va:
ALCOHOL
✓_tf4£____ _____ _
{l?_;t:_/ f __________
-----------@d._______ _____ 19~6 __-----~
19i!o_ __ ____
On hand __
Be ing ba h nce from last mon1h .
Purchased during __
'I'otaL ____ ___ __ ____ ___ ____ _
_<lid,_ _ _ _ _ _
I~
/t
/IA
Bala.nee on hand _/_ua,:-: __ __ --~ -___ ____l ~--- __ . ~/~ _____ __ _
I
-';'Z"~ - .-
I h e reby certify tha~ the a bove inventory of Ard ent Spi r its is a
tru e and acc urate state ment of all r eceipts , dis bursements and qu::mti t.v
of Ardent Sph-its nn hand at
S'rATE OF VIRGINIA,
COU NTY OF
RoCKINGHAM---To -Wr r :
thissu;zibe:.:n~,'~o~or~7;;_in::ec , _ _ ~1 F
_
-------------- - --,-~~A- -----
~_/ L ___
My Commiss ion exf)ires ___
19~
'
��/2-,,
/41 11
~_z,;___t(,o,k-:L?i:_~
To_
ELK};?~·
v&~~ - --
_190?,o
lerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
On hand
c{if-A_?-,/~___________
l9J/6 _ _ -~
___
Bein g balan ce from last month.
Purchased during _~
----- ____ 19:\!_o_ __ -- ~
_
- ----- ------
Total.. ____ ____ ________ ____ _
S ~/~--19~~L ----~
Balance on hand ___
1
---------
I hereby cer tify that the above inventory of Ardent Spirits is a
true and accurate state ment of all receipts , disbursement s and q uantity
of Ardent Spi1·iti-; on hand at the above m~ i~
# µ:;
4?/2_
My Commission extJires ___
--- ----
-·--- ·-- -----
��rJ ci:-JJ
,1
~
LKTON,
V~
.£ht--~
__ 1f/f?/
To_~"""-- - - - ~ . , 2 £ . a . , ~-- --- , Clerk of t h e Circuit Court of
Rockingham County, Va:
ALCOHOL
On hand __
,&_4c;/~ _ ____ __
19i,!,L _
Being ba lan ce fro m las t mo nth .
~
_ _____ _
-~d4 : _____
Purchased during -~ ? : -- ____ --__ 19ti'_e ___
Tota,L _____ __ ~ _______ . _. __ _
Balance on
I hereby certify that the above inventory of Ardent Spirits is a
tru e and accurate state ment of all r ecei p ts , disburse ments and qu antity
of Ardent Spi,:its on hand ot th
-=~ ~-- -·--- ------
�'
'
'
'I- ..
Filed in the Clerk's Offlce
Rockingham County, Va,
JAN5- 1921
-
Clerk
..
�,,Z-,,11
To
/J
E:,p_JN, VA.,.
~ff _ __
J9'q'
~ ~ -!/.; ! C a ~ l e r k of the Circuit Court of
Rockingham County, Va:
ALCOHOL
cf!:
~
~/~
On hand _____
___ ____ ____ __ __ __ 1gq' ___ ---~
_____ ____ _
B eing balance from last mon1h .
...1 ~ ~
drL ..
. .
--
~f'La &
Bala.nee on hand _ ~~ - / £ ~ /
I
-~~P L;-_
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburse ments and qn antit.v
of Ardent Spirits on hand at th e a ove ~ tioned dates .
, ~
. A
/.._~
- ---- - ___ _
STATE OF VIRGINIA ,
COUN'.rY OF ROCKINGHA M --To-WIT:
My Commission ex"f)ires_~
- ~r _ _ _ ~
_
19
-- ~ --- --·---- -----
�'iled in the Clerk's Omce
Rockinghalli County, Va.
MAH 3- 1921
-
�.
~/r
f__~&~ ~.
~
ELKTON,
To ____
~ - ~- Rockingham County, Va:
V ,,-- ____ ______"'!' ________ _____ _19~
Cl ·
of the Circuit Court of
ALCOHOL
On hand_ ____
/!/f__________ 19l!/__ _-- ~
----- ------
_ --~ __ _
ei112: balance from last mo nth.
Purchased ducin~
---- - ____ 19t1/__ _
--~f:t'f~ --- _
iftl~----
'l'ot•l . _ - --- - -- -- --- ---- - -- -
v.ir
.
__ / ~______ 1gd___
I
.d..if4-k__________ .
I hereby certify 1at the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spi1·its on hand at th e a(}e mentior~
;v -&, _____
--- - -
STATE OF VI RGINIA,
COUNTY OF ROCKINGHAM - -TO- WIT :
Subscribed and sworn to before me, in the Co
this ___ -~
---day oL ~
,---- , l 91V-..._,uib~"~"'"".'"'- =~~
7
,t#C-~ --
��4'-To
» ,? .,,•N, ~~/£_t'Jt?'/
- ~ - --/-"~ , Clerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
--✓~-- - --------
Balance on b a n ~
~t?I---,
~ -·-- ----· -
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hftnd at the a~ove
6 ~o~
ii - --- -- - -
�✓
11
�fl
f',r;)/1
._f'--r:J--£-a_~
/,KT ON ,VA ~~/ ~--- 1~
---,
To_~'! '_l___ __
Rockin gham County , Va:
Cler~ the Circmt Court of
ALCOHOL
On hand __
/§
_
_ _ -··- · _!~ __ _ ____ _ _ _ _ _ ___ __
neing ba lan ce fro m last mo nth.
, :I/
19.t:;/--- - --- - - ---- --- --- ---··· --- - -- -- --
Pucchased d u r i n ~ ----- - ____ 19'!1' ___ ----~ ~ ~
--Tol•L.
Balance on hand __ _ _
_
___
~tf'a-L-:- _
__
_/..f__rnw/__--~
I
--- ___________
I hereby certify
the above invento ry of Ardent Spirits is
true and accurat e ~tate ment of all r eceipts , disburs e ments and quantit a
y
of Ardent Spii·its on hand at the a~ --- -~ ~-~
STATE OF VIRGI NIA,
Couw.r Y OF RocKIN GHAM- -To-W1T :
---- --- -- ---
�•,
�{)
z
CZ::_!___ _,___ _______ ~ - ,
~
To __
/!LK'L'ON, VA
_____ ____ _
Cler.
.
.
of the Circuit Court of
Rockingham County, Va:
ALCOHOL
I hereby certify tt the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursement s and qu antit.v
of Ardent Spirits on hand at the a b o v 4 ~ t ~
_
__,_ j:_,- -------- ---- ----------.------ ---- ---- ----
S'rATE OF VIRGINIA,
COUNTY OF ROCKINGHAM - -'r o-WIT :
Subscribed
d swo ~o before me, in the Co
thi s ____~ __day oL____ __ ------- , 1~ ( . b
�Filed in tfte Cle rk's Offlce
Rockln~ham County, Va,
~UG 3- 1921
-- - -
-
--
-
-
-
-
-
Clark
�the Circuit Court of
ALCOHO L
On hand
Purchas ed during . _
~'.A-1
_V
__¥-"_"____
--
19k'/ -- --- ~ --__________ _
'··~ · c!.1~
~d,/
v,b .19'1/... ,.~
.....
I hereby certif~ hat the above inventor y of Ardent Spirits is a
true and accurate stateme nt of all receipts , disburse ments and quantity
of Ardent Spi1·its on hand at the above mention ed dates .
..;. ,a .~. . ... . ....
STATE OF VIRGIN IA,
, COUNTY OF ROCKING HAM - TO -WIT :
Subscrib ed and sworn to before me, in the County of Rocking ham,
this __ _,J_~ ____ day of _
19:tl.j, by ______ ______ __________ ___ ______ _
-H ~ ~--,
. ..
"'r•
.
My Commrns,on ex,,
.lff _li. ~.U ./P . .
.£:, ·· ···· ···· ···19 ·1 -lf
��/4~;;1
~A/}
To_Lf~-~- _
E'bJ;)!·
VA,_@it'Zf_---'~/
_ , , , , _ 2 { _ / / ~ ~ l e r k of the Circuit Court of
c ingham County, Va:
ALCOHOL
On hand _A_"-~JAbalan ce fr
,;ir__ __
~
19,?_/_
last mon th .
Purchased d
/
-
____ l ~ -- - __
TotaL _______ __ ____ ___ ____ _
Balance on hand
_
£if~------~ --
J:_o/a..&_~ __
@ii!YfC,~ ,ct tf:~ . .
'
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spieits on hand at th e above mention ed dates.
-£_.<Z
_, ~
- - -------- --- ------ - ~ - ---- --/2
L-~
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM--To-WrT :
�rriled in t e Cl rk1
,,..
O~I C
Rockingham County, a.
. OCT l· 1921
--_ _ __ _,.,..Cieri·
�JAME S L. A VIS
DRUGGIS T
AND DEALER IN M E DICINES. SPI CES, BRUSHES
. CIGARS, PERFUM ERY, TOILET SOAPS,
GARDEN SEEDS. TRUSSES , ICE CREAM. SODA W"
ATER,
S OLE
AGENT FOR W"HI'l.'M AN'S SUPREM E CANDIE
S.
PHYSICIANS '
PRBSCRlPTIO NS
A
SPBCIALTY,
TELEPHO NE NO. 4-1.
HAnn1so NBURG, VA .. De c • . 1st • , 1 ~ l 7 • .
To the cler k of the Ci:c·c ui t Court o f Roc k in r h a:::i Coun t y, Va
.
The follo vling I s an invent ory of
dates herein aft e r enume rated .
191 _
l e :10 1 of Jame s L . Avis as of the
On h and rov . 1st . ,l S/ 17 ------ --- ---- - - 10 5/8 ga l::; .
Purcha s ed duri ng :r.ov. 1 S l 7 . - -- ---- -- - 00
Total -- ---- - --- -- -- --- - - ------ --- -_-_-1-0-5/-'-s - ti
Us ed during r;ov •. 1 1 7 .
--- ----- -- - - - -
Bal . on ha d Dec. lst ., 1917 . - -- -----
3 6/,8
ti
G 3/8
II
I hereby c 3r tif y -yh.c, t the a·bovc i nv e nto ry oi Alcoh ol is a
tr ue an:::i n c curRte st ate ,:ient o f al:1.. rec ei p t::; , <.1isbu " e r..1c nt s a Ed qua ;-_Liti
e :::; of Alco h ol on hanl nt th e a b ~vc ~ c~ ti o ned
S t a te of Vi rg inia , Citj of Ha rr i~onb· ·c , to - -1t : f/
Sub s c r• i b e d. e. nd sworn to be f ore me , ir,. the Ci t:r of Ha rr is o nbur·c
, Va .
•t h i 3 lnt . dey o f Dec . 1 9 1 7 , by Ja r.:1e::; J . /vis .
J(!<f:7~ o Jt /?
�.~-.
...
.
'-
-,
�JAME S L. AVIS
DRUGGIS T
AND DEALER IN MEDICIN ES, SPIC ES, BRUSHES ,
CIGARS, PERFUM ERY, TOILET SOAPS,
GARDEN SEEDS, TRU SSES , ICE CREAM, SODA "W"ATER.
SOLE AGENT FOR "W"HITM AN'S SUPREM
E CANDIE S.
PHYSICIANS '
PRBSCRIPTT ONS
A.
SPBCIALTY,
TELEPHO NE NO. 4 1.
HARRTSO NBURG,V A. ,
To
C1c
FPh .
l
Cl or!c o:' the Circ ui 'v Court ocl Ho c :;:ir: :1~,_;-;; Gcur:t~ ,
0
,-, t .
' 7 " 1
8
re. •
'I'i:10 follo · · nc .i. ::
:011 i ivcr~ Lory of l.lcoh© l of J[~ ,1es :-., . Avi3
e::, of th
dates h c rcinGf ~c ~ v:~~c rctc~.
On h Rcd ~~n. l st . 191J
Pur c hrsed durin~ Je~ .
Tot_
Use
J.
-
--
-
~ rin: J en.-- ·-- - -- --- -- -Bal" on ha~d Feb . 1st.- - - - - -- --
l
7/8
00
s.
II
7,..,
1
'7
l
7/8
00
£;n l
I I
C..,
[;8 1S.
II
If
191-
��JAM ES L. A VIS
DRUGG IST
A ND D EAL E R I N M EDI C IN ES, SPI CES, BRVSHE
S, CIGA R S , PERFUM ERY , TOILET SOAPS ,
G ARDE N SEED S , TRU S SES, I CE CR E A M, SODA
"W A'.L'E R .
S OLE
A GENT
FOR "WHIT MAN'S S U PREME CANDI
ES.
P HYSICI ANS'
PRBSCRIPT IONS A
SPBCI ALTY.
TEL E.P HON E NO. 41.
HARnis oNB U RG,VAM cb.
l st,., J 9J 8 -.
19 1_
To the Clerk of Circu it Court of Rocki ngham Coun ty, Va.
The f ollow ing is an inve ntory of Alcoh ol of Ja mes L. Avis
as of the
dates herei n after enum erated .
On hand Feb. 1st., 1918•:HHHH:- -:'. *•:HHrn ,cn° -lHH H,
00 gals .
Purch ased durin g Feb.
II
• H -.-;H:- -:HH'. :· ·,HH:-,H: *{H ..
9
-Total w :: :: ~,::H: - - -9 gals.
Used durin g Feb. * ,H:- • H HH,- :~•:H:-•: -• HHH,* * -lHHHH" *
II
7
Bal . on hand Mch. 1st • ~-* • H,,:--i:--::--e:--r.- -~-~-c~-::-• HHc
II
2
0
I hereb y certi fy tha t the above inven tory of Alcoh ol is a true
and
accur ate statem ent of all recei pts, disb~ seme nts and
quan
tity
of
Alcoh o l on hand at the above menti oned dat e s .
)t(Chdd ,-
State of Virgi nia , City of Harri sonbu ' , to-w it;
/
Subsc ribed and swor r to befor e me , i the City of Harri sonbu
rg, Va. ,
this
day of March, 1918, by James L. Avis.
Jst
-;o
/
,
/4d f-/l )~ nt7 "t;;; -rl~
C mn1I... _ , ......
¥ ·
7-o /
9' ?-'O
��JAMES L. AVIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA. "W"ATER.
SOLE
PHYSICIANS'
PRBSCRTPTTONS A
AGENT
FOR
-W-HITMAN'S
SUPREME
CANDIES.
SPBCIALTY.
TELEPHONE NO. 41.
April 1st.' 1918_.
To the clerk of the Circuit Court of ~ngham County, Va.
HA.nmsoNBunG.VA...
191_
The following in an inventory of Alcohol of James L. Avis as of
the dates herein after enumerated.
On hand March 1st-. ,191 8 .--- --- - 2
, gals.
Purchased durin g March --- - - .::..::.::.._~_!_L2 _ ;
Total------------ ------ 6 1/2
Used during March---- --- - - ---- 3 1/2
Bal. on hand April 1st. ------- 3
"
11
I hereby certify that the above inventory of Alcohol is a true
and accurate statement of all receipts, disbursements and quanty of Alcohol on hand at the
mentioned dates .
C//'/A
r
,,-..-,L---'--~'-'=-== < - - - ~ ~
,__,_
- _ · _ __
State of Virginia, City of Harrison✓
u;;, £6 -wit;
Subscribed and sworn to before me, in the Ci ty of Harrisonburg,
Va. this Gst. day of April,1918, by James L. Avis .
-
___/4 £Ca}~t lf;;;;;ry~
c
~ · n. •
•
·
/-3/4--- ?-# ~9' rv
�...
't
.c
�JAME S L. A VIS
DRUGGIST
AND DEALER IN M E DICINES, SPICES. BRUSHES, CIGARS,
PERFUME RY, TOILET SOAPS,
GARDEN SEEDS, 'l'RUSSES, ICE CREAM, SODA W- ATER.
SOLE AGENT FOR WHITMA N'S SUPREM E CANDIES
.
PHYSICIANS'
PRBSCRIPTION 8 A
SPBCJALTY,
TELEPHON E NO. 41.
HAnmsoN BURG, v A..
May l sL , 191 8 •
191_
To the Clerk of tho Circui t Court of Rocking ham County , Va.
The foll~w ing is an invento ry of Alcoho l o'- James L . Avis as of
tht. dates here in after enumer ated.
,r
On hand April ls t., 1918
Purcha sed duri ng April
.,;.~--lHHH:- -;:-HHH,--:'.--i<·
3
gals.
4_1___/~2__"__
• HHHHHH HHHH,_
*_
•;-_ __
Total
Used during April ************** ****
Bal. on hand May ls t .1 918 • HHHH'"·:,-i;-****
7 1/2 gals.
5 1/.s
2 3/8
II
"
I hereby certify that the above invento ry of Alcoho l 16 a trpe
and accura te statem ent of all receip ts, disburs ements and quantitj of Al c ohol on hand at the
o~e mentio~ eJ7 dates. t
rX:; ,, a C/Z-4 , -Harriso nburg, Va.,
��JAMES L. AVIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA "W" ATER.
SOLE
PHYSICIANS'
PRBSCRlPTJONS
A
AGENT
FOR
"WHITMAN'S
SUPREME
CANDIES.
SPECIALTY ,
TELEPHONE NO. 41.
HARRJSONBURG,VA ..
June 1st. 'l 91 a e
191 _
To the Clerk of the Circuit Court of Rock ingham County , Virginia.
The following is a n inventory of Alcohol of J ames L. Avis as of the dates
herein after enumerated.
On hand Ma y lst.,1 918 --- -- ---- --- -- 2 3/,8 ga ls.
Bought during May,1918.-- ----------- 4 11/2 ,,
II
Total ---- - ---- - ---------- - -6 7 8
Used during ifay, 1918 ------------- - 4 7 /a
Bal. on hand June lst.,1918. ------- 2
"II
I hereby certify that the abive inven tory of Alcohol is a t · 1e and accurate statement of all receipts, disbursement s and quantity~of Alcohol
on hand at the above mentioned dates .
!,._,/ I
t:!_
~~(
State of Virgnia., City of Harrisonbur vto-w ·t;
Subscribed and sworn to before me ,in : the City of
4"'s t . day of June,191S, by James L. Avis •
.
arrisonburg, Va.this
��JAME S L. AVIS
DRUGGIST
AND D E ALER IN M E DICINES, SPICES, BRU SHES, CIGARS
, P E RFUMERY , TOILET SOAPS,
GARDE N S E EDS , TRU SSES, ICE CRE AM. SODA "W"ATER.
SOLE A G ENT FOR "W"HITM AN'S SUPREM E CANDIES
.
PHYS I CIANS '
PRBSCRIPTION 8 A
S P B CJALTY,
'J.'ELEPHO NE NO. 41.
HARRJ S ONBURG,V A., _ _ _ _ __ _ _ _ _ _ 1 9 1 _
To the Cl e rk of the Circ uit Court of Rockin ghnc County , Va.
The follo wi ng is a ir:ve tory oifl Al cohol of James L . Av is as of t:ie
dates here in after enumer ated .
On hand J une ls ;l 91B T- - - - -- --- ---- 2 ~als .
Purcha sed during June -- - - ---· --- -- 4 ~ "
Total --- - - ----- ---- -6--1~7+·2- g_a,,_s .
Used during June- ------ -- ---- - --Bal . on hand July 1s t . -- -- - - ---- - -
11
4 1/4
2 1/4.
ti
I here by cer tify that the above invento ry of Al coho l i s a true
and accura te statem ent of a l l rece ipts , d i sburse men ts and quan tity
od Alcoho l on hend at the above mentio ned dates .
~
Stase of Vi r gini a , Ci ty of Harriso n
g , t~~ (!
ubscrib cd a nd s worn to before me , n the Cit of Harr i sonburg , Va .
this
7st.
day of July , 1918 , by JaI!les L.
1v is . Ii)
- ~~Z .At ~__;1 oi@ ~
/
' ,
Comm rs. ••n ,
,
~
~Cl
/
f' fl-tJ
�~
.
�JAMES L. A VIS
DRUGGIST
AND D E ALER I N M E DIC INES. SPIC E S . B R US H ES, CIGARS , P E RFUMERY . TOILET SOAPS .
GARDE N S EED S , TRU S SES, ICE CRE AM. SODA "W"ATE R.
SOLE
PHYSIC I A NS'
PRRSC RJPTTO N S
A
A G ENT
FOR
-W-HI'l' MAN'S
SUPRE ME
CANDIES.
SPB CIALTY.
TELEPHONE NO. 41.
Aug . 8th . , l ~18 ..
To the Clerk of the Circuit Court of Rock i ngham Coun t y , Va .
HARmsoNBURG.VA ..
191 _
The foll ow i ng i s a n i nventory of Alcohol od J ames L. Avis as of
the dates here i n a f t er enumerated .
On hand July l s y . , 1918- --- ----- -- 2 1/,4 ea l s .
It
Pu r cahs ed during Jul y , 1918 - - --- 4 1/ 2
Tot al - - - --- - - - - - - --=-=- 6.,......,3~7
~4- -.,.--Used
r i ~g Jul y . 1918 - - -- - - - --- - -- 3 1/2
Ba l. on hand Aug . Ls t l ~ms. -- --- --- 3 1/ 4
"
"
I hereby c ert i fy tha t t he ab ove i nv entory of Al cohol i s a true
re c · pts, d i s bursements a nd qua. t it y of Alc ohol on hand a t t h e a o e ment i ned a tes .
a nd a ccurate stat ment of al l
S t at e of Vi rg i nia , Ci y of Harr · onburgt to"':'.wi ;
Subs cr i bef a nd swor n t o befor e me i t he City of Harr is onburg ,
Va ., his i st d y o Au gust ,1 918 , by J ames . . Avi s .
~ :7.~u hdFfd~
.......
,..
~
.,.
~'-'-
~
L.
�' .
�J A MES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPTCES. BRUSHES, CIGARS. PERFUMERY, TOI LET SOAPS.
GARDE N SEEDS, TR U SSES. ICE CREAM, SODA W" ATE R .
S O LE
PHYSICIANS'
PRESCRIPTIONS
A
AGENT
FOR
W-H I TMAN'S
SUPR EME
CANDI ES.
SPECI ALTY.
TELEPHONE NO. 41.
H ARRTSONBURG,VA .S9p t, .
T o the Clerk of t he Circui t Cour
19 1_
of Roc1:ineham coun y, Va .
The follow i ng is n inven t ory of Alco ol of J ,mes
dat es herein fer enumerate d o
On hand Au g . lst , 1918 0,,-:HHHH.-
urc .ased during Au • -::-
1st • J 1 ( 18 •
0
0
Av i
as of t he
3 2/0 ga ls.
II
4 4 8-----....L,-
,HHHHE:-
:- ,HHHc·'H.-,H:•,HHf
Us ed iu i 11g Aug . • i- • HH:-,, -:H,-*,HHHH, -::-,c • HH~
On h&nd S e t .
st . ·~f.;c-~•1r1~..'!t-1;- ~:·~r~~~~ • }~; i :-~t"~f
7 6 8
It
6/ 8
II
2
II
I hereby cert i f
t hat the a o e i nventory of Alcohol is a true
and ~c urcte sta te me~ of all ccei
,
· sbursements a ~d quan t i ty of A c ohol on hanJ at the a.bov
0 ,ti ne ~__,,te ~ .
~ VU!d r
t a e ·r Vi e n ·a , City of
u~s cri bed and s worn to before
this l ot . day of S e ember,1r.1 , by
to4 ;4
Ci~iof/ .arrisonburg,
U~CG
ii
,
,. Av s
a. ,
c
~ J};fgJ&CULLJttil_i;;;(f).Jk
.
eh{«-
?-0 , ,
~
9 ?-e>
�•
I
;
�JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS.
GARDEN SEEDS, TR U SSES. ICE CREAM, SODA W" ATER.
SOLE
PHYSICIANS'
PRBSCRIPTIONS
A
AGENT
FOR
W"HITMAN'S
SUPREME
CANDIES.
SPBCIALTY.
TELEPHONE NO. 41.
HARRISONBURG.VA .. Or; t, .
] st . J 1 91 8 .
To ~he Clerk of the Clrcuit 6 ourt of Rockingh~m County , Va .
191_
The followin c is n i ventor y of Alcohol of Ja 1~s I. A i3 as of the d a tes
herein fter e ne umernte •
On h nd Septo l s
1918-- --- ----- -- - - -
Purchased during Sept ., 1918- ------ - - - ---Total-- ----Used during Sept. --- --- - - - -- - -- -- - --- Bal . on had Oct l n • 9 8. - - -- ------ --
2 ials .
~4~1~_2_'_' _
6 1 2 ga~s .
5 /
"
1
"
I here y c ert fy hat the abiv e i vert ory of Alcohol is a true ad accur a te atatement of al receipts,
isbursements n ~ e ntities of alcohol
on a
he
L
ove
mentioned dates .
..J;/,
---- -L
u~ -
it y of Harris-:;;U'To- w1
. .17
. ubscribed rd sworn to before me, in the Ci
of ¥rrison ur", V . ,
this d s
day of Oct ober ,1 918, by James L . Avis .
Sta te of Virgi ia,
/e JN@~ ?zQ~ ~
,.. C "'m;5 io
'",ire , ~ ~
/f ~
�•
�JAMES L. A VIS
DRUGGIST
AND D E ALER IN MEDICJ:NES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRU SSES, ICE CREAM, SODA "WATER.
SOLE
PHYSICIANS'
PRBSCRIPTIONS
A
AGENT
FOR
"WHITMAN'S
SUPREME
CANDIES.
SPBCIA.LTY.
TELEPHONE NO. 41.
HARRTSONBURG,VA.,
To the C e k o
ourt or Ra cki nGhom C
ircuit
the
l ow·ng i s on in cnt ory of Alc oho
ates here iP fter enu~e rate .
The f
o~ Jomes
On '.1on Oc t 1 st ., 0 -'c·'- ·H·'-~-,- :· r1
P cha.& J d r _. t ! 6 Cc: t, . h:..: - ' ·: .. ··--~•_-i•_"-_, _ _g
0
:-
1
Us ea
P.
o
in[; ct • /--'~- ;!..~~-t--~f~:-H- •~ .H-.;t · • ~ -;"-.!~
or1 haric. I o·v o l at o •·: •• ~.-:~ \• v \- ~• -;~
Nov~r 1 st. . ' 1...9_
c..t.-- 1 9 1 _
nt y , Vn .
• Av is
f,
8S
of the
II
ga s
0
II
dl1
4
,,
ov c inven toi>y of A:)_c ohol is a. true EV1 ,
I hereb y c ert "fy th t the
cc urate statement of all re c eipts , i bur soments and quan
o
titiAs
;
of Alcohol on hand et tho t limea ove ;n nt i or,ed
lt·:,u
~/. r
. ll/ 10-f
oGt
' ,
U
~ c -.
St<".~e od! !iq;iniE', City of ·: . "'r .'.. -ci1bu.c g , to - \, ·t;
~J. 8C::'.' l bcd
ct sw l"n o efol'"' "'.l , i n tho Cir.,y of 1:~1•f'i3onbu g, Va ,
th i j st . r:iy of Uti! , 18~8,
Jr • OS l" . •v i ci .
0
,;
~
~~~2td!
d ..t(d~
Ca mm hmlon ax iMs
~ r/
/C(?-o
�r
C
r
�'
JAMES L . AVIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY
, TOILET SOAPS.
GARDEN SEEDS, TRUSSES, ICE CREAM. SODA W" ATER.
SOLE
PHYSICIANS '
PRBSCRTPTIONS A
AGENT
FOR
W"HITMAN 'S
SUPREME
CANDIES.
SPBCJ.ALTY.
'.l' ELEPHONE NO. 41.
Dec . 1st. , 1918 .
HAnnrsoNBU RG,VA ..
To the c lerk of t he Circuit Court of Rockingh am County, Va.
The f ollowun g is an inventor y of Alcohol of James L. Avis as of the
dates hereina fter enumera ted.
On hand Nov. lstl918-l :* ~-,;-: ",H:--,:-lHHHH,.;,-
.Purchnse d during Nov.
Total
Us ed durine Nov.
-;c-;:',h. ; : .; c., -;.~hH rn-
gals .
It
----- ----.-,,.- -
-.H , -lH ; , ;- .:;. .,; , .-• '.- -::- ,dHHc*·);
Bal. on hand Dec. 1st.
4
0
4
•
r* • ~•;;o--;,.,. 7~·frt: -;, ..:-:,
2 1/2
1 1/2
II
I hereby ce rtif y that the above inventor y of Alcohol is a true and
accura e statem~ nt of all re ceipts , i ~bur s eme n t s and quan t j of Al cohol on ha nd at the above menti one 0 ates.
{/
~~
( .;x~/· (,~
~
Va.
191_
��JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA. W-ATER.
SOLE
PHYSICIANS'
PRBSCRIPTIONS .A.
AGENT
FOR
W-HITMAN'S
.
SUPREME
SPBCIALTY.
CANDIES.
j
·TELEPHONE NO. 41.
HA.RmsoNBURG.VA. .•
Je.n . 1st . , 19l i .
191_
To the clerk of the Circuit Court of Rackingham County , Va.
The ! ollow i n.g is an inventory of Aleohol odI Ja.mes L. Avis a s of the
dates hereinafter enumerated .
On hand Dec . lst . 1918 .
Purchased during Dec.
1 1/2 gals.
II
9
ii
10 1/2
Used during Dec.
Ba l . on hand Ja n . Lst .1 919 .
6
4
II
1/ 2
II
I hereby cert ify that the above i nventory of Al cohol i s a true and
accurate statement of all receip s , disbursements and quant ity
of Alcohol on hand at the above
ned date: v
.
.
:cn~i
L 11/t&L-Ht
_ ~
fl
(!__fj_
d ,
-
State or Vir•g i n ia, Ci ty of Harrfsf 1nburg, .l°- wit ;.?
Subscr i bed and sworn to bef ore ~
i n th~ ~~it y of Harrisonburg , Va .
this 7 st. day or Jan . 1919. , b_y James L. Av i s .
h ~~
~»o~~
'
• •
~..
. 1 .. ton
x~I
..
¢~,&/
?--o
I
If' 7-0
��JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA -W-ATER,
SOLE
PHYSICIANS'
PRBSCRIPTION8 A.
AGENT
FOR
-W-HITMAN'S SUPREME CANDIES.
SPBCIA.LTY.
TELEPHONE NO. 41.
HARR:rsoNBURG.VA ..
Fe b J • t . , J 91 9 .
191_
To t he clerk of the c i r cui, Court of Roc k i ngham County, Va.
The f ollO\,in g i e a n inve n tory of Alcohol of James L . Avis as of the
da t es hereir-after enumerated .
___
On ha nd Jen . l st o 1919 . .?,:- ;;;.;:- ~:-~:-~~i~• ~~: -1}-r
Purchased duri n g Jan . • H HH~{HHHH'c-::-, =-*
Used dur i r.g Jan .
Tota l
{HH, -:H H 0 • HHHHHH H'•-l~
Balo on hand Feb . l st . • r• :- ~~- ~,- ~:~ :- ~:-•;(" {}{f-:~~-*
4
4
9
4
4
1/2 ga l s .
_,__
1'/2
s/s
3/8
ti
II
"
II
I hereby cert i fy t hat the above inven t ory of Alcoho l i s a true and
accurate statement of all r eceipts , d ~bursements and quan tity of
Alcoh ol on hand at the abo e mentio
a ates.
.Sta te of Vi rg i n i a , Ci ty of Ha rriso u rg , to - wit;- - '/
Su bsc ~~ ed and swo r n t o before me, in the Ci ty of Harrisonburg , Va . ,
t h i s , ~. day of Feb ,1 919 by James L. Avis o
JltT commission
J ll'es .; LUV :.:.no.., l.d.::l.
��I
JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA W-ATER.
SOLE AGENT FOR "WHITMAN'S SUPREME CANDIES.
PHYSICIANS'
PRBSCRIPTIONS A
SPECIALTY,
'1'ELEPHONE NO. 41.
HARRTSONBURG,VA.,, _ _ _ _ _ _ _ _ _ _ 191_
To the c erk of the Circui t Court of Raclcing a~ County, Va.
The foll owi~g is ~ invento y of Alcohol of James L. Avis
t e dates here inafter enumerated, .
s of
On hand Feb. l at. , 191 9 ,,:..,,.-~.;•,H'·* • H~ 4 3/8 go.ls.
Pur chased dur i ng Feb • .;~:.H ·. ,,.;: • , •:rn_~,._:_-_..::;4.....:;;a...L.,;2:;;.__....,','...__
11
Total
8 7(8
during Feb . -?HHH~ oHH·- ~a-,:•• HHH: •:•
Bal. om hand March 1st • .HH:- -:HH:-,H:-
Used
5 5/8
3 1/4
If
If
I hereby certify that the ab ove inventory of Alcohol is
and n.ccyrnte statement of nll rec3 iptp disburseme
of Alc ohol on hand at the above mentlo ed dates .
O
true
quantity
---.
State of Vi rgin ia , City of Harriso urg , tJ(5".:wit; Subscribed end sworn o before me , i n the/ City of Harri son burg, Va o ,
thl3 ·S s t o d ay of March , 1919, by Jam~s • Av i s.
~~a&
d~~~
A'1-LfW• ~
Cj ?-o
C mmt9!!'fo R ..,.,res
��'
JAMES L. A VIS
~ DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CHEAM, SODA -WATER.
SOLE
PHYSICIANS'
PRBSCRJPTIONS
A
AGENT
FOR
-WHITMAN'S
SUPREME
CANDIES.
SPECIALTY.
TELEPHONE NO. 41.
H A RRTSONBURG,VA., _ _ _ __
___
_
_ _ 191_
To the c e k of the Ci rcu i t Cou t of Rocxingham Count, , ~The following is an i nventor of Al cohol of Jame s L. Av i s
the dates hece i ~ · er enumer ted .
On hand
1,
arch 1st . , 191
arch
Pur hased during
•: :; ::
x~<- :rn
i/ 4 ga l s.
3
sed durir-_t; tiar,ch
• i".;~~~~·c-)~1 :- ~:-~~ii" •
pr i l 1st.
"II
9
-1H:~HHHHi--::•_* ---,,....:;.__,,.-+
/4
1
Bal . on hand
r~c.*
,-i_H:-~:-{HU**
s of
"II
G 3/.4
5 1/ 2
I her e by certi f tha t e a ove inv Pntory of Alcohol ia a true a nd
ac cur Rte statement of all re c e · pt c , d i sbur s ements and quant i ty of
Al cohol on hand at tho ab ove me n o 1ed ates ~
,C ~
, ,,.---
tate of
rg i n ia , Ci ty of Har
rg , t cy!wi t ;
Su? sc r ~ ad ""· 1d :EJO P:-' '.,o b t",f::. re me , n t!:le Ci ty of
th1 S'fl~ . r-"f
f Ap1, · 1 , 1 919 , b~,r James L. Av i s.
rir "Lrnnburg , Ta.
_ __ __df
"--'-'-'- (J.
,
;:~ cl Mr,/_cuy c»~
ioi:. ex piree Ju.ly ·
1, ,
J: 41
��JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SOD.A °WATER.
SOLE
PHYSICIANS'
PRESCRIPTIONS
A
AGENT
FOR
"WHITMAN'S
SUPREME
CANDIES.
SPECIALTY.
TELEPHONE NO, 41.
HARRTSONBURG,V.A.
To
he
st . , 19 9 .
ay
.
lerk of the Circu i t Court of Rockingham Co1nty, Va .
Tile f 11 ow · ng i
vn .. nve ntory of Al e ohol of
d ate here raf er enumerated .
ri
ames
. Avis es of
l s t . , 1 qHJ • ~-:# -:· ~~-~~,:~ l: 5 / .~ gals .
i'· ~;:-..~: ..:: ~: ~~-~: 0
ur i n Ari
0 D
5 1/2 "
h anC 1\p!' i l
Pure esed
sect during Apri~
B 1 . on hun
~Y
3t c
~:
II
"
he
191_
��JAME S L. AVIS
DRUGGIS T
AND DEALER IN MEDICIN ES, SPICES, BRUSHES , CIGARS,
PERFUM ERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES , ICE CREAM, SODA "W°ATER.
SOLE AGENT FOR -WHITM AN'S SUPREM E
CANDIE S.
PHYSICIANS '
PRESCRIPTIO NS .A..
SPECIALTY,
TELEPHO NE NO. 41.
HARRTSO NBURG,V A. _ _ _ _ _ _ _ _ _ _ __ 1 9
1_
To the clerk of the Circu it Court of Rackin gham Count y, Va .
The follow ing is an imven tory of Alcoh ol of James L. Avis as of the
dates herein aft er enume rated .
On hand May lst . ,1919 it- {f4E-~~ -H-.;r'* •~ 2
Purcha sed durine May if-*{f' • }~:•~·** 9
Total i:--,~~ ~f'~ z. ~r~~~~ *~;-- 7;- ~f'-£f-~~ 11
Used during May **•r•**{f{}•:i" • Z..4t·-!~-4:{r
Bal. on hand Ju ne 1st . **~~-~r"~"~t;-
6
5
2/s
2/s
Ga.ls.
"
It
It
,,
2/s
I hereby certif y that the above invent ory of Alcoh ol is a true
and accur ate ststem ent of all receip ts disbur semen ts and quantity of Alcoh ol om hand at the a bove rn tioned dates .
State of Virgi nia, City of Harris on ( e, to- wfi;
Subsc ribed and sworn to before me , in the City of i?a'r ris onburg
, Va .,
this ~' / -~ day of June, 1919, by James L. Avis .
-4 .~
••
y Cemmi
ien •
L~
ii"
'
-
��JAMES L. A VIS
DRUGGIS T
AND D E ALE R IN M E DIC INES, SPICES, BRUSHES, CIGARS, P E RFUMERY, TOILET SOAPS,
GARDEN S E EDS, TRUSSES, ICE CREAM, SODA "WATER.
SOLE AGENT FOR -WHITMAN'S SUPREME CANDIES.
PHYS I C IANS'
PRB S C RIPTJON S
.A..
SPBCI.A.LT Y,
TELEPHONE NO, 41.
HARmsoNBUR G,v A..
JuilaJ ls t • , 1919 •
191 _
To the clerk of the Circuit Court of Rackingham County, Va ••
The following is a rc inventory of Alcohol of James L. Avis as of the
da t es hereinaft er enumerate d.
On han d June 1st • , 1919 ****.:HIPurchased du r i ng June
***ir**
Total
***-!},:--:.-****~~
5 2/,a gals.
If
4
9 6 8
Used during June
*~. ~i!-·**-X-*7~ *
Bal . on hand J uly 1st. 4HH}****
5
4
~78
4/8
2/a
"
If
ff
I hereby certify that the abov e inventory of Alcohol is a true and
accura te statement of all receipts , disbursem ents and quantity of
Alcohol on hand at the above ment~o ed dates ~
_
a;,
1
·~~ ~ - ~xi
State of Virginia, City of Har 1 onbucg~
Subscribed and sworn to before _e , in the City of Harrisonb urg, Va ,
thl s 3,st. day of July, 1919, by James L . Avis.
~
-/4 ~:ftMI.. s7!:i~
.
��JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY
, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA -WATER.
SOLE AGENT FOR -WHITMAN 'S SUPREME CANDIES.
PHYSICIANS'
PRBSCRIPTIONS A
8-PBCIAL TY,
TELEPHONE NO. 41.
1919 .191_
HARRJS0NB URG, V A.,
To
be cl rk of the Circui
Cour _t:, . of Rock i ngham Couht.y ,
he fo lowing is a inver. tory cf Alcohol of James
dates hereinaf t~_r num . r ed .
On han July st . , 1919 • 1-*~HH1- ·:--,~*;~*
Purc hased during July {'**~'"*n,."**
Totnl
.
ed ur i ng July
iHHH• • ~*•:H:--r.•*
, Ba l . on hand Aug. 1st . ,·.HH1--::--i:-• rn -:H' •::
a.
• Avis as of the
4 2/,8 ga lt1.
~ %2~--"
8 6 8
"
5 11/..2
"
2/8
"
I herebyA ~ b~ve inventor y o:!' Al coho l as a true and accur
ta tern
of al 1 receipts , dis burs .. nts and .. uant i ty of Al coho l
on ahnd at Lhe ahove ment i oned dat ~
Stat e of Virgima a , _Ci ty of Har
Subscrib ed nd worn to before
this ls • dBy of A us , 1919,
e
a. .
t
��JAME S L. A VIS
DRUGGIST
AND DEALER IN M E DICINES, SPICES, BRUSHES, CIGARS,
PERFUME RY, TOILET SOAPS,
GARDEN SEEDS, TRU SSES, ICE CREAM, SODA W-ATER.
SOLE AGENT FOR W-HITMA N'S SUPREM E CANDIES
.
PI-IYSICIANS '
PRESCRIPTIO N S
A
SPE CIALTY.
'1.' ELEPHONE NO. 41.
HARRJSON BU RG,V A.,_ e_:p:...._._
T
he
the
_
s_t_ ._:,:_1_c._J_ 9_._ 101_
1 rk of the Circu it Court of Rackirg h n Count , Va.
o. lo1 i ng is an ir.vento ry of Alcoho _ of James L . Avis a s of the
do.ten herain aft r enu.mera te
~
On hE nd A ·eu~ t 1st., 1919
urcha s~d
u;;~!1A ug.
Usod durir..g
Ba.1. . on han
iHLHf*.;.'.- *{F -r~
2/a gf ls.
~HHHHrn -::-_,r-_• _
H_··-=lc;::~:...._.!:;; 7__,:; .:~ :.-..--::
ept. 1s t . ****~*~****
8
II
8 6/8
"
I hereby cer t ify that the above invent or, of lcohol is a tru e nd
ccure te state:n ent of all rece'!.p ts
is bursem ents
quanti ti y of
Alcohc l on h&nd at the ah cve mcnt
d
~--
to- wit ;
City of Harriso nburg , Va . ,
James L. Avis o. .
/T\
/)~
~ ~ oui d
"My Cemmls'SI
.
~-~
��JAM ES L. AVI S
DRUGG IST
AND DEA.LE H IN MEDIC INES, SPICE
S, BRUSH ES, CIGAR S, PERFU MERY ,
TOILE T SOAPS ,
GARD EN SEEDS , TRUSS ES, ICE CREAM
, SoDA W-ATE R.
SOLE AGEN T FOR W-HIT MAN'
S SUPR EME CAND IES.
PHYSICI ANS'
PRBSCRI PTIONS .A. SPBCIAL TY,
TELEP HONE NO. 41.
HARR ISONB URG,V A,. OCt .
To
1st ,. ,1 919 .
he cl er k of the Circ uit Cou rt of Rack ingla rn Gou
ty, Va .
The fo _low g is an ir,vcr i tor~· of Alco ho l of
,Ta:nos L. Avis 2.
date s her i
n~ft er ene
ra ed o
191_
of the
On ahnd e t . 1Q t ol91 9 *-l!·{HH:~i- ~ -l~,~*•:•* 8 6/,8
g als .
Purchc;...sed dur ine Se pt . ~~ .~-:i- • ··~HHH ~*~HH } 4 1/,2
tt
Tote l • } :-*,HHHf..¾-_1..,3,.,
-..-2""/+e...,- -ff'n -0
0
Used. duri ng Sep .
Ba l . on h nd Oct . 1st .
6
7 2/a
I here by cert ify that the abov 6 inv£ n torJ of Al
coho l i a a tru
nd
nccu rate state men t of all reve ipts , isb rser. ients
d
qua
n
ity
on
and at the abov e me
t ione d dcle 3
St ate of Vig n ia,
i
4
y of Ha r riPo nbur g
-wi t ;
Subs cribe d an d swor to befo re 'me , in th. ToCit
of H rr i sonb uPg , V .,
this
day of Oc t . , 1°19 , y Jame s L. Av i 3.
7s .
n ·
-~~~-~~~----&~~
��JAMES L. AVIS
DRUGGIST
AND D E ALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRU SSES, ICE CRE AM, SODA "WATER.
S O LE
P H YSICIANS'
PRBSCRIPTION8
A
AGENT
FOR
"WHITMAN'S
SUPREME
CANDIES.
SPBCIALTY.
TELEPHONE NO. 41.
t v .. st. ,
HARRTSONBU RG,VA.,
919 .
191
_
To the clerk of the Ci rcui t Court of Rockingham Courit~r , Va .
The follow i ng is an inventor y of Alcohol of James L. Lvis as of the
dateo hereinafter enumer ed .
·,f
n .an
ct 3t . ,1919 it-i}..X--• ;~•~f-~:• 'i" *
Purchased du.ning Oct . "1'r ·!~·i:"*·!:" •:f ,t:.. *~
Total * i;*{:•~f °)~· {} 1 ~~ ~
*i:"{(·*·~ {~ .;:*~e..7~.
during
sed
Oct .
al on h a nd Nov. 1st . {t' Li!-~i- -if~.. ~:;-{:.* ~
gal . 7
"
---ir"II
2/a
0
7 2/8
i:;
..,
~'/,8
1 6/8
I hereb y certify that the B ove i'lve nt or-y of Alcoho l i~ a rue and
ac y rate tatement of all re c c i f ~ G~isbur sements and qua t it
f Al -
co10
om h·nd
the abov e me ~
_;:;_~
_, __'_ ~'- - - - --
St ate of Vi r g ~r a , Ci ty of Harri onburg~
- wi { ;
Subs cr i cd nr~ sw rn to before n e , i the C ty of
•
th s
A<! t .
rj -::_ ,
of November ; 1 91 9 , by
anes L . AvL,o
&
ri~onbur g, V ,
_____/a_____~ ~ n~
tr •
S p . 20 192
4k
��JAMES , L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA -WATER.
SOLE
PHYSICIANS'
PRESCRIPTIONS A
AGENT
FOR
-WHITMAN'S SUPREME CANDIES.
SPBCIALTY,
TELEPHONE NO. 41.
HAnmsoNnuRG,VA.•
Dec . , 1 t=:t. . ,1 91 9 . ,
191_
To the clerk of the Cir cu it Cou rt of Ra c k i ngham County , Va .
The follow i ng i s an· inventory of Alc ohol of Jam~s L . Avi s as of the
dates here i nafter enumera ted o
On hand Nov ls t . , 1919 -;; • H, ..HH,-,HHHH,-lcPurcha.sed during Nov . .,-,.r,..,:..fHHHHHHrn
ga ls . 1 6/,8
"~_4_4/.8
6 2-n;--
Used dur i ng Nov .
-,HH:· • f- ·:HH':•::- • H ..~* -::•• HE-*
Bal . on hand Dec . 1 s t ****~*******
"
"
41 .. 6/.'
/a
4 8
·
I he r eby cer t ify that the a bove inventory of Al cohol i s a t rue a n d ac cu r a te s tatemen t of all rece i pts , dis
eme nts and quant i ty of Al coh ol
on h a nd at the a bove men ti oned dates o
Si.ate of Vi r g ini a , Ci t y of Harri so . .1 g ,/4:.wit-;'I
. __,
Subs c :t,.i bed and sworn t o before m~, . m. - the Cit y of Harris onbu rg , Va ,
this ~ ~t . day of De c . , 1919, by James L. Av i s .
4
"My Comm
~ L.~~~
1
"expires S ep
20, 19 2
�Flierl in ,
cki11:J1·ham
erk's (1,,,,
Cou,,ty, .Va,
or-cs .. 1919
---
fr!rk
�JAME S L. A VIS
DRUGGIST
AND DEALER IN MEDICINE S, SPICES, BRUSHES, CIGARS, PERFUME
RY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA "WATER.
SOLE AGENT FOR "WHITMA N'S SUPREM E CANDIES
.
PHYSICIANS'
PRESCRIPTION S A
SPBCIALTY,
TELEPHON E NO. 41.
HARmsoN euRG,VA.•
April ls t. '1 920 •
191_
To the Clerk of the Circui ·J Court of Rockunr,ham County , Va.
The follow ing is an invento ry of Alcoho l of J aL.1es L. Avis a s of the
da t es herein after enumer ated .
On hand Jle.rch 1st . ,1 920 ,
Purcha sed dur ing March
Use-:i during Hapch
~~-~:~~-?~~~➔r
1: ::0::: :·r.
00
----.
4 1/s
.;<--::;:·: :,:: ::;:;:::.;:
Bal. on hand April l~t.;
4 1/s
1:--:H:•-lHH:-
3 5/,8
1/2
gul3 .
"
"
"
II
I hereby certify that the above invento ry of Alcoho l is a true and
accura te statem ent od all receip ts , disburs ements and quanti~ y of
Alc ohol on h .. 1nd Rt the above r:ientio d dates .
~
,- -- ·- -'--I.! ~
---
..,..:::;µ,,.at.Zl t.~f._. _ _ _
State of Vir g i r ia , City of Harri:.· nbur~
Subs c r V,) ed and sworn t o before r.1e , i n the City of Harriso nburg , Va. ,
this ~ . day of Apr il , 1920, by James L. Av is .
��JAMES L. AVIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRU SSES, ICE CREAM, SODA VV ATER.
SOLE
PHYSICIANS'
PRBSCRJPTIONS A
AGENT
FOR
VVHITMAN'S SUPREME CANDIES.
SPBCIALTT.
TELEPHONE NO. 41.
Mch. ls t . , l 920 .
To t he Clerk of the Circuit Court of Rockingham County , Va .
HARR:rsoNBURG,V.A.,
191_
The following i s an inventory of Alcohol of Ja1,1es L . Avis as of
the dates hereinafter enuneruted.
On hand Feb . ls t . , 1 920 , -:HHHHH,-:rn,rn 2 gals .
Purchased. during Feb. :: ): :: :: :::::: -1~:i- :: :: ~ 1/2 "
To + a l
"
Used
dur i ng Feb.
" ,c .,c,
•. ~•--'CC•. ~· • <., , ~,,• .,,.-, ••-,.-.~-~*-6...:::...1..-,,7
...2-=--,.,.
", , . . . .. / . J\. , -. ~ '°rr •\ l \ h l ) l • f \
I
7'C" H
2 2/a "
:: 1,:0:0 4 1/8 "
c3/.--lHHHHHH:-::-• HHc-'>-HHH}
Bal . on hand Mch. lat .
¾: • :1: -in: • :
I hereby certify that the above i nventory of Alcohol i s a true a nd
ac curate statementof al l rece i p ts , ct i~bur sements and qua n t itj eoa
hand at the above mentioned dates .
State of Virginia, City of Harris n urg to - wi t ; /
Sub~eribed and sworn to before me , i n the City of Harrisonburg, Va ,
this 1st . da y of Ma rch ,
by James L . Avis .l b
~ n./i;;jr?.,,jj.;.
ll
•
y Cornn-tis io
expir ~ b ept 20, 192
�Fil d 1n
.ockinbh-am ( I ,·,t.;,
'v
r'
~J;i,; 5 19 ~o,
- ----------
')!~1:i
vi•
"·
�JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA "W"ATER.
SOLE
PHYSICIANS'
PRBSCRIPTIONS A
AGENT
FOR
"WHITMAN'S
SUPREME
CANDIES.
SPBCIALTY,
TELEPHONE NO. 41.
HARRJSONBURG,VA .,
Feb . 1s t . , 1920 . 191 _
To the clerk of the Ci rcuit Court of Rockir1gham Coun t y , Va. .
The following i s a n i nven tory of Al c oh ol of Jao es L . Avi s a ~ of tha
dates hereinafter enumerated .
On hand Jan . 1st . ,1920 . ~H:-~:-.;-.,:--:;.-:-:5 gals .
Purc h a sed dur i g J a n.
• H ' ,;*_
-1(-_, _H_;_ _O
_ _ ...,','..._
Used dur ing J a n.
-:r--:HHHHHt
Ba 1 . on h and Fe b . 1st .
~r-•;f .;~~ • ~· ~'. ~~
9
5
3
2
,,
ti
I he r eby certify that the above inventory of Alcohol i s a true and
accurate statement of al l r eceipts , d i sbursements and quantity oti
Al cohol on hand at the abov e
~,State of Vir g inia , City of Harrisonbu•g , to - wi t ;
Subscribed and swo r n t o before me, i n the City of Harr i s onbu rg, Va .,
th i s )fly. da y of Fe b . , 1 920 , by James L . Avis .
~
"My
/a A -~
Cett1 m l a
n ex;Jir••
s.,.t.
20, 18 20
��JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY
, TOILET SO.A.PS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA. W-ATE R.
SOLE AGENT FOR WHITMAN 'S SUPREME CANDIES.
PHYSICIANS'
PRBSCRJPTJONS A
SPBCIAL TY,
TELEPHONE NO. 41.
HA.RRJSONB URG,V A.. ,,_
0
1
t he cle r k of
fo l ow rig
h ° Circu i t C u r t o
s a'1 i nvc . ,or
=
J a,.,,"'"'•~-__,l,__s~ t,___,.,lc.9.e~2=0:. _a;.__191_
Roc k h ,r,ham
ru~es L. Av i s
o f Al coh ol o
ate., her ei nafte r rma or " ted ~
_
BS
o~ the
/in hG nr1 c c . 1st . l 2
-::--: HH'•:::c.:•--::--;,-;;.
~r 11D. :,ed d uri n £; i. ec . ,:--::--'~v1;.•·c·:·+ ,·_•::_,_,._ -.;;,_..;.J......._::___ __,
To n.l ~~
~ ~1 ·:~ •:.~'-..;•-..~= . . ~-~
'---: '
t' se cl d 1r i r· -:- - e c
~r=
'~ .~: -'~1~-' :- ; :·-.!•-~- ~~ ~~~:-.;:--i.~·-;'i"
Ba l . on h and J~n . 1st . , 192 0 1c-: ;i--;H, 5
"
0
- .!~ ~·--~~"'... ,... . .
G
0
I her11'h y cer't i f th.at t h e e.bove ir.vento
of Al c ohol
· u :, -ue ~J r
nccur& c ta terr.en t of o.11 r ecc ipts , d i sbur s e:ier.: ts 8 cl qur,n t i t,~r of Al cuho l on ha n . at Lhe bov e ment io n~
~ !
.
Llfatr
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-
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f'/
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'
a-:c o f Vi• i "lia , i t ~· ~f 1.a~1·ir,0 n;u
, t · - \·: ·t,.r;
.
Sub cribcd or,d Emorn t o cfore 1rp ir t he
·t,-·.i
f
Ha
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r
s nbm~, .. , ,rc o,
1
111
t :-1i c "'st
. dn y o f ~r..uc r :/ , 192 0 , y Jar.1e 3 • . / V i ;J •
'
11._ ff
. , rlarlrfJ.~
" My CommlNl• 11 --.,,_
a...t.
20 , 192
�,
.
�JAMES L. A VIS
DRUGGIST
AND DEALEU IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS.
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA "W"ATER.
SOLE
PHYSICIANS'
PRBSCRIPTIONS ..t..
AGENT
FOR
"W"HITMAN'S SUPREME
CANDIES.
SPBCIALTY.
TELEPHONE NO. 41,
5t'
HARRJSONBURG,VA .,
...
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�------c~i
\) ' ? -
�JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA . °WATER,
SOLE
PHYSICIA.NS'
PRBSCRIPTIONS A
AGENT FOR
-WHITMAN'S
SUPREME
CANDIES.
SPBCIALTY,
TELEPHONE NO. 41.
HARRJSONBURG,VA.,
.,
Cl ,_,rl;: oC: t
~-:.i1, Lr
of
.t~
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~~4At.b.. ;;,,,ef;
�•if)
Flied in the Clerk's Office
Rockir·i.wam Guunty, Va,
~51921
�JAME S L. AVIS
DRUGGIST
AND DEALER IN MEDICINE S, SPICBS, BRUSHES, CIGARS,
P E RFUMERY , TOILET SOAPS,
GARDEN SEEDS, TRUSSES, ICE CREAM, SODA. "WATER.
SOLE AGENT FOR "WHITMA N'S SUPREM E ~ANDIES
.
PHYSICIANS'
PRESCRIPTION S A
SPBCI.ALTY.
TELEPHON E NO. 41.
HARRJSON BURG,VA., _
_
"~t"-,
. -'--_
,~r~l
o_ 101_
_____
___
'=.'' J.r f :.11~·.: i r :
is r ·- i. v r t ot>? 0 f
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riled in the Clerk'~ Office
Roci<ini~harn County. Va,
r-rc 6- 19 ...
___ _ _ _ _ Clerk
�JAMES L. AVIS
DRUGGIS'J.'
AND DEALER IN MEDICINES, SPICBS, BRUSHES, CIGARS, P E RFUMERY, TOILET SOAPS,
GARDEN SEEDS , TRUSSES, ICE CREAM, SODA "WATER.
SOLE
PHYSICIANS'
PRBSCRIPTIONS A
AGENT FOR
-WHITMAN'S
SUPREME
CANDIES.
SPBCIALTY.
TELEPHONE NO. 41.
HARmsoNBURG,
v A.. Oct • 4th., 1 92 4 •
T• th e Cl ~rk e f t ho Circui t Cuu r t of Re c ki ngh•~ C~u n ty,
The f &ll ew i ng i a an inv e ntery
dates h e r e ina f te r enumer .t e d.
f
Alc • h 1
Us ed during Sept emb e r.
Ea l. en h ~nd Octo 1st
f
191_
V~
J me~ L. Avis ~s • f t he
.-?~.,=
·* .;r~:. ~·*i~i C'
1
if?$-ll-~~ ~(·-3~*4'•~:•
3
"
It
40. "
96
"
I h ereby certify t h~t the Qb ovs invent • ry • f Alc eh ol i s ntrue ~nd
:it ccura t e s t :i.t 0mc nt o f a ll receiptG, d i s bur 0omen to and qur..n1y f Alc • hol on h a nd a t: the n bovo mentioned d a te•~
~
~ •
ffe/~.~,to,
Stat e e f Virgi..ni a , City e f H~rri s nburg , t -wit;
Sub:rnri_bed ,.nd s,1er n te bef r e me, i n t h e City ef H~ rris e nburg, Va.
t,hi s
d y • f Oct eb er, 1924 , by Jame s L. Avis.
7-
.
G~t ::~
�'C '\ l ·, " t'ne C\et\( s a~~\ce
t \8U
I\ocl<ingha\\\ Count~ ' ~a,
1'
t'O~
1,0
\'?{I.A
__________......--·-··· C,-\ef¥-
�JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDICINES, SPICES, BRUSHES, CIGARS, PERFUMERY
, TOILET SOAPS,
GARDEN SEEDS, TRU SSES, ICE CREAM, SODA "W".ATER.
SOLE AGENT FOR "W"HITMAN 'S SUPREME CANDIES,
PHYSICIANS '
PRBSCRJPTIONS .A. SPBCIA.LTY.
'1.' ELEPHONB NO. 41,
HARmsoNe uRG,
T e t he Cl r k of the Cir c uit C ur t
Th e f l l awi nG i o ~n i nvent ry
d ,. t e ... ho r c i no.f' t e r cnumc r ... t a d.
v A ., J\fov
4 t h • , 1 g2 f
O
191 _
f R c k i g h "'m C unty , V •
f Al e h 1
f
J • es
L. Av i s
0 11 h rt nd Oct • l s t . , 1 924 . -,r-,c.~:-;~
.. ~:-• !•{r~:Purch n ed duri ng Oct. .,H,-::• • H HHHHr
T t c~ 1
.::. ~:•.Jf- .jf~.. ~'°*1,r~:--
3 ga l s .
0
"
d
3
Uo od d tir i ne; Oct •
-* r::-~~'7:•!~-J,{. . ;:--!:•• :-1:•-:f
Bet 1 .
n h . nd ?-J' V • 1 G t • -;}~:-1i"l,~~f.;~.*{l ~""
1
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96
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It
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84
f
L h e r e by c r t if y t h n t t ho "'·b v c inv e nt e r y f Ale h 1 i ::; rn. tr u o " n d
c cura t e s t a t ement o f ~11 r e c e i p t s , d i n bur sements nd qu ~ntity f
Al e h 1 t1 h ~nd " t the b v me , t i nc s d ,,_ t c s .
/, ~ .
Sta t e f Vi r g i n i . , Ci ty f H rr i s n bu r ~ ~ " v / [ , { ' ~
/
Subr.; c r ib e d .. nd s w r n t
be f r e mo i n t he Ci t y f H .r ri G nburg , Vm
th i n /0~ d y f N v emb e r , 1 92 4 , b y J u • e s L. Av i s o
3/ ~
0
O
Mv Oom ission expires Oct, 22, 1928
,
�fi\ed in the C\erk's om~e
Roc~i ngham County, Va.
llO~ .10 1924____ __. _:__,_ C-\erK
i
�JAME S L. A VIS
DRUGGIS T
AND D E ALER IN M E DICINES, SPICES, BRUSHES , CIGARS,
PERFUM ERY, TOILET SOAPS,
GARDEN SEEDS , TRUSSES , I C E CRE AM, Son.A. "W"ATER,
SOLE
PHYSICIANS '
PRB SCRTPTION8 A
AGENT
FOR "W"HITM AN'S SUPREM E CANDIE S.
SPBCIA.L TY,
TELEPHO NE NO. 41.
HARRTSO NBURG,VA.,
I1: Ch • 4t. h • ' J 92 fi .
191_
•ro the-~l erk of the Circu it Cou r t of Roc k i ngham Count y, Va .
The Foll owing i s an invent ory of Al cohol of Ja mes L. Av i s as
the d t e s h e re i nafte r Enume ruted .
/j. :-J'! 1;
J
- .
a.;:J
~
k
.-
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c
cs
,__ ,=..
t:,:,
; Q
'l
Onha.n d F eb . l s to,1 925 . ~H:•• H:--:H; -::--:'.-:(,
Pur chased durin~ Febru ary . • H;-• :-~;-.,:--::Tot e. l
:t:~~\ ;· :: ~~ :: :, ;~. :~1f • t
Us ed dur ill.[; Febru ary -;:- • ;--:m ~:--::--::-;: -::•• HH;Bal
o
on h&nd 1,arci1 lst o -r·•~' ~:-~~.~~•• :~; • ~-~~
69
0
69
56
13
o zs .
"
"
,".
-- I h ~~eby cert i fy that the ab ov e i nvento ry of Al coh ol i s~ true
~a c cu,rate s tateme nt of al l rec e ipts , disbu rsemen ts a nd quant ity and
-~
of
-s- Alc--...·h~ ol on hand at the ab ov e nentio ned d t es .
x7
~t
~t"Ydr
~
~
State of Vi r g ini a , Sity of Ha rr i s o n b u r ~
Subsc ribed and s\lorn to before me i n the Ci ty of Har r ison burg , Va
.
this #.~ day of March , 192 5,. by J ames L. Avi s .
., -
t - d ~_
��JAM ES L. A VIS
---.,
PHYSIC IANS'
DRUG GIST
AND DEAL ER IN MEDI CINES , SPICE
S, BRUS HES, CIGAR S, P E RFUM ERY,
TOILE T SOAP S,
GARD EN SEEDS , TRUS SES, ICE CREA
M, SODA "WAT ER,
SOLE AGEN T FOR "WHI TMAN
'S SUPR EME CAND IES.
PRBSCR TPTIONS
A.
SPBCIA.L TY.
TELE PHON E NO. 41.
HARR TSON BURG ,VA,, _
a:,
o
t;::
0
_w
_ _ __ __ __
_
_
191_
To ti:1e Cl erk of the Ci rcu it Cou rt of Ro
ckinsh~r, i Cou nty , Vu .
The fo l lo -; i ng i u c.n i nven tory o f Alco :10
1 of J m.men L. Avi s s o f the
du te s here i r..af t er nume rc. t ed .
~
._
-
::>
ro
>
~
w:J-
;
N
i,.,
~ :::i ~
'- o
On hand ~ov . l s t,1 924
Pur cha.s e c. dur i n 6 Nov o
To t ':'. l
Used duri ng Nov o
4\.. *~r-.;\aJA~~~":~·1}~: , :•~-{~~}
B . 1. o n r1~ nd De co 1 s t o ~'"~·• (·~·~~·7i" {:-if ~~
2
0
2
c;, ls .
II
84 ozs .
It
0
8~
.
"
.
l
64
i
2
20
01
"
!
~ ~ {..) L h_l,r eby c e rt i fy thf. t the abov
inv ento r y of Alc oho l . i s
truw and
- -fui Q a cc ,p~ t e st v t emen t of n.11 r e c e ei p ts
, d i sbur sem ents ::-.n ' qun nti ty of
~
o n h' nd
the ab ov e
~ (.,)
(.,) r-
-1
O')
Alcrl
t
It
ment:;;d ~
'ii, ~
~~~
1
St t e of VirG ini &, City of Hnr riso nbu rg
, t o - wit; -~
Sub s c r i bed r, nd swor n to befo re me i n t
he Ci ty of Ha r ri sonb ur g , Vn o
t 'o i s
da.y o f De c emb "r , 1 924 . by Jame ~ L.•
Y.iL ,., ~,
"'~
...~~
�'·
�JAME S L. AVIS
DRUGGIS T
AND D E A LER IN M E DIC IN E S , SPIC ES, BRU SHE S, CIGARS,
P E RFUMER Y, TOILET SOAPS,
GARDE N SEEDS , TRU S S E S , ICE CRE AM, SODA -WATER.
SOLE AGENT FOR -WHITM AN'S SUPREM E
CANDIE S.
PHY S I CI ANS'
PRBSCRIPTI ON 8
A
S PB CIAL TY,
T ELEPHON E NO. 4 1.
HARRTs oNBU RG, VA ..
Fe .. . 2 n d ., 1 C)25 .
101 _
T o t h e Cler k of the Cir c u i t Cour t of Rockin e ham Cou nt y , V . •
Th e fo ll owing i s m. n i nv ent or y o f Alcoh ol of
he r e i n o. ft e r c numer te o
{
J:tr.i.es L . Avi s 0. s th~ date
On h f,nd Je.n 1 ~ . '1 925 . i H:·{H~·*M :--1:--!H: , H HH~ 1 ga l.
4 9 oz s .
Purch~seci. du r i ~ J a.n. -1:-~·• H:-.;:-.,~.r,-• ,*~t •X·{H:-_-1::- ,-_.;.
0_ _ _ _ __ a
1
•
4 9 It
Used clu ring J a n .
.;:-* -1l-~H-{:•• HHl-* -iHHc*
1 08 It
Bo. l. on hfl nd Fe b. l ot ., ~-~:•~r~~·*• ~ ~:~~;.- • ~•• r- ~:·-¾i"• c--:~
69 It
O
I he r e by c er tify tha t the e.bove i nv e ntor y o f Alc oho l i s ~ tru e a n
ccura
t e . ., t .t emc n t of ~- 11 re c e i pt s , d i s b ur s ement s i n c. qu ;;i.nti~ o ~
~
Alcoh ol on hand a t t h e bove mr nt io h
a~
~~
,I
St ~t c of Vi r g i n i ~ Ci t y of Hr r ri s on bu re , t o-wit;
·
.
Su b s c ril!.9d .nd sw o r n t o bef o r e me in t h e City of Ho.r ri s o nburg
, Va .
tlb.i s /o~ d ..'.y of F e b. , 1925 , b y J · mes L . Avi s .
~-- ---- ---- ---- ---- ---- ----
.
~ - ~ires
.
Oct,
My Oommiss~
- - - ----
~~
. .
_
_
,
~
�/
--"'<.
.-
�JAMES L. A VIS
DRUGGIST
AND DEALER IN MEDIC INES, SPICES, BRUSHES, CIGARS, PERFUMERY, TOILET SOAPS,
GARDEN S E EDS, TRU SSES , ICE CREAM, SODA "WATER.
,
SOLE
P H YSICIANS'
PRBSCRIP - ONS
A.
AGENT
FOR
-WHITMAN'S SUPREME CANDIES.
SPBCIALTY.
TELEPHONE NO. 41.
HARRTsoNBURG.VA .•
,Ion . 2nd. ,1 92 1 .
To the Cl e r k of the Ci r cuit Court o f Roc ldngh D.m County, ·va. .
191_
Th e f ollowi ng i s a n inv e ntory of Alcoh ol o f J &mes L. Avi :. a s of the
da.te·s h e r e ina. ft " r e numorn t ed o
On h :1.nd De c . 1 s t . ,1 924 ~f-.Z~• Z.. • E- • =·*-!t· ~-!&~~
Purc h ~ secl during Deo emb er -J{-- i f ;,f ~!.. -}(--"'--:~
Tot a l -,r~~~i' 4~>,~{~.. ~t -,:-~-~-* ~f-.;}~~-t.·J,<i r',<·• :· 1t- ~:,. ~- ~,-;~. ~i· i~- ~~
Used durine De c ember
2 ga ls .
II
0
2
20
1
99
49
~i"{i· ~~--;~-?,- J,~--!~?~~i"i~~- ~-
13&1. on h n ncl J a n . 1 st . ,1 02 5
i f ~t'¾:••
f*
•
.
2 0 oz s .
0
•"
It
It
I he r e by c e r t i f y that t h e rt bov e inv e ntor y of Alcohol i s at true •-ml
&ccura t e r.i t o t emont o cl c, 11 r e c e ipt s , d i s burs ement s and qua ntit y of Alooh ol on h a n d " t t h•. ab ov e me nt i one d d~~ ' ~
St a t e o f Virg i n i u , Cit y of Hmrris onbur g , to- Yl i t~
~
Subs cribed .m i sw orr.. to b e f ore me i n t h e Ci ty o f H~r r i ~onbure., V&.
t h i s ,:,~ d~.y o f J &nu a ry,1 92 5, by James L . Av i s .
MyOommi••oo~ ; , ~ ~
•
��n-c
or
rf 1r
)1 n
1
nt S
1
t8
J' r.cpo1·t
·i gcvater , Vir "nla .
Te
o
oving is an
of t 1e cla
a
s her inar
st ,
Ia
~
r c h, bee
1
...
ring
p
•
y
p
01
oz
s
91R
e
,
st
une
pz
IJtS
nven o
f
.'O
11.}
a1· c t s lr
i"'eJO
he :fol
of' t
n
n entorr of ar en
·ci r :ftc1·
wne ·a tc
• &
&t . 10
une
l a&c
dUl
11 .
t1:>
n
e
J
<J
otal
e
d
i 1g
he eb
an_
CCU t
Pts
t:f
f
t
t
of A d nt Sp . •its
0
l~
11(
eyd e s
r
Sto e
oz,
ts
02: ,
I
,
0
he abo e in cnto y
e state e11t of
a , Jully/ st/..
n nc
Q
J ne
ce ·tif
at
1 pz
L
3
al n e e on lan
irits of
&
s
t
B ic g
u
1uh Sn c .
's
s,
in
0
~
N ne
~,;,-
B
cy
I:> ,
ota
e
f
1r e t Spirits
st. 1.
enun.era te •
------
-------------
an
0
or
·c tory
ul
11 re ccip s
at
0
n
,
rdc t
isbur
S >ir t s
Cl
s a
i& a true
ua
t
he a bove ment
~ 7 r ~ i ~ / ~~ '7-?f~u~~ ~~ .
--t1-<-LI-,_~,,_ "'---,_,. ,,,_ ~ f;; ~~ ~, 7 ,(j,,,_ 9..,,,:-~ ~
~
~ ~ d_4t
ctt---- , ~
/'7/~
»_/yZ,Y/-_<2yA_d
-
~d-~
mmis11ion Expires Septcm er 18th, l i2~
0-~
��to
V
Are t S
o
. on hl
Tot
e fo
a,
r
f
O'
I::>
t e
e o
o:r t e
C
o,ing i
Cou
i
r e t
inve toy o
~1
rit ·
or
its
e
es '
Store
ates h rei
e
tC'l'
,
A
n
011
st
Ju
Pu~c ha e
.
rin
0
g / st ,
I ll
cert · ry yha
e e
oz ,
t,
0
0
o· ,
L
ri
ce
y
c&. ~
0
al
oz .,
Q
-~
9
t e a o e in e 1tor
t e anc cc ra e st tement 0
a d qu nit of
Cl t s · r
s 011
of'
rdent Spit-i
cei t , D s
a
rs me
I
a
s
81
V
I
G
Cou ty of
Sub cri e
rcl ' day of
s
--.. - ----------
,
00
gh m
rn to bef ore•~
.•
to
e, i
e Con
of
0
~· n
u st
M y Com.mi.:;sion Expire1 Scptemb.:r 18th, 1Q21
am th
�!l ed in th e Clc"k'"
Rocking~am Cou,-ty, va.
i\ UG 2-1918
) ,!f,(J_ •
Clerk
�r
ne
:ro t · 1
t
0
p ., .
,ort
st. 9 1 •
tl c
l crk o
he
To
ro
s ir1
r c
n i ··cntor
·ei1 af'tcr Pnmncrat
atC!:i
S Ol'C
l
ourt of tl e Co .. L
lr cul t
• l . ug . 1 ,
,
•
ock ing liil •
~
1
cluring .tg .
urchasc
Total
se
va
lh' l 11g
at u <'
n ham. .
ab
<l.11(
0
/~pt..S.
2
re cnt Spir · · is
o
~bursemrn
of a 1 receipts ,
hancl a t l. ._.,.Jr n, .H .. u t. n , ~ :, s.
lVC
i ,..- ntor0
~ ~--~-- ---- ~~
;C.foVJ'
~
St tc
...&(~~_a~~ ~~
y Commi!S~io1, ~ xp, rt~ • cp•,.mbcr 18th, 192
By he l aw~ o1 Vir inla. n, tax
L
ls requ1r:,:d upon tl1!11
~
�- -----
~
•
() :t
""\,
'i
(
·~
/.
01
I
~
G\
~
!-
�BRYDL}j~R'S DRUG S'J:'ORE
H. H. BEYD:J.JER,
1>il O PRlETOR ,
BRIDGEWATER. VIRGINIA
In ent ory of Arden t Spirits
Mon
y report
Oct ,
o
the Cl erk
he
ollmvin
f
t e
/ 191
irc u t Cou r t of Roclr.1 gham Co,
is an Inve nto y of
rden
r :leyd l er
Spirit s
Dru
St r e
as fo the dates here in a ft e r enumerated,
Alcohol
~--~--------~ ---~-~~
~------~--~---~-~---------------------------s 191 8
12, /
Pt,
On h and Se pt,
Purc h
ed
______ a~A-et~----
ur· n g Sept, 1918
1 .1 /2 P t ,
To t a l - -~----- -- ---------- - -- -----------Used Dur i ng Sept, 1 18
5, pt ,
Ba l anQe on band Oc t , s t , 1918
6.pt,
I hereby certi f y that the above
a true a n
L
.
,1/
oz,
, 1/ 2 oz ,
nvent ory of ArdentSpiri ts is
accurate s tatement of all receipts, disburs eme1 t s
a n d quanity of Ardent Spirits on hand at the above men ioned d ates,
tat e of Virgi nia ,
County <£' Rovkingham ,
- to-Wit :
S: ubscri b ed and Sworn to before me , In t he County of Rockingham
this
M [cm ssmn txp1re
is requ,red Upon
c- 1,!
"fber 18th, 192f
�.l.
--
,-
,
�Iaveatory of Araent Spirits
Moathl:y
Repert
Bria~ewater Va, Nov, 1st
1918
To tke Clerk of the Circuit Court of Roskiagham co,
The followiag is aa iaventory of Ar•ent Spirits of the
Beyaler Drug store as of the dates hereinafter eaumeratea
Al e ohol
0• hand. Oet , 1st 1918
26 Pt, 2 1/ 2 Oz.,
PUrchaseli d.uri:ag Oe t 1918
4 7/8
To tal
Used. Duriag Oet
.ualance
01
han
1918
1-.0V
1s t 1918
Gal,
65 Pt ,
2 1/2
19 Pt
3
45 l t,
hereby certify t hat the above I ave•tor :y
a
oz ,
oz,
15 1/2
or
c- z,
Ard.eat Spirits
a••
is
true
accurate statement of all receipts ,Disbursemeats
ana quanity of Araent Spirits on ha~d at the above meationea
aates
STATE OF VIRGINIA
COUNTY OF ROCKINGHAM: to wit:
Subseri bed. a1ul. slforn to before me, i• the County of Roekingham
thts
3rll Day
or
Dec, 1918
fi
,
--~~---- -- ---~~
_
L -"---Z?'----?7
��I•ve•tor J or Ar•ent Spirit s
MoJatkly Report
Bridgew ate r
Va, Dee /2/1918
To the Clerk of the Cieeui t Court of Rooki•~h am Co,
The followin g is an iDveBto ry of Ar4ent Spiri t s or the
Beyaler Drug Store as or the Dates herei•a fter e»WJlera tea
Aleohol
45 Pt ,
0• han~ Nov , 1 st 1918
15 1/2 Dz,
Purohase d During Nov, None
45 Pt,
Total
16 Pt,
Use4 aurin~ Nov, 1918
Balanee o• hand Dec, 1st 1918
29 Pt,
15.1/2 Oz,
14 1/2
1
oz,
Oz,
I hereby eertify that the above i•ventor y of Araent Spirits
is a true aaa accurate stateme nt of all reeeipts aisburse me•ts
and quanity of Artle nt Spirits on hand at the above me».tione cl
ti.ates,
STATE OF VIRGINIA
COUNTY OF ROCKINGHAM : -to wi t-:
Subsori bei a•d sworn to before me, i• the County of Rockingham
this 3 ed. d.ay efJ Deo, 1918
-~ ~ : : ; r ? - ~
~ .7-a_:::~----c7,::: =er~ -7~_
�.-
--------- ---~ --
�Iave•to ry of Ardent Spirit s
-&~&&&& - --- ------ ------ Monthl y Report
Bridge water Va, , _ /1/19
Te the Clerk of the Circui t Court of the county of Rockin~ ham
The follow i•g is an invento ry of Ardent Spirits of Beyale rs
Dru Store as of the dates herein after enumer ated,
One hand
Aleoho l
Dec, 1st, 1918
Purcha sed Vuring Dec, 1918
Total
used during Bee, 1918
Balanc e on hand Dec 3tst
OR ha•d
Jan, 1 St 1919
Purcha se« During Jan, 1919
Total
Usea durimg
29 pts
NOile
29 Pts
1oz
19 Pt s
4 .. l/2 Oz
--------~-~~l---- ~~-!l~9 Pt,
12 1/2oz
39 Pt,
48 Pt,
Jan, 1919
Balanc e on hand
Fea, 1st 1919
1 oz,
10 Pt,
38 Pt,
12 1/2
oz
10 1~ Oz
2
oz,
I hereby certify thet the above invento ry of Ardent Spirits is
a true and accura te statem ent of all receip ts, aisburs eme•ts and
quanity of Araent Spirit s on hand at the above mentoi ned Dates
STATE OF VIRGI N I A . ~
COUNTY OF ~~-ns aiim~ ~- to-wit
Subscr ibed and sworn to before me, in the County of Rocking ham
this 4th, Day, of Feb, 1919
By ,8~ --- -------------------
��INVENTORY OF ARDENT SPIRI TS
MONTHLY REPORT
-&&!&&~- -----
Bridge water Va, March lst/191 9
To the Clerk oftbe Circui t Court of the County of Rockin gham
The follow ing is an Invento ry or Ardent Spirit s Of
Beydle rs Dru~ Store as of the Dates Herein arter enume rated
Alcoho l
38 Pts
On hand Reb,ls t 1919
Purcha sed Feb, No•e
Total
9
Used During Feb, 1911
Balanc e on hand Mar, 1st, 1919
2
Oz,
38 Pts
2 Oz,
12 Pts
21/2 Oz,
25 Pts
151/2 Oz,
-------------------------invent
--------~--~----~Spirit
-----~
I heheby
certify
that------the above
ory
of Ardent
s is a treeand accura te sta teme•t of all receip t s disburs ments
and quanity of Ardent:#- Spirit s on hand at the above mentio ned
dates,
Store
STATE OF VIRGINIA.
COU 'TY OF ROCKINGHA. -to-wi t
Sibscr ibed and sworn to before me in the County of Rocking ham
~th , Day or March 1919
---
By
��I•ventory Of Ardent Spirits
XO the Clerk Of the Circuit court of Rockingham Co,
the following is an Inventory of Ardent Spiri tc· of Beydle r s DrQg Store
a s of the dates her e inafter enumerated,
....
Alcohol
0• hand March 1st 1919
25
Purchased
March
Noje
Total
March
Used during
1910
191V
March
Bala•ce <' n hand
Pt,
2!">
1919
1 5 1/2 Oz
Pt,
15 1/2 Oz,
6Pt
March 1919
5
19Pt,
oz,
10 1/2 Oz,
I here•y certify that the a•ove i•ventory of Ardent Spirits is a
true a»d accurate statement of all receipts d is•ursements and quani ty
ofArdent Spirits on hand at the a•ove mentioned dates,
.
--~~
-.J-~~ -~
STATE OF VIRGINIA .
COUNTY OF
- t o-wit :
OCKI GH
Su•s ri • d and sworli. to •efore me, j_n t he Count
this 5th,day of Apr, l f 19
/.i •
--
By,
........ __
of Rockin ham
--==---~~ ----- ---
_d~&. .~~-Q{,_--~-{Z :~
~
/
"~-,
192.
1
I~ r y_
��1aveJ1tory Of Ardent Spirits ..,
-------~-------------Monthly - Report
••
V
Arpil -Report
---------------
To the Clerk of the .Circuit Court Of RockiBgham Co,
The followiag is an Inventory of Ardent Spirits of Beydlers Dru~ Sture
as fo the dates hereinafter enumerated,
· •··
Alcohaol
~
On hand Apr, 1st 1919
Purchased
Total
19 pt,
Apr, 1919
io 1/2,
None
Apr, 1919 -
19 Pt,
. Used during Apr, 1919 .
5 Pt,
Balance on hand Apr 1919
13Pt,
10 1/29z
14 tj'l#=fz,
12 1/2
oz,
I hereay certify that the aaove inventory of Ardent Spirits is
a true and accurate
statement of all Receipts Disaursement s and
quanity od Ar4ent Spirits
OD
hand at the aaove meationed dates
--/.l=y~~~--t1::~-~.£ii..
STATE OF VIRGINIA.
· COUNTY OF ROCKINGHAM Ne to-wit:
Suascriaed and swora to aefore me ,in the County of Roekin~ham
this 5th, Day 10 Apr, 1919,
By
d£-.?. :1c..~ -~~-0: '~
By lf- e l~\l•s c' vi~~fnia , no ta~
,i:; JE(sUl ·ec upm, th's ::.ea.I.
�~
///)
/
,._
Date Sold
Folio
ROANOKE DRUG CO., Inc.
WHOLESALE DRUGGIST
/
ROANOKE, VA.
Ter ms
No. _ _ __ _
Sold·to _ _ _ _ _ _ _ _ _ _ _ _ __ _ __ _ __
F illed b y
P. O. _ _ __ _ _ _ _ __
,-'> /I --Chccked, ey
D ate Billed
Salesman _ _ __ _ _ _ __ _ __
Gl.L Depot _ _
State _ _ __ __ _ __
Ledger
___________ _ State
'
· ,.. - - - ---~-·-Remarks _ _ _ __ ________________ __ _
II1 Shi p".i QUA-N
,_ llTY
Cheelt-
.• ,
,,..
- .. ,
I~-"''- : ---'.
.
ARTICLE.S
--
r-
- -- -- ------- -- - --- -· -
-
- i:" -: :·>-~
=:
-
1
.- - I
SALESMEN MUST NOT USE
THESE COLUMNS
Price
-
-
•
--
l___ -
J
I
--=-=-. - - -
-----------------1~~,
:
'
__
;
___
;
1
- - - - -- - - - - --1- -,1- - 1
ll- - -,- 1 1 -
____ ,___ ,, __
I
I
- - -- - - -- -- -- - - - - -- - -- - - - - - -
1-- 1 -- - - - 1
1- - --ll - - - -l --1 1-- - -1 - -11-.
1=~~11 - - - -1-·--11~~ - 1 - -11- -
- - -- - - - -- -- - -- - - - -- -- - - - - - - - - - -- - - 1 -- - - 11
I
I
11 - - - --1
11- -
- - -11-. - I
I
I
- - - - - - ---l-- -- - -- - - - -- -- - - - - - - -- - -- - - - - - -- -
l-
-1- -
II
1- - --11
I
= - 1= =1==
I
II•
·-:1=-11- - - - 1---11- -
- - - 1 -- - - -- - -- -- -- - - - - - -- - - - - - -- - l- - --ll --- - - l
1 - -- - -1
II
11-- - - 1 - - 1 1 - -
1
1- - --1 1-- - -- 1--
= = = = ==
= = = = = = = = = = = ==
=
Amount Forwarded,
MFC Bv AME RICAt,.i ~ALES BOOK CO .. LlO .. ELM ' RA. N Y
= ===I
11
l- -11--
l= ll= = = -1-
-,,-
�BEYDLER' S DRUG S'l'ORE
B. H .
BEYDLEH,
PROPRLE'.l'Oll.
HHJDHFIWATJ<JR. VIROTNIA
JULY 1 st 1919
To the Clerk of the Circui Court Of Ro c k n ~ham County Vir
a i nventory of Ardent Sp r·t of
The followi ~ i
Beydl er ' s Dru
<
of
store
Br~dgewa er V
hereinaft er enumera ed.
date
6 P nts 3 1/2 Ouace s
On hand J une 1 st 1919
Balance o
J
hand
Noae
June
Purchased durin
Used durin
n a
7
e
J ul
1st 1919
Pint s 7 1/2
38 Pin t s 12
tt
It
I hereby certif that t he above inventory o~ Ardent Spirits is a
s a tement of all receipts disburseme t and
u e and accura
quantity of Ard en
Spi it s on hand at
he a bove men
on d
te.
Be dlers Drug Store
Per _.,__....,
Subscribed and sworn to be~ore
:My commission expires Nov. 12,1919.
'
��BF.YDLER' S DRUG S'.l'ORE
B . H. BEYDLER,
PK O PRI E".l'O U ,
RRJDGEWATRR, VJR GTNTA.
s
A G
e C
To
r
of t1e C re·
o low n~ is
h
ore
e
B
C
re t
nvento
qn
Ounc es
b
ue and
u
t
C
1t -
s
"
"
s
l
0
s
ven
b ove
y th
e
of Arden
cc
If
5
1
Au us
ts · o
pi
O'ewat r Va.
B
st '
On h a
9
tg
B
Pe
a
of Ar
re c
a
rs D
s, i
h
!!
s
0
0
e
w-.-Y~ '
s
:i.
u se e ts a
n
men
s
s
es
��BEYDLER'S DRUG STORE
B. H . BEYDLER,
PROPRI ETOR ,
BRIDG F.WATF.R, Yrn61NIA.
TO lill C
K OF THE CIRC T cou
i s an n e 0
The :fo l
i
s o:f the d
enum ra e d •
naf t
he
On h a
e
Furch
Used
1 t
U'
....,
n
us
p
3
c rti r .
ri t
ts
Oun
o
V •
B y
ore
e
•
None
"
a ce r a e s a em n
A en
,
,
u~u
On hand Sep .mb r
I he e
'1
s or
"
0 Pin
s
ha
h
i
V
ntor. of A dent ·
or a I re c
,
hand a t t he
bo e me
y
r s Trul
B
ler ' '
e
d i s burseme
d d
u
s a
i
•
and
or
��.
BEYDL E R'S DRUG STORE
B . H . BEYDLE.R,
PRO PRntTOB ,
RRIDGEWA.TER. VLRGINIA
TO I
l
C ERK OF THE CIRC
i ve
The f oll o, n u i s a
Br idu wa er V • a s
ALC H
C HO
I h
n
:f
eb
CO T OF
of Ard
CO V
of Bev 1
s D
Store
s he r 1
da
0 ·P
1 Qb ' 9
EP E~1B i
ED L S 1 P TE.1\IBE NONE
ON 1-1
CH
ff
ff
ALCO HOL U ED
&I.COHO
or
or
N H N
C OBE
1
3
'1
oz.
ff
6
ff
10"
that t he ab ov e l Bven oryof Arden s r
dis b r eme s a
re c
of a l
~~me~
0
da s .
b e a b ov
r t on had a
cer i f
e s
sis a
qua n
u
Your s T ul y
B y
P r _ _...,..~ - ~~= ~ i~
State of Virgini&•
.
Cunnty of Rockingham to-wit:Subscr ibe d and sworn to be fore me, in the c ounty and State
aforesa id this the 13th day of October 1919, by B. H. · ~eydler,
-n . \v J
-vv--'.l-v . ' ~ - '~' l
? do t ti..... -=-.. , . ~
~ ~~ ~ ~
. : ..
�'-
I
�f)
:. !BER
1 t
9
BEY DLE R' S DRU G STO RE
0
B . H . BEYD LER,
PR O PRfE'.r O n ,
RRJ_DGR WA TER. VIRCl 11'.Tf. A
'f-; ...
'T'l}
ERK
n
On h
Pu c h
~
I
H:.~ C
is
0
0
l'l
1 T"T' •
V
n
•
n e or of r d n
p
s Of B vdl r s Dru
e Va . s or he d e s
f er enume ra
•
Oc to r 1st. ,
p nt s 10 0 ce
d dur in.e: 0 t obe r one
se
ft
Bal a ce on
II
and
r bv cer
0
fy th
a d ac e r t e s a eme
Ar den
IT COUll
STJ
s
on h
Pin t s
m
e
1
•
ove
or al
B
es
p
e
d at
On
0
Sp r
a a
s bur
St
D
Pe r ~
n i
0
e
/~
~
~ ~
s
bov e men io ed da e
dl e
~~
of Ar
0
r ce ·
h
Sto
'°" ''\
~ ___ ,_
e -~ ~
~
""'
~~ ~
or
�•
�, BEYDLER' S DRUG S'rORE
B . H. BEYDLEH, PROPRili:'J.·on,
HRIDOF.WATR R. V:LRGTNTA
TO THE CL
K 0
THE C 1 C T C0U
an in en orv o
"'he 0 owin~
Bri ~ewat
Va ,
On h nd
Pre
OV
mber 1st
ur.
se
-,
t
nts
9
•
, ROC K NGHl\'f CO V •
r en Sr,i
the dates hereina t r
s 0
s
ts
e
0
e
S
ft
UP"
Store
nnmera e •
~
em
0
fl~
e
Or
durina;
De cembPr
an
herP
nd
0
ovem er
V
ertt
unccs
s
1
~t
c rate s
relent
II
e
eme
ot'
pirits
a
l
t
o
e11
ec ip s,
e
a
r ent
V 0
ll
s
r
n s an
e mentioned
at
c;
C:
uan
l"'Ue
t
•
Yours Trn v
rs n
ev
gs ore
Pe
,,e;/,G7-<-
'1-
Jr~ ~
-ti~
f-o
.:!:- ~
7-
/
,,
~ 7--- Ccrr-G.£0
~~
f l ( } ~ /'f t'7
~,:L
~ :z:; ~ ;"
~ ~
7
lf'.11.A., . <i?,/, <~ ~
~ ~...i:r~~ol ~~~
My Commission Expires SPptember 18th, 1921
~
��BEYDLER'S DRUG S'-1'0RF.
13. H. BEYDLER. PnOPltlETOn,
J
RRIDGF.WATER. VIRGI1'TIA
·uARY
TO TIIE CLERK OF TUE CI UJT COU T HOCKI 1 G1I M CO VA.
Th f o ov g s an I n v en ory o
rden
pir· s of, Beyd er
Br ge ter V . as oft e d · es ere n fer enume~ ed*
0
nd l)e cemb r ls
Purchased i
fl
Us ed dur ng
ti
Jal nee on han
r e
, ..., P · ntc;
Dr u
Stor
Ounces,
"
l
Ja
1') 0
ha
th
abo v
u ate s a e me
0
cert f
Sp
. 20.
one
1
I herb
and a
1
' 9
s
son
and
ff
P nt
I n e to
a I re ei
the a bo
Ve
Oun c e s .
V
of
r en
s ,d s u se ens
men ione
C
teso
Tru y Your
e d e s Dr g Store
Pe
~~
s ir
n
s
'l U n
s
r
f
��BRY DLE R'S DRU G S'-1'0R lD
B. H. UEYDL ER,
PnO PRTETOn .
HRIDf iE,VA TER. VIRGI NIA
Y
st
o.
TO 'l'Hll CLERK OF THE CIRCUIT COURT, ROC KI GII M CO
VA•
The fo l mv
an I nven t or
of Arde n Sptr ·
of Beyd ers Drug S or
r ic g wa er Va , as of d t e he r e naft r enum erate
•
On Ha d J an 1 r . st ' 20
p s f\ oz
Purc ha sed ti NC' n ~
~
sed c uri
a
I
C
rr
,-.
on
J anua
a
(
V
II
Fe ru ar
.
FEBRUfi
'
II
~
s
3, Pts
oz.
rev ce
t e abov e Inve n or of Ar dent s "rjts
a
and ccur ate s a t men of a 1 r ece · s , i~ ur sem
sand u an i
rden Spir " s on hand a
e abov me n onecl date s .
Your s Tr ul
ne
er
Dru~ s ore
rue
of
�l\f'
1 \
e lerk; s (itt;,,0
oc \n _h m County, a,
M R 6 ~ 1920
�BEYDLER'S DRUG S'l'ORl~
B. R. BEYDLER,
PnoPRLll:'l.'On,
. Iarc
BRIDGE"\VATER. VIRGINIA
THF. CLERK O
The fol o
n~
THE CIRCT TT COIi T OF RO K
s
Br de at r Va , a
On Hand
n
nven orv of
of da e
Februar
den
nH . 1
S~irit
1
o•
0
of,Deyd es Dru~ Sore
herei af er enumerated .
First, 1920, 3 ~ P in
6 Ounces
Purchased durin~ Feb ' v, one
Used durin. Fe b ' y
11
Balance on hand .Marc
hereb
cert "fy
ha
i
s
1 s t,
4 0 nces
2
Pint
O nee~.
he above i aven ory of
rdent
irits
and accurate s atement of a ll r e ceipts , dis u r semP.nts and quant t
rdent Sp rits on hand a
t he a b o e me n t oned
Yours Tr u y
nevdl ers Drugs ore
Per
ates .
ru
of
�Fifed In the ii , 1c
-00 fn ham C 1111
qrn
,.
"" · 6~ l'tl~D, ·
1.,lork
�BF.YDL ER'S DRUG S'l'ORE
B. H. BEYDLER,
PnOPRlE'.rOR,
RRmfi.F.W ATFJR. VTRGTNTA
AP IL
o the Clerk of the Cir cui t Court of the County ,
1st 1920 .
The follow ing is an invento ry of Ardent Spirits of Beydle rs Drug S tore
as of t he dates hereina fter enumer ated .
On hand
{arch 1s t 1920
urchase d
one
sed during larch
Ba lance on hand
22 Pints , 2oz .
9 Pints 6oz .
April 1st
12 Pint s 12oz .
I hereby c ertify that the above invento ry of Ar dent Spirits is a true
a nd ac c urat e statem ent of all receip ts , disburs eme nts and quanti ty
of
rdent Spirits on hand at the abo .e mentio ned dates .
ery TrJlly
ours
Beydl ers Drug S tore
Per
--~ -
��BEYDLER'S DRUG STORE
L
B . H . BEYDLER,
PR O PRac'.l'Ou.
TO
HE CLEl K OF THE C RCU T CO
Te f o Jowin
On
and
st
pri
es
Ma
of
ere · n f e
enumc
rug
e •
Oz
ra
r en
19
st,
o Pi ve1t rv of
e
a
'l rnnti
•
fl
Be an eon han
and ac
7
ft
ft
sed
O
s of Beyd ers
~?0 1 12 Pints
ur ng
Purchase
r
rden
he d,
a , as o
ore, Bridge a e
,OCKI GH l\I
T,
s an inventory of
st ' O
':I.[
BRIDGF,WATER. VIRCHNIA
statemen
o
Sn~
son
our~
Be
all
ece n+s,
re
and at t e a ove men io
ru
tor
e· ~ ~
~--~; - , ~
,s
S
s urserien s
ru
ers
Tl r
e
ateso
��BEYDLER' S DRUG S'L'ORE
B. H . BEYDLER,
PR O PRTETOU ,
. une
BRIDGEWA TER. VIRGINIA
· s an · n entory o
o
he f o
or ,as of
On
se
on
of rrl n
GII
CO
7
•
Bevd ere;
PrPnt S, " rits o
r
~
s
ll
erate
nts
9 0
1rn
nts,
9
anc,
..,. ...
rp
C
, OC I
o
on
ur np: 1 av
Ila ance
erP n f ter e
st
Pd
ur h
• nc
a~ e9
MV
ad
0
T
C
TO T~ CLFqK O TH~ C
c;t, '
T'
l
t
nt
t e a
emc t nf
s i r ts on
9~0, ~q p
st
e
oz
?
n
V
l')
-~---~- ---
s
t
(lf'"''
ts,dic:
oz.
t
of
r
('
nr•C'l"lP
1-
s
ts an<
'1.tes.
o tn
i
e
�\\ ,;~\<.\ngr,arn Qount 1, \Ja,
, ,· ·
j li '.
·~ ,r ,... n
~:J J
- { :
__________Clerk
4\
�BEYDL ER' S DRUG STORE
B. H . BEYDLER,
"PROP'IUETOH ,
J
:RR1-DGFJV vA'l'RR. VIRGINIA
counT,
TO CLERK OF Tt1E CIRCUIT
Th
fo
s
e, B
0
0
"
en or
a
t
Us d d
C
d r
C:
n
HOCKI GHAM co, VA.
of Ar en
JU
Pi
•
s
q
te
s
,o f Be
s Dru
Oz
eo
e
Ju
ha d J u
0
,
s
ti
I h reby cert f
t
o.
t
Va
d ewa e
On fa
Pr h a
1
ra e
C
A
of Ad
e
n
0
r
n h nd
oure
Pe
e ce
ts, is
e a
ve men
s
e e
on
a
d ·d
e
��BRYD LER' S DRUG S T ORE
B. H . BEYDLER ,
PR 0 1•R11t'.l'0 1t ,
Augus t 1st 20.
TO THE CLERK OF THE CIRCUIT COURT ROCKINGHAM CO VA.
HRlDHF. WATER . VIRGIN IA
The follow ing is an iaTen tory or Arden t Spiri ts or Beydl ers Drug
Store, Bridg ewate r Va.
On hand July tat •20,
18 Pints 6 Oz
PUrch ased during July
39
"
9
•
2 •
Aug 1st 48
•
"
Used during
On hand
•
I hereby certif y that the above inTen tory
or
Arden t Spiri ts ia a
true and accur ate statem ent or all recei pts, disbur semen ts and
quant ity or Arde• t Spiri ts on halld at the abeTe mentio aed dates .
Yours ,
BeycU ers Drug Store
~his da y b . H. Beydle r per__,._,ug......-ac appea
a nd made a ff idavit that
the fore going statem ent is
ue and a ccurat e .
~iven under my hand this 5th day of Augus t, 1920 .
flW J~
�j
�BF:YDLER'S DRUG S 'l'ORE
B . ~• BEYDLE H , PRo-rnn..-...i·on.
HRIDHFTWATER. VIRGINIA
9/1/20.
TO THE CLERK OF THE CIRCUIT COURT OF ROCKINGHAM CO.
The tollowinc is an inTentory or Ardent Spirits ol Beydlers Drue
Store,Brid1ew ater Va.
On hand
Aupst 1st 1920
-4:8
Pints 2 Oz
Pur•based durinc Aupst None
Used durinc August
28
"
Balan•e on hand September 1st 20 Pints 2
oz.
I hereby certify that the aboTe inTentory of Ardent Spirits is a
tru and an aeeurate statement of all receipts,disb ursements and
quantity of Ardent Spirits on hand at the aboTe mentiened dates.
Yours.
�fi\ed in the Clerk' s Offi · P.
Rockingham County, \: a,
0C1 5- 1920
..,...,.,,,.......
=--,,,=- - ---C\er
�Bl~YDLER•s
'
DRUG STORE
B. H. BEYDLER,
PltO PRUCT O n ,
Octokr 1st
RRIDGF.WATER. VTRGlNTA
•2e.
TO Tlffi CLERK OF THE CIRCUIT COURT ROCKINGHAM CO VA.
or
Tbe following is an inTentory of Ardent Spirits
Beydlcrs Drug
store Bri4gewater Va.
On
hand Septem•er 1st
Purchased
1
20.
20 Pints 2 Oz
None
Used durin, Sept'
Balance on hand Oct 1st
7
"
12 "
12
"
6 "
I hereby certify that the aaoTe inTentory of Ardwnt Spirits is a
true and accurate statement of all receipts,dis- ursements and
quantityof Ardent Spirits on hand at the aboTe mentioned dates.
Yours
Beydlers Dru~ store
,.,
Per@rt~
4 -&x_ 1-1r~ ~ , ~~ 7- a~~, ~ ;' :2';-,if'~
~ ~
~ ~ ~ ~
~
.-
~71-
(}a::_' t'<J,2_o
-Ir/#'-~ / ~ c1'~
,i~\1.: •
~
~
,_;
' 132,,
�Filed i the C rk' n , r,e
Rockingham Cour ty, V· ,
OCT v 1 20
c:=-~==---- -Clerk
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Liquor Inventory
Description
An account of the resource
Series III of the Prohibition Records collection consists of records documenting the inventory, sale, and transport of alcohol for medicinal purposes in Rockingham County. This series contains printed inventory records of the alcohol on hand of licensed commercial businesses during prohibition. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Identifier
An unambiguous reference to the resource within a given context
Pro003
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/6">Prohibition Records: Affidavits for Ardent Spirits</a><br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Liquor Inventory of Businesses: 1
Description
An account of the resource
(A-B) Printed and signed letters by a notary public reporting the on hand stock of alcohol of licensed commerical businesses.
Subject
The topic of the resource
liquor
inventory
commercial
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-014
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
-
https://omeka.lib.jmu.edu/erp/files/original/352cf1c41bec79bedc16eb2d69e29eab.pdf
e631bfc0e6fc5afd9e52614c3ecef357
PDF Text
Text
Ib. rr ieonburg . Va •
,!ch., ith. 19~ 4 •
To t· e Clerk of the Ci rcuit Court of Rocking
1am.
Glo . Va ;
The fold.owing is a n Inventory of' tho Ce ntrttl Drug Co of Harrisonb urg . Inc .
On hand ~eb l st .19G4 e
Purc!la.oe
durin
Feb ., 19~ -1 .
Total .
..,.
__________
5 Gal .___ _
5 Ga l .
Used during Feb o1924.
O
i one .
he.11d !arch. ls t . 19 24 .
i Ga l . , Pt .,, oz .
-------- ----- --------j
Gal . 5 Pt . 14 oz .
I hereb:{ certify tl:!E'.t the above is a t rue and accurate statement o'f a i
Alcohol rece i ved ;dispur::;e d and on hand on the above date .
Central Dr~
Co of Harr isonburg . Inc.
Harrioonb u rg . Ya .
1igr.
ubscribed to and
'orn to be:'or o we this 8th day of larch . 1924.
~ J[) (/J ~ 71,,/4 f1JL
��:e.rriso burg. Va .
ri . l0tl . 1924.
To The 6 erk of the Circuit Court o f
o c i ngham Oo . Vu ;
following is a n Inventory of the Central Drug Co of Harrisc nburg, H n o.
n hand i!s.rc!l . lat . 924 .
Pu.rchasoa duri..,g LIB.rch .
Total.
I
ereb
t.
14 oz .
Jrone ,.
------------------ -3 Ga l. 5
Used d ri.."1g J.rarch . 192 4 .
On 1.t.an dt April .lstl'J24.
3 Ga l., 5
t. 1 oz ,
'/ Pt .
4 6z.
----------------------~
Ga l.. 6 Pt. 1D oz .
certify that t le above i s a truo and accurate statement of
a ll Aloo,ol r ace i ved, dispursed and on hand on tle above Qate .
Cent r a l.
rug Co . of Harris onbu r g . Inc .
Harrisonburg . Va •
Pe1· . ~ ) '
~~
;1gr o
Subsc r ibed to
d sworn to before me thin 12th day of Ap ri l. 1924 .
�_____ 4
_
___
.
_
---------~--- ---------
�CENTRAL DRU G COMPANY, INC.
PRESCRIPTION DRUGG ISTS
Patent &edicines, Toilet <:!Articles, Candy, Cigars and Sodas
HARRISO NBURG, VIRGINI A I
.. lQ
UP-;e4f'c.h . 1924 e
C')ol l o•.1i n~ .• .J nn
, 1. 1 .
0
•
: 10 1.0 .
------- -------------G Gal . 1
Usoc tlu:ri
~r: , u l _r •
rt..
1
oz ;.
l 'ul. 1 t . 13 oz •
.. __,.. - --------------·-
....,
o1
ha. 1 J\-:;i . 1.., t . 102-:.: .
ove da·c. •
ci· .
~-~~~
1-:r .
31.l.bwcribod to
• c~<) ro · G th i.., 9 ·'·h d Y • ~
fi.. l!~ • • 10~:>h
kJ ~~ 110/fllvlf f f , ~
y Commi ,on E.xp n: · ·
,
•~~;
! !
��Har riso nbu rg. Va .
J uly . 11th . 192 4.
of Rock ingh am co . Va.
To the Cle rk of t he Cir cui t Cou rt
oho l o f the
The foll cmi ng is an Inve ntor y of Alc
•
Cen tral Dru g Co of Har riso nbu rg . I nc
5 Pts . 13 ozs .
On Hand Jun e . lst . 192 4.
5
Pirc ha.s ed dur ing Jun e .
Gal .
- ---------------
5 Gal . 5 Pt . 13 oz .
Use d dur ing
4 Pt.
Jun e·.
2 oz .
--------------------
On band July . lstl 924 .
5 Gal . 1 ~t . ll oz .
a. true a nd
I here by cer tify t hA.t the abov e is
rece ived ;
accu r ate stat eme nt o f all Ail,oohol
r.
disp urse d and on hand on the above date
.
Cen tral Dru g Co of Har riso nbu rg Inc
Har riso nbu rg . Va .
Per .
g r'o
me this 11th day
subs crib ed. to and swo rn to befo re
of July .192-1.
J (.
Ill - •~ 111,, ~ I
,kA_I!).~
I.. :JUi. A~ 1\
7'/0 la/lA(
~~
�.
'
riled in he Cle k's 'hie
Rockingha , ounty, Va,
.J JL\l \9?-1
_____ ___Clerk
�Ha rris onb urg .Va .
Jun e.J Jtth .19 24
To the Ole rk of the Ci rcu it
Co urt of Bac kin gm m Vo .la
The fol low inC is an Inv
1
ent o';j
0e htr al Dru g Co
of &r ris on bu rg. Ino .
J¥ ~
On ban d Ma y.l at.1 924 . l Ga
l. 5 Pt. 3 oz.
Pur cha sed dur ing Ma y.
No ne.
------e.i---...--l Ga l. 5
Pt. 3 oz.
Use d dur ing
Ma y.
7 Pt.
6 oz.
---------------~--5 Pt.
13 oz.
I her eby cer tif y tha t the abo
vei s ·a tru e and
acc ura te sta tem ent of all Alc
oho l rec eiv ed;
dio pur sed and on han d on the
abo ve da te.
Ce ntr al Dru g Co Of Far ris onb
urg Ino
Ha rris onb urg .Va .
Pe r
~ -, ~::,i,,...,.....,....,_.._..
Mg r.
Sub scr ibe d to and swo m to
bef ore me thi s 13t h day of
Jun e.1 924 .
I.a IJ--lg)~ 'll~--,/4-~- -:- -1
Aled tn
i Cummiaaion fxpirt1a 01:t. ~th. 192
Clerk's Orne•
..~• r« ha m Coo.11tyt -·'4a,
1
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IIN 13 \~? I
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�Flied. In the Clerk's t )rt'ice,
Rockingham County, Va,
11\Y lU 19?J
-----::---Clerk
�CENTRAL DRU G COMPANY, INC.
PRESCRIPTION DRUG GISTS
Patent 8'.1edicines, Toilet cArticles, Candy, Cigars and Sodas
HARRIS ONBUR G, VIRGIN IA
'lb t
Clork
or
t' c Ci rc
Tl , f ollo Ji
of ! rri~onbur
,,ept • 4th, 1V2 .i: •
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o :f Al c oho l o ~ t he Contr nl Dr ug Co .
-t.01~
Inc .
On b nC A e• ln
1921 .
re~ Jed du r in~ Au
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ono
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oment
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.y Con mi ion
Flied In the Clerk's Um,-~
Rock-mgtum, County, Va,
,rp 3- 19'M
_ ___ ___Clerk
�1
�CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGIS TS
Patent t.Medicines, Toilet eArticles, Candy, Cigars and Sodas
0 o t i 9.h . 192 -= •
HARRISONB URG, VIRGINIA
of
7 P t:..: . :,.4 oz •
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e Clerk' 0"•
ockingham
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unty, Va.
CT .., 6 1924
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��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent 8'.,1edicines, Toilet cArticles, Candy, Cigars and Sodas
'lov e 0t.11 el 92 .: e
HARRISONBURG, VIRGINIA
On · o xl Oc • s • 92
4 n11 .
..: e
6 Ft .
2 oz .
-------------------2 oz .
t'I
; .JO
('
"l
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G
t.
3 Pt .
d u i !l:_; Oct . 192 .
11 oz .
-----------------------ov .
0:
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t
10
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t 01· . _
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~ ry
...__\ _~ -----------------------
Filed in the Clerk's Office
Roc kingham County, Va,
NO\/ 10 1924
............. -................................... . .
c-l erk
�---------- - - ---------
----------------------
�J
CENTRAL DRUG COMPA NY, INC.
PRESCRIPT ION DRUGGIST S
Patent 8'.1edicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBUR G, VIRGINIA
To th
Dec . lOth.1924.
lerk of the Oircuit Cour t of Rockingham Co . 7e.. •
The followinf is an Inventory of Alcohol of the
antral Drue Oo of
Harri onburg oino .
On ban
Nov . lst ol924 e
Purcha.aed during Nov .
4 Ga.lo
-
2 Pt.
7
None o
---
-
4 Gal o 2 Ft.
Used during Nov. J924 o
OZ o
7
l Galo
..--------·-
~
3 Ge.lo 2 pt.
OZ o
.............--.
7 oz .
hereby certify t hat the above i a a true and a ccurate ste.tement
of all Alcohol r ec i ved. tlispursed and or hand o n the abovo date o
Central Drug Co Bgf
Ha.rrisonbur g . :no .
Ha rr isonburg . Va .
ubscribed to and swo1·n to befor
m e this 10th day of Dec . 192 4 0
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�CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent tMedicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBURG, VIRGINIA
J o.:1. 1,~·::.J-.1925 .
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1 omni i n Ex ires July 251 1928
��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGIST S
'Patent 8'vfedicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBUR G, VIRGINIA
, lee l o l o;: t
o
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~ile~ '.n
•·
t~~ Clerk\ Olfb.
IFC,Q
.......__
County, va.
1(1 /92ff
...;. 1
O~
o
/ ~~
My Commission Ex ires July 25, 1928
1~
��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent ::.Medicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBURG, VIRGINIA
. C
,.
., r
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r·
e J..,.; t:.i V e
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, ~.10
to '. id u-;ro ·•
f"oo \n the Cler~'s Office:
Rockingham doti'flty, Va,,
.
• • .)Oi,921
u:
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o ,"
��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGG ISTS
Patent t.Medicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISON BURG, VIRGINIA
_*o e,
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�CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
'Patent 8vfedicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBURG, VIRGINIA
'?1- f'ellMdng 1•
a 11
lnventery
ot Ala.hol et
th• Central ul"llg Ce •••
Barri .. nburg . Ina .
On Hand April . lat . 1926.
4 Gal .
Puroba••d during it ril .
Tl•n.e •
4 Gal.
~
U••4 during Apri l .192 5.
On llancl ...ay . i.t . 192 5.
=<"'-
1 Pt . 9 •• •
1 Pt .
Gal.
s
n.
2 0..1.
s
pt .
l
9
9
···•
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I hereby certify that th• a1-•• l a a true a nd accurate at.at•nt.
•• t all Al o.ehol rec.eive<t..di • ,ur ..d . and en hand8n
t ho abe,re
date.
Sunp:rlbed. t.. a nd _.Jl'u to bet •re •• tbia 12t . day •f -.y. 1926.
'
~ f l ~ / t Jf
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��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
!he t.ll tldmg l a an l ~ et lleelwl
•t t.he Oeatal
Drug 0. d
Bll.ffiM nb\lrg •J ne l
7 Gal. I pt.
1JP4 ~
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Oa hall4 Juu. J.at.J.9;2i•
;
f
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....
the· abfte i• • true ad aoOUNte ·~
,u.l ,&label N*Y4Ml.cllapurHd ~ ft 1-nd •• t.hl· abew 4a\ee
1-rrt•nburg.Va •
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��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent a.1edicines, Toilet cArticles, Candy, Cigars and Sodas
JlllJ'ellt.heJ.tlle
HARRISONBURG, VIRGINIA
u... •
. ~
..
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I Gal.
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•nthe•--- at..
ta.rn•al>urc •I••
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....
SabseribM ti. _ . ...ra t. bef'ere ae tbia llt.h .., d Jw,. 192&.
�),
•'
�CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent Medicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBURG, VIRGINIA
!he f •ll.-S.Jil la· aa l....t.iy
~
11.nhel • ~ the 0.-.l hue 0. d
HarriaeUIU'ft•l ...
i c.i. '
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��CENTRAL DR UG CO MP AN Y, INC .
PRE SCR IPTI ON DRU GGI STS
Patent /:Nfedicines, Toilet cArticles, Candy, Cigars and Sodas
HARR ISON BURG , VIRG INIA
s.,t.ellt.b .elll le
l i l ~ eI1u1 .
••1.
1 ft .
4 aikl.
I Pt:..
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��CENTRAL DRUG COMPANY,
INC.
PRESCRIPTION DRUGGISTS
Patent a.1edicines, Toilet cArticles, . Cand:y, Cigars and Sodas .,
HARRISONBURG, VIRGINIA
Pt .
u ·
II
. I
,
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al .
2 Pt..
l Gal .
t.
2
t..
i •• •
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U• • '- duria v ' opt.. 192 •
6
1 •• •
7
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��CENTRA L DRUG COMPAN Y, INC.
PRESCRIPT ION DRUGGIST S
Patent .5Wedicines, Toilet cArticles, Candy, Cigars and Sodas
HARRISONBUR G, VIRGINIA
Nov.lOth . 1926.
To the Cle rk of' the Ci rcuit Court of Rockingha m Co .Ve. ;
The follo,vi ng i s an Inventory of Alcohol of the Central Drug Co of
I:arr isonburg. Inc .
On Hand Oct . lst . 1925.
l Ga l .
Purchased during Oct .
5 Gal .
7 Pt .
5 oz .
----------~----~-----6 Gal .
Used during Oct.1921.
7 Pt .
5 oz .
6 Pt.
14 oz .
-------------------On hand \Jov . l st .1925 .
6 gal .
7 oz .
I hereby certify that the abovs is a trua and accura te statement
of a ll Alcohol received,di spurs ed
am
011
hand on the above date .
Central Drug Co of Harri sonburg .Inc .
Harrisonburg . Va .
Subscribed to wbd
fifed in the Gler:'-ocki nglla111 Ccu ,tv
NO l o m·s
-//:-; / / JJ
'-:...Cir
��CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent &edicines, Toilet cArticles, Candy, Cigars and Sodas
Dec . J.Oth . 1925 .
HARRISONBURG, VIRGINIA
of the Ci rcuit Court o
Rocki nebam Co . Va .
nV9nt ory of Alcohol of the
ent ral Drug Co of
l erk ~
To
Th
fo l lO\vi g i s a n
H rriao bur g . Inc .
On
and
ov . lst . 1925 .
P rchas d During fov .
7 oz .
6 Ga l .
!Jo
"
6 Gal o
Used du ing
ov . 19 25 .
o n Hand Dcc ol st . 1925 0
I h r b~ c
2 Ge.l.
3 Gal .
tify t ho.t t e a ove i r, a tru
Alcohol rec i v od, d i spursed and on hand on
7 oz .
1
t ~ 6 oz .
7Pt .
1 oz •
.... nd a ccurete sta t mn• nt of a ll
he abovo date .
Central Drug Co of Ha rr · sonburg . I no .
r r isonbu g . Ve. .
~ub cri bed to a nd swor n t o
�..
•
�CENTRAL DRUG COMPANY, INC.
PRESCRIPTION DRUGGISTS
Patent &edicines, Toilet cArticles, Candy, Cigars and Sodas
Jan . 1 t. . 1926 .
HARRISONBrJRG, VIRGINIA
T
t
CJ.,rk
f the
u •
f'o llo•r1in
.::-cuit Court of Rockine am Co .,, • ;
is an Invon o
olfr A co •o
t _rn Contre.J Drue; Co ~f
r · son u r ..., . nc .
I.
0.
TT
rt .
::..d Jecb t . 19'-5 •
urch.
J.J
"30
r i n~ Jcr .l 25 ~
- ed
I
or
of . l
y ce tL.
• 7 Pt .
u ring Dec . 192 . •
t
l !'.
1 oz •
t.
f>
le d J n . s t.126 .
1 oz •
one .
3 G
On
o
oz .
Ge. •
t t he a o o i
lco oJ r cui 'ed , dia uru
ru
07 a
anr1 - ~cu , te s t tel;\~n-
on t e
n . on ban
Ccntr 1 Drut: C
Or , -
o e de. te .
ri on ure; . In •
Iii. r ison 1urt; . a .
er .
?.; r
- u :JC ribe
to
d
wo n
o before , e t .ia
t
e.y o r jan . 1926 .
~c;T~ 10.P.
�•
�RETAIL STORES
PHILADELPHIA, PA .
CO-OPERATIVE DRUG COMPANY. INC.
ROANOKE. VA.
HAGERSTOWN, MD .
RETAIL STORES
HARRISONBUftC.. VA.
CHARLOTTESVILLE, VA .
LYNCHBURG , VA .
STAUNTON, VA ,
NORFOLK, VA .
PHILADELPHIA. PA .
F'REDERICK, MD.
OPERATORS OF CHAIN DRUG STORES
HARRISONBURG, VA.
LEXINGTON , KY .
Oct elste1920.
To the Clark of the 6irouit Court Of Rockingham o .va .
The follcming i s an inventory of
all aloohol
of the
o-Oparativa Drug Co I nc.
of the dates herein enumaratad o
On hand wept olst . 19260
Nono .
Purchased during Sept .
4 gal • 7 pts·.
4 Gal . V Pts .
Used during 3opt.
On band Oot . lst.1920 .
2
1. 2 l/2
2 G le 4 l /2
ts/
ts/
I hereby certify that the above inve tory of' Aleo ol is a true and accurate
statement of' all Alcohol reod ; dispursad and on band on the above • data'•
�•
,
in the Clerk'·s O.f~c,
------------F-i
Rockingham County,
0C.T 26 1920
_______Clerk
�RETAIL STORES
RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA . PA .
ROANOK E . VA.
HAGERSTOWN, MD.
STAUNTON, VA .
NORFOLK, VA .
PHILADELPHIA. PA.
HARRISONBURG. VA .
CHARLOTTESVILLE , VA .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG , VA .
HARRISONBURG.
Tc the
f"REDERICK , Mo.
LEXINGTON, KV .
lark 0£ the
Te follcwin
lrcui
is
n
Court of Roc·ingh
VA. !
nv
ct . lst . J92 •
rche:.sed during
cL .
2
.,
t.192 •
Co V •
ory o l cohol
as of the dates herein enumerated ;
1 nd
·-
.
O
erative
lo . • 1/ 2
rue;
o.Inc .
t ao
t s.
2 6 Gal ., 4.
?C 8al . 8 1/2 Pts .,
Used
Eal.en
I here
certif
statement of
uri ng Oct .
d !ov al t . J920
that the a
2 Gal . 4 1/ 2 P -cJ
26 Gal . 4. Pts .
ve inventory of
cool recei ed ; d spuroe
le ho l is a t u
on ha
and nccu:r t e
on t e a o~e
ate •
Co-Cper tive Drug Co Inc .
-r~
Earrisonburg .Va .
Subscri bed to
l'\l~ s,TOr .l
to before me this 1 st . de
of J v. 920 .
flied in the Clerk's nm
R k'
. r.e
oc Ingham County I
va,
·.' OV 1- 1920
- - - - - - -Cl •
��RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA, PA .
ROANOKE. VA .
HAGERSTOWN , MD .
CHARLOTTESVILLE, VA .
OPERATORS OF CHAIN DRUG STORES
Deo .
HARRISONBURG, VA.
To the
e • o'! the Circuit Court o
The
ollm in
of the
Rockingha m Oo.
STAUNTON, VA .
NORFOLK, VA.
HARR ISONBURG, VA .
FREDERICK , MD .
LEXINGTON , KY .
PHILADELPHIA, PA.
LYNCHBURG , VA .
RETAIL STORES
t . 192 •
a.
ic an · nventoxy of lcohol of tne Co-Operati e Dru0 Co I c .as
tes b.G e
enume
tod a
o • st . 19 O.
Pu •cbased dur
g
1
t:J .
26 Gal . 4
•one .
0v .
6 G 1
U odd rin Nov .
Bala.nee o 1
hereb
ct.ate
cert
and
ecll/l
3 Gal 13 Oz .
23
l s t . 1920 .
1 3 Pts., 13 o~.
s:I
tl t t.l e above i voi toxy of' Alcob. l
nt of all
lcohol reoe_ od ;
j,3 ~ u r sod ;and 011
h
Ha rr is onbur
u"!:> c
bed to a n
~~or
to
e~~re me this 1st .
r,;y C rnrni;sion bpircs June 18, 1924
a
a true a nd accurate
d on the above
.va.
es .
-~4-
of Dec . 920.
�Fi\ed \n the C\erk's Offlti'
Rockingham County, Va,
c.rc1- 1920
~---- ----C ,\erk ·
•
�RETAIL STORES
CO-(?PERATIVE DRUG COM P ANY. INC.
PHILADELPHIA, PA .
ROANOKE.
VA.
STAUNTON. VA .
NORFOLK, VA.
PHILADELPHIA, PA.
HAGERSTOWN , MD.
RETAIL STORES
HARRISONBURG. VA .
CHARLOTTESVILLE. VA.
FREDERICK, MD .
LEXINGTON, KV .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA .
J a n e4th . l 52J:.
HARRISONBURG, VA .
To the Clerk of the Circuit Court ot Rookingham Co oV.:-.
The following is an in"Hntol"'Y' of Alcohol 0t the Co-cpere,t iTe Drt11 Oo Ine • .,: of th•
dates herein emaerated;
On band Dec elatel920o
Purcbaaed during D•c•
2Z
Gale S Ft'e
oz.
None .
2S Gal-e
Ueed during Dec.
5
5 Pt
3 Galo
Balance on band.Jalielat ol92l o 20 gale 5 Pto l5 Oz o
I hereby certify that the a.bovu inventory of Alcohol io a true and ac curate stater.tent ot all
Alcohol receiTod;diepursed and on band on the aboTe dateuo
Co-operatiTe Drug Co
=....£~-swso;.-il,ed t
o and ffOrn to be:tcre me on thi
Ino.
�Rockirigh
8fflca
y, V.
+JAN 4-1 21
~Cler
+
------------ -
•
�RETAIL STORES
RETAIL STORES
CO-OPERATIVE DRUG COMPANY, INC.
PHILADELPHIA . PA .
ROANOKE, VA .
STAUNTON, VA.
NORFOLK, VA.
PHILADELPHIA, PA.
HAGERSTOWN , MD.
HARRISONBURG , VA.
F'REDEIIICK, MD .
CHARLOTTESVILLE, VA .
LYNCHBURG , VA .
OPERATORS OF CHAIN DRUG STORES
LEXINGTON, KY.
HARRISONBURG, VA .
To th~
l~x o
The foll
rcuit
t he
f Rockin
ourt
ng is an inventory of.
f the Co
l cohol
t ve Drug Co Inc .
pe
s of th d ts her~in enumerated ;
On
d J a.n. lst . 1921
Pu .: •
!:Cd
Durin
20 gal.
n.
20 gal.
Used during rr n .
B lti.11C8
0
nd
.. z.
t.
eb olst . 192 •
15
•
3
t
3oz .
5Pt o
l z.
6pt .
2oz.
t her by certify that the a oove inventory of lool o i s
statement of 11 l ohol r e ceived, diapurse
tl"\.1:
on the
cl on h n
o-operative Dru
0
nc •
o
d teo .
(F
.rriso bur •V •
/J Q - ~ ~~r-Per.
r·r
" ubscrib d
nd
orn to
efore me thie 3rd . day of Feb . 1921.
-~
Flied in th
Rockingha e Clerk' s 0 fflcB
r.
te
cc
d
m Coumy, a,
rdJ. • 1921
Cler
.
��RETAIL STORES
RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA, PA .
ROANOKE, VA.
HAGERSTOWN , MD .
STAUNTON, VA.
CHARLOTTESVILLE, VA .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG , VA .
LEXINGTON , KV .
HARRISONBURG, VA.
To t he OlerA of the Circuit Court of Rockin~l
The follm in
is
inventoe
as pf the dates herein &nune
On Ha
u c
of
lcohol o the
aa
o - pera
iVt,
r
~
Co inc.
ted .
eb . lai:. . 1921.
dur in
16 Gal. 6 Pt .
Oz o
None o
eb .
16 Gal. 6 Pt . 2
sad during Feb .
4 Gal(J
z.
5 0 •
-----~----~--~--.-. ---~~--~-Be l
hercb
statement of
c
o.
certi
oh. lst ol 92l o
that the abov
~
¥
12 Ga l .
invanto
5 Pt. 13
z
of Alcohol is
true
:n<l
ccura
11 Alco:ol rovei ed , dispursad and on hand on the abovo da t .
erati~o Drug Co Inc .
C
Harrisonburg . Va •
. er.(
Subacribti
o..nd sworI !:,o bu ore ma thia 2 d C:
Filed In the ler ' U
Rockln#?;ham Court y,
MAR 3- 192
:I ~
of
·
NORFOLK, VA.
. HARRISONBURG, VA.
FREDERICK, MD.
PHILADELPHIA, PA.
l·
roh . 192111)
'
��RETAIL STORES
CO-OPERAT IVE DRUG COMPANY. INC.
PHILADELPHIA, PA .
ROANOKE. VA.
HAGERSTOWN , MD .
CHARLOTTESVILLE, VA .
LYNCHBURG, VA .
~~
STAUNTON, VA .
NORP-OLK , VA .
HARRISONBURG. VA.
PHILADELPHIA. PA.
FREDERICK, MD.
OPERATORS OF CHAIN DRUG STORES
or
,...i.i.·cui t, uourt
T:1.::. ~ol~.o~ · 1."" • •• ~
of the d~t~ wV~v~
l
.
.:.:.1 b~
C.
inv l.,-.. .,
' t ..
c-::
collol
~
01 'UlHtl r:J."l.vU ..
... u. a.,1. Ler . l t .
the /Jo-(' e e.t.i. ve •.,r 6 Co,
1•
Tot l
anu
LEXINGTON , KV .
.pr . 4 9 1S2!. •
HARRISONBURG, VA.
To th
RETAIL STORES
l
p .. .
0:tl . E • t • lv C .c.. •
7 " 1. l
t.. .
5 , l. 1
i. .
1 ')., •
tr o and
a.cc• r t
.,t to en'
'£ a::.1 AlcoLol •uco::.vacl»
.; sburoe<l.
.:th(:
o
Co-Ope:i:· .t 'vi3 v.,:ub Go ., Inc .
O:ub cribt;jd 11nd S'r:o
.
1
,. ....... ...
,
-
h, In the Clerk's Offi
1.:1<
n ham County, Va.
~
0
R 41 21
- ~ -- --Cl
i.
to
.. , .. ,.. ,
c.:'cre
-" • ~
1 "~
l
l.anu o
tLe
��RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PH I LADELPHIA, PA.
ROANOKE, VA.
HAGERSTOWN, MD.
RETAIL STORES
STAUNTON, VA ,
NOl'tF"OLK, VA.
HARRISONBURG. VA ,
FIIED E IIICK, MD.
LEXINGTON, KV .
PHILADELPHIA, PA.
CHARLOTTESVILLI!:, VA.
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA.
HARRISONBURG, VA.
a .. ·c- ....lt
ou.d,
o ..
f . ock i •i)1
..,.
...
t
14
C
1.a n
ur
1.
. .. • 2 .........:. :., , .,
•
-
,
,..
..,.,
V
V
.::
..,J d.u .; 1.. ...,
.._ ...-i.
.•
i.~Cr.O o
'. _ t : •
.. .1 :2:s
:Ione o
le
. . ..... . .
~
cc . . . r "_,
. l cor
..•- o
• .p '....
.... ....
1="iled in the Clerk' Office
l0 ckingham County,
f,1/t.Y 1- 1921
1
- - - -_.Cle
t...
,.
s
lune 18, 1924
��RETAIL STORES
PHILAD~LPHIA 0 PA.
ROANOKII!:, VA.
HAGll!:l'lSTOWN, MO.
CHAl'lLOTTll!:SVILLII!:, VA .
LYNCHBURG, VA.
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA, PA.
OPERATORS OF CHAIN DRUG STORES
RETAIL STORES
STAUNTON, VA .
NOl'll'"OLK, VA.
HAl'll'l l SONIIUl'lG, VA.
F"l'lEOll!:l'llCIC , Mo.
Lll!:XINGTON, KY .
J une . 1st . 1921.
HARRISON~URG, VA.
To t he Circuit Court ot Rockingham Co.Va.
The t ollotring is an invento cy ot Alcohol ot t he Co-Operative Drug otl Inc .
ot the date herein e numerated.
On hand l\Iay .lst.1921.
None .
Purchased during May •
.,.._
26 Ga l . 5 Oz .
_
_____________
26 Gal. 5 Oz .
Total.
3 Gal. 3 Pt . 12 Oz.
Used during !.Iay .
Balance on Hand IJane·. lst . 1921.
2&. Gal. 4 pt • 9 Oz-.
I hereby oertity that the above inventory of Alcohol i s a true and aocur~te
statement of o.11 Al cohol ro-c i v <l , dispurs ·cl n.nd on l
a.' 1'
o
o
T
Co-0 ... erativo Drt,G
tho above date .
c.
Pc ...· e
Subs cribed to an
G o n -~o
efo ~e
~
:i.i::: l~t, . 2.8:
~
" · ":""YI'
I.I ~
: ... ,..
•
o
.;u.ao 19 l
·
,
�'-'
�RETAIL STORES
CO- OPE RAT IVE DRU G COM PAN Y. INC.
PHILADE LPHIA, PA .
ROANOK E, VA.
RETAIL STORES
S T AUNTON , VA.
NORF"OL K, VA.
PHILAD ELPHIA , PA.
HAGERS TOWN , MD .
CHARLO TTESVIL LE, VA .
LYNCHB URG, VA .
HARRISO NBURG, VA.
OPER ATOR S OF CHAIN DRUG STOR ES
HARR ISONB URG. VA.
FREDERI CK , MD .
LEXINGT ON , KV.
July .lat. 192J:.
To the Clerk of the Circu it Court Of Rockingham Co . Va ;
The f ollow ing is an inven tory ef Aloohol
f the Oo-Op e rajiTe Drug C Ine.
of the date her in enume rated.
On
hand J un~. lst . 1921.
Purch ased durin ~ June.
Total .
U od durin g June.
Balan ce on hand Juljl'e lat . l92le
I herob y certi fy that th
22 Gal. ~ Ft . 9 Oz .
---
Nena .
------Ii.a-----~~---
22 Gal. 4 Pt.
4
9 Oz .
Gal.
-----------------------
-
l8 Gal. 4 Pt . 9 Pz .
ab ve inven tory of Alcoh ol i
a true and acc#l.irat e
statem e t of all Alcohol recoiv ad , dispu r3ed . and on hand
on the above date .
fled In the Clerk' s Ofnce
ftock\ngham County, Va,
JU L1Jl921
Oo-Op e ratiT e Dru
Co Ino.
Harri sonbu rg.Va .
- -- -- --rnerk
Mgr.
Subao ri bod t
and sworn to befor e ne this 1st. day of J ly. 1921.
�.
.
.
�RETAIL STORES
PHILADELPHIA. PA .
ROANOKE. VA.
HAGERSTOWN, MO.
CHARLOTTE S VILLE:, VA .
LYNCHBURG. VA .
RETAIL STORES
STAUNTON. VA .
NORF"OLK, VA .
CO-OPER ATIVE DRUG COMPAN Y, INC.
PHILADELPHIA . PA.
HARRISONBURG. VA.
FREDERICK , MD.
LEXINGTON , KV .
OPERATORS OF CHAIN DRUG STORES
HARRISONB URG, VA .
i
• u«•~~.1921 .
I
l8 Gal. " ~ - 9
5 Gal. ,
Uooj during JuJiy'.
0 11.
Ft.
9 01 .
I hereby c;.trlify t.i:i,i.t t;ue
®°""
i.11--:•ontory •f Al•hol 1a a t rua a.n4 aoourat.•
atateant ef all Aloohol reeeivec1 1 d.1apuraod, an4 en ba.n4 en tl1• ab•v•
'
:1arr£11enbur g .va •
.:1tibaoribed t • and ..,.m to befero nc '-21:is Srd.<;lay
•t A~.1921,
~
1•
;✓
Co·r11r .... ·
ut••
�~---,,-------~-----------------~------~--~------- -------------------------------.
•
•
�RETAIL STORES
CO-OPER ATIVE DRUG COMPAN Y. INC.
PHILADELPHIA, PA .
ROANOKE, VA.
RETAIL STORES
STAUNTON, VA .
PHILADELPHIA , PA.
HAGI.EIISTOWN, MD .
NORFOLK, VA.
HARRISONBURG, VA.
FREDERICK , MD.
CHARLOTTESVILLE, YA .
OPERATORS OF CHAIN DRUG STORES
LYNCHBUftGI , VA .
LEXINGTON, KV .
S
HARRISONBU RG, VA.
T
tll o Cle k
f t ',o Oi r ct it 0
l ~·d n,,. i3 a n i vo t
T' _e f
of t ,o
t cf
t . 3r . 192 l e
ocl~inf"ha m Co . Ya;
~
-, . AJ c
1
f
C
~r at·
rure; Co I c .
heroi _ .n m_,t1 ·a toc-1 ;
..~
0:.1 ., .d A l" • l t 1921 .
P
1.
cl a. z o
'..:'o
13 '3-a.l-'
r in . A " at .
9
z•
9
oz.
'10 e
l.
l
1.
3 Ga.1. 3 Pt .
------ -------- ----B lanco on hand Sopt . lst . 1921 .
I
t the bou invo t or , f Alcon 1 · a t
nc· e..cc ur t
1 Ale ol rocoive , tli ~p 1 nod • ., _ or ,a .,,_d
t o ab o at •
certify t
o ob
t a.to ont
...
.D
9 Ga l . 5 Pt . O Oz .
1
C
p o r a.t iv
u~ C
Po r .
f.._
•
'tb
C
t
•.nd
on t o b
o o
o t io 3
13, 19 4..._
('le In the Clerk's Office
Rockingham County, V ,
;[ p 3- 1921
f
o_ t . 1s21.
��RETAIL STORES
PHILADELPHIA, PA .
CO-OPERAT IVE DRUG COMPANY. INC.
ROANOKE, VA.
HAGERSTOWN, MD.
CHARLOTTESVILLE, VA.
LYNCHBURG, VA.
RETAIL STORES
PHILADELPHIA, PA.
NORFOLK, VA .
HARRISONBURG, VA .
f"REOERICK , MD.
LEX INGTON , KY .
OPERATORS OF CHAIN DRUG STORES
HARRISONBURG ,
VA. Oot; • -thh.1921.
Th• tel1-ing 1• an 1.nvont,e~r ef Alc•h•l.
• t +,he kt• herein •nuu.1't ecl ;
•t
tme
0•-()p• ratlve Drug 0• Inoe
/'•'
I
On banli
J•pt..late:i:.~2le
9 Gal. 5 Pte 9 ez.
9 <lfl.l . 5 Pt . 9 •••
Used
clur:,.ne
tlnpt .
3 Gal. C P'b1.
------- ----------------6 Gal. T Pt.
0 oz.
Filt')d in th e Clerk's Office
R01.Jingham County, Va,
CCT 5-1921
_ _ _ ____....,.r---Clerk
OUb1aribN \ •
ana ••rn
,
"' •
t.• befere
, ~ I "
M
l ,t
t hia 4th. uy •f Oct.eber.1921.
L.J, i
S T AUNTON, VA.
��RETAIL STORES
RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA, PA .
ROANOKE, VA.
HAGERSTOWN , MD.
STAUNTON, VA.
NORFOLK, VA .
PHILADELPHIA, PA.
HARRISONBURG. VA.
FREDERICK , MD .
LEXINGTON , KV .
CHARLOTTESVILLE, VA .
OPERATORS OF CHAIN DRUG STORES
LVNCHBUR:G, VA .
VA.'. v . 2 ' • · "2 1.
HARRISONBURG,
,.,
.,_ ,
+' '.
01 · k
l,
:!
f
•
-'-'
l,
• C
C~.l.C '
C
.n
l"'J"
"
J.
C
.
C
...
·r
l
i
19
.
~
.
)
.,_
+'
i) ~..
0
J
.
'I
l
J
..•
.,_
C
,
Oc'
., .,
g
, 2~
~
"
• 7
n v a
,.,
la 7
•
Zo
C~ , •
.-,
'
1•
, .. l" 5.
-
...... . . ..; .D ..
I
V
1' ,
f
,
·1 1 ,..
t'
.
..
,.,
.
C
'
. ..
•
"'
V
,
0 ::: .
-----------------------
-1:. . 1 21 .
, -'J
Al ce' , 1
r
•
,
. ·n·
,.., .0
,
A.c
..
-1 ,
C "'
··o
C
J '
-
..
• 'T
p . •
.U vv~
J.
red hi t ~, Gier 1s Offlc
ockln h m ,ounty, V
~' V • ·~ 921
f
'
~,--~ --
'
-------------.,.
..
_
. 1 . 21 .
-
i ._-i-,
•
�'
,·
,
�RETAIL STORES
PHILADELPHIA, PA .
CO-OPERAT IVE DRUG COMPANY. INC.
ROANOKE, VA .
HAGERSTOWN, MD.
PHILADELPHIA, PA.
RETAIL STORES
STAUNTON. VA .
NORFOLK, VA.
HARRISONBURG, VA.
CHARLOTTE:SVI LLE, VA.
f"REDERICK , MD .
LEXINGTON , KV .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG , VA.
HARRISONBURG ,
VA. • DeO'.Sth.192]:•
To the Clerk of the Circuit Court of Rockingham Co Va:
The f ollOl'l'ing is an Inventory of Alcohol of the Co-Operative Drug Co Inc.
of the date hereL~ enume1-..ted.
On hand
No~.lst . 1821.
Purcha•ed during Nov..
t '
.'
Total •
Used during Nov.
Balance on band Dec . lst.1921.
5 Gal.
________
______...,.
._
5 Gal.
6 Pt. 5 Oz.
-----~--------------4 Gale
27 Oz .
I her•by certify that the above inventory of Alcohol is a true and accurate •tatemat.
of all Alcohol received. dispursed and on hand on the above date.
Oo-Jperative Drug Co.
Earriaonburg .va.
Subscribed to and morn to before me this 5th. day of Dec.1921.
•
I
vck1r1gh Ill
C rk::;
County, Va,
DEG 5- 1921
------C lerk
Mgr.
tr~
11t1
m!~~•on
"l!rc-sJune 10, 19'
�"
+
�RETAIL STORES
CO-OPERATIVE DRUG COMPANY, INC.
PHILADELPHIA. PA .
ROANOKE. VA .
HAGERSTOWN.
MD.
STAUNTON, VA .
NORFOLK, VA.
PHILADELPHIA, PA.
CHARLOTTESVILLE, VA.
LYNCHBURG , VA .
RETAIL STORES
HARRISONBURG, VA.
FREDERICK , MD .
LEXINGTON, KV.
OPERATORS OF CHAIN DRUG STORES
HARRISONBURG. VA .
J an.3 ... d.. 1921.
To th• Clerk of the Circui t Court ot Rookin&ham.Co. va.
Tho . f ollowinc is an !nvontory of Al c ohol o't t he Co ~
eratiTe Din O Inc
of t he dat e herein en'Ulller a t ede
On
d
acela t .132l e
Purchased during Dec .
4 :Gal. 27
None.
"9
Total.
Used du r in~ Dec .
oz.
--~--
-
----
4 Gal. 27 oz.
4 Gale 27 Oz.
--...,_;a~ _ _ _ _ .,. _ _ _
Balance on hand J an. l st . 1922 .
Noa.
f
I he reby cert it, that t he above, Inventdlr, o:r Al cohol is a t r11e and ac curat e
st atement ot all Al co ol received . dispuraed and on hand on the above dat e.
Filt - in the Clerk's Offlc
Ro(.kingham County, Va.
JAN 3-
10.L'.2
------Cler
Subsc r ib ed to and swo rn to b etore
m6
t his 3 rd . day- ot J i 1922 e
/. y
µ '- '\
-,
I
Mer •
/- -t_/
~
,,r?
1--:·
//A_,,,
YO rqfas!on expire No . t, 1924 ~
��RETAIL STORES
CO-OPERAT IVE DRUG COMPANY. INC.
PHILADELPHIA, PA.
ROANOKE, VA.
STAUNTON , VA.
PHILADELPHIA, PA.
HAGERSTOWN , MD .
CHARLOTTESVILLE,
RETAIL STORES
NORF"OLK, VA.
HARR I SONBURG, VA.
VA .
FREDERICK, MD .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA .
LEXINGTON, KY,
BLUEF"IELD, W , VA.
eb it ,. HJ
HARRISONBURG, VA.
k of the Ci cuit Co
s
of the d te ho •e i
n f
e1
01
tor
OJ:
t
du i.1&
"'o a
Ucetl d. rin.; J
_ l e.:c
CC.tvi.1.J Ll
! 3.llu.
~
e •
Co .,Y •
Ir;.
l col ol o
s
T
u
the
o
,..
!:one .
'-- •
l
per~ ti a C ug '.::o Inc
,.
Gr,
l~
•
.•
a • 2 Pt .
~ --.,:---- a. . -------E . . -- .
3 Ga o 5
t ., 19 2
o ace
cohol
o L.i ;;
of
J n ~ ct ..
.rl
u.cchaso
.... e.lanc :e
~
of
:1,
n e to
t
Al cohol i
i
lrue. .nd
to l,ei'oL'C :::.e th:..s 4t •• da
.,.
CCu!'
t
li»o o tl te .
per ti e D
l' .
nc s ·,o
z.
tlceiveC:..tli::; u1•sed
o
scribed to
4
s....
o.f Fob ,. .922 .
JUn 9 lO, 1&25
Co •
�\\ed \n the C\er\,'~. 0
Roc""hw,ha~ county,
f EG ·"4,91'2
--------
-
1I
I
I
I
I
}
I
•
I
•
I
I
I
I
'I
,\er
�RETAIL STORES
CO-OPERA TIVE DRUG COMPANY. INC.
RETAIL STORES
PHILADELPHIA, PA ,
STAUNTON, VA.
NORFOLK, VA.
PHILADELPHIA, PA.
ROANOKE, VA.
HARRISONBURG, VA.
HAGERSTOWN , MD ,
LYNCHBURG, VA.
MD.
FREDERICK,
OPERATORS OF CHAIN DRUG STORES
CHARLOTTESVILLE, VA.
LEXINGTON, KY,
BLUEFIELD, W , VA .
HARRISONBURG, VA.
ffi 'fr:/
To t
T e
o
Cl e rk
ill
in
·all
f the Ci · oui't 'Jourt of rrocki n h
n
n o tory o f
or~ir. er ..ie
tho cl~t
t.c
urc·
i1 6
Fe:b,.
:J~o:l cl
3 C·t'tl e 5
r •
5
•
......__.,,.
t
eta
er...01
of " l
bo
c,
co 1· o
::. .
No ..
i.1 g .cb o
I hcrcb:,, ~orti , tl t tho
1
. ;)?t
------------ ---------
~o gl,.
CUJ.
...:.- Co It c .
o
3G
v
ti
lcol ol ~f i.l.c. Co-Ope
.,.
ve
4 Cz
----------
true
cry cf .-o~l l i
rc~,..;;;_;r J , ·
d o
i
d
a d or th
: · r i onbu g Vn
- '='r •
-e~i,.~r'tr..,.
.:, bec r · bat
o
ncl
Flied In the Clerk'
~
u ... to
fflc,
Rocklngh m Cou ty, V ,
MAR?- 1Q2
_____ __Cei
efo•e
:th:Y.~ ~
My Oommiasion expire! ~
- 1, 192!
.Q
�+
�RETAIL STORES
RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA, PA.
ROANOKE, VA.
STAUNTON, VA.
NORFOLK, VA,
PHILADELPHIA, PA.
HAGERSTOWl'i , MD .
CHARLOTTESVILLE,
LYNCHBURG, VA.
HARRISONBURG, VA.
VA.
FREDl!:RICK, MD ,
OPERATORS OF CHAIN DRUG STORES
LEXINGTON, KY.
BLUEFIELD, W. VA,
HARRISONBURG, VA.
'ilo the
fihm
April.4:th.1922 .
Cl erk of t he Ci r cuit Court o:f Ro ck ine;ham CO. Vae
The :following is an inventory of' Alcohol of the Co-Opei-e.ttve Drug Co Inc
of t he date here in enuner a t ed.
On Jland \ie.rch.lst.1922 .
Purchased during t1arch .
Tata l .
Us ed during l la r ch.
D&.:h:Lnoe on hand April.lst.1922 .
None.
5 Gal.
5 Ga l .
2 Gale 1 P t. 12 Oz.
2 Gal. 6 Pto
4 Oz.
I hereby cert ify t hat t he above is a t rue andaacurate statement of al.l
Alco hol received,dispur s e,-and on hand on t he above date.
Co-Operative Drug Co Inc.
Harrisonbu r g .Ve..
Per.
:..
Mgr.
Subscribed to a nd sworn t o before me t his 4th .day.oU,ril.l9i::2 e
.,~~
M:r
'- u.f .
mfasion. eXPI . . unit f<,, 1"25
��RETAIL STORES
PHILADELPHIA, PA,
RETAIL STORES
CO-OPER ATIVE DRUG COMPAN Y. INC.
ROANOKE, VA.
STAUNTON, VA.
NORFOLK, VA.
PHILADELPHIA , PA.
HAGERSTOWN. MD.
CHARLOTTESVILLE , VA.
HARRISONBURG, VA.
F REDltRICK, MD.
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA.
LEXINGTON, KV.
BLUEFIELD, W , VA ,
HARRISONBUR G. VA.
!Jay . 2nd . 1922 •
To the Cl e r k of t he Circuit Court of Ro ck in8ham Co . Va .
The Following is an inventory of Alcohol of the Oo--Operativ e Drug Co Inc •
of the date herein enunerated .
On Hand Apr . l at . J_92 2 .
2 Ga~. 6 Pt . 4 oz .
Purchased during Ai) ril .
To t al.
2 Gal . 6 Pt . 4 oz .
Used during April .
2 Gal .
4 oz .
- ----------- ---------------Balance on band May . lst. l92l .
6 Pt .
I hereby certify that the a bove i s e. true and accurate statement of all
Alo hol r ecE>iVud :,di Gpursed and on hand on t he above date .
Co-Operativ e Drug Co Inc .
Harri sonburg . Va .
Per .
Sub sc rib e d to and svrorn to before I!le this 2nd . day o f
ilay . 1922 .
f,,/~-~ ~ -
/1'--;/ J.J.A--'~~
jlo~ l\
L
Y Qrymmis.i~::1 , rplres No,-, , 19,
F\led ,n the Cl rk' Office
Rocking m C unty, V •
.1A'{ ~-19?'l
--- ---Cler
·
Mgr .
��RETAIL STORES
PHILADELPHIA. PA.
ROANOKE, VA.
HAGERSTOWN . MD .
CHARLOTTESVILLE . VA ,
LYNCHBURG, VA .
CO-OPER ATIVE DRUG COMPAN Y. INC.
PHILADELPHIA , PA.
OPERATORS OF CHAIN DRUG STORES
RETAIL STORES
STAUNTON. VA.
NORFOLK, VA,
HARRISONBURG, VA.
FREDl!:RICK, MD.
LEXINGTON, KV.
BLUEFIELD, W , VA ,
�.,
�PHILADELPHIA, PA.
'
VA.
HARRISONBURG, VA.
FREDl!:RICK, Mo,
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA.
STAUNTON, VA.
NORFOLK, VA.
PHILADELPHIA, PA.
ROANOKE, VA.
HAGERSTOWN , MD,
CHARLOTTESVILLE,
RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
RETAIL STORES
LEXINGTON, KY,
BLUl!:l'"IELD, W , VA.
J~e5th.l922·•
HARRISONBURG, VA.
To the Clerk of the Cirouit Court ot Rookinglam Oo.va.
The following
i s an Invento~fot1-€%g 0 1co-Opere.t ive Drug Co Inc.of' the date
herein enumerated·.
On 1-nd
Mfff#
June.lat.1922.
.
3 Gale L Pt 9 Oz•
Purchased during Jun•·•
None.
-------~~----ai.------'.L'otal.
I Gal. l pt•
Used during Jim.e.
5 Gal. 1 Pt.
nalanoe on band July<olat.1922.
9 Oz.
9
Or .
----------..-------------None
I hereby certify ti.t t}:le above i• a tr,w and aocmate atateme11t
of all Alcohol received.dispursed.and on band on the above date"ii
Co-Operative Drug Co Ino.
Ba rriaonburg.Va:•
, Per-9(f
.
Subacr1bed to and •orn to before •
My
om
1
th1a 6th day
,,:
ot
i -~~
.
Ju¥el922"e
Mgr.
.
.
��RETAIL STORES
CO-OPERAT IVE DRUG COMPANY. INC.
PHI L ADELPHIA, PA.
RETAIL STORES
STAUNTON , VA.
NORFOLK, VA.
PHILADELPHIA, PA.
ROANOKE, VA.
HARRISON BU R G, VA.
HAG E RSTOWN. MD .
CH A RLOTT ESV I LLE,
V A.
FRED~R I CK, Mo.
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA.
L i!:X INGTON , KV.
BLU E FIELD, W. VA.
HARRISONBURG, VA.
the
e k of the Circuit Court of Rookingam Co .V •
Thet fol-a.o wing is an Invent ory of Alcohol of t he Oo-Opere.tive
of the
ate herein enumer
On band
P
rue Co Im
e •
J uly .
che.wed
None .
te l922 .
5 gal11
uring Jul •
Total.
Used during July .
---------~---Gal.
3 G 1. 5 Pt. 2 oz .
.
----~- --~~------------
l Galo 4
u • s t . 1922 .
Balance o ho.n
t . 14 oz .
the above a a rue an aocure.t e s t atement of all
I hereby cer tify th
lcohol r c i ved. dispurs ed and on had on the above dat •
Co-Oporo.tiv
ug 0
er~-i•~
• ubacribad to and
swor
o before me this 3r d . day o
o.
[gr .
Aug.1922 •
*
~ ~c.'1 ,/J,
fl\r-;
u~
\ \\-j
a,
o·
?
-
_C\er
�--------
�RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
RETAIL STORES
PHILADELPHIA. PA ,
STAUNTON, VA.
NORFOLK, VA.
PHILADELPHIA, PA.
ROANOKE, VA.
HARRISONBURG, VA.
HAGERSTOWN. MD .
CHARLOTTESVILLE1 VA .
LEXINGTON, KY.
BLUEFIELD, W, VA.
S
HARRISONBURG, VA.
To the
FRED~RICK 1 MD ,
OPERATORS OF CHAIN DRUG STORES
LVNCHBURG 1 VA.
loi-k of the
irouit
ourt
ocki'lg.i.e.m Qo •Va •
f
an inv nto_r of A cohol of
T. e fo
t . ltJ~ . 1922 0
er~tive Dr . Oo
0
no .
of th6 da e gerein enumor-ted
n n:'l.
At1e .. lat . l922
se
urc
t'
uri
Au •
t a 14
z.
Gal .
--------~------~---- 4--
Tot~l .
Used dm•ing A
1 Ga l . 4
1 . 4 _t
•
2 Gal .
6 t.
1
z.
10 Oz .
- ---- --------~------h.hce on hand Se t . ls • 1922 ,.
I he
b
• oo.o
certi~J
bat
rece · v d, dis
3 r
a 6
•
t a
t ..e .b-:w e ic a true and ao ~- . to otate
sod an
n band on the ab ve
J 0-0
o_ tive Drug Oo a Inc .
Per
o nd tmo
Filfd 11 t•; ,' i :1 '--~, 1 i ce
R-.kl,..beur ~~ 1;1 ,ly, va.
SEP l· 191
_ __ __ __ Clerk
t of e..1
ate .
Harris nburg . r ••
Sub o ibod
~
��RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
RETAIL STORES
PHI L ADELPHIA, PA.
STA UNTON, VA.
NOR F OLK, VA.
PHILADELPHIA, PA.
ROANOKE , VA.
HARRISONBURG, VA.
HAG ERSTOWN , MD .
CHARLOTTESVILLE,
VA.
FR E DERI CK, MD .
OPERATORS OF CHAIN DRUG STORES
LEXINGTON , KV.
LYNCHBURG, VA.
BLUl!t F I E LD, W . VA .
HARRISONBURG, VA.
o the
r k oft
:follOl'li
an i nv nt
o all
o ~in snumer te •
lcohol of the C
d So t . L .t . 19 2 .
0
ci:• aed
urin
Se
3 G
t.
2 G
___
B lane· on
d 0
t t
e
t.
6
n •
., t .
d duri g
•
t . 19 2 o
1
bove i . a truo
r ativo Dr~ Oo
•
0
t. 4
. SP
\:Iii_ ...____ ._ __ _
-o-
•
-----....... __
----------3
1.
1.
T
er1.:1b:,r cert ify
.v .
Court of Rockingham
cui
0 t . 5t . :l.922 .
_
•
nd .... ccur
•
•
0
l
z.
- -.....----10
z•
te ato.
em
co ol r cei e. , io urae1. and on h9. don
C
c.
g . vn •
•
., b cribod t
o.nd
7
!'n to
efor
thi s 5th,. d - of O t . 1 22 •
t
11
c.
��RETAIL
RETAIL
OPERATORS OF CHAIN DRUG STORES
STORES
STORES
LYNCHBURG, VA .
NORFOLK, VA.
STAUNTON, VA .
FREDERICK, MD.
LEXINGTON, KT.
MUNCIE, IND.
COLUMBUS, GA.
PIDLADELPHIA, PA.
ROANOKE, VA.
CHARWTTESVILLE, VA.
HAGERSTOWN, MD.
HARRISONBURG, VA.
KNOXVILLE, TENN.
BLUEFIELD, W . VA.
FROM
EXECUTIVE OFFICES
PHILADELPHIA
r ri ~on· ur . • \ •
- - - - - -- - - -- -STORE
.. ov . ~+.
"'" t Lo ~l ed: Qf '-1 o Circuit Court o · noe. i n. 1 o.u Co . v •
;,-.
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n 1 1ventor;;t ei:' '-'l:i. h.l c o: ol of t ho Co~. crn ti vo
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\
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i
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nc1 <_1.c i.,. l rrt . 11)2;_ •
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l\11¥,· c:m:icr.l ,1 ... ,:;.u~ \ :ct .
I
10 oz.
,,
I
'
.i. .
i
--------------------
I
I
I'
6 Gol. 10 oz.
I
2
nl. 7 . t. 7
oz.
~---------------3 Gnl. 1 't• 5 oz.
: .o.rri aoi bUl"'; •Va.
or .
r~ r .
I
:iu.b..,cri b ocl to n.t
1
b ui'orc me t l L ,,
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•
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or
r)
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I
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'
CHAIN STORES-The Modern Method of Merchandising
:1ov .1922.
�..,.
T•,
�RETAIL
OPERATORS OF CHAIN DRUG STORES
STORES
RETAIL
PHILADELPIDA, PA.
ROANOKE, VA.
CHARLOTTESVILLE, VA.
HAGERSTOWN, .HD.
HARBISONBURG, VA.
KNOXVILLE, TENN.
BLUEFIELD, W. VA.
STORES
LYNCHBURG, VA .
NORFOLK, VA.
STAUNTON, VA.
FBEDEBICK, MD.
LEXINGTON, KT.
MUNCIE, IND.
COLUMBUS, GA.
FROM
EXECUTIVE OFFICES
PHILADELPHIA
Harrieoaln1rc, Va.
sToRE
De••ith.1922.
To the Clerk
ot the Oireu.it Covt ot Roeki.Jt&ba• Co.Va.
'l'h• toll01riac 1a an lnTeatory
ot
ot All Aleohol ot th• Co-OperatiTe Dnc Co
th• cat• herein ••-•ratei.
Oa ham NoT.lat.1922.
I &al.l Pt.I oz.
P1lNha • ei iuria& NoTe
1'o•••
I Gal.l Pt.I 01.
U&ei iuriJll& NoTe•b•r•
2 Gal.lPt/ 2 Os.
-----~-------1 Gt.le
1 ------Os.
lalaue on halli D•••n•r.lat.19 22.
I h•r•-.Y ••t,jlit., t.bat th• aboTe is a true aa• aHuat• atat••••t ot all
Al•ohol r•••iTea,iiepur eei an• on hani on th• aboTe
u.t••
Oo-0,eratin
Dr-co, h••
Harri1on1t,rc.Va.
¥ er.
f>.~ '"
»,r.
S••s•ri••• to ani lfforn to before•• this 5th.aq ot Dee.1122.
filed In the Cf rk's Offl
0
kin« m Ct unty V .
• 1f!i?'>
CHAIN S_TORES-The Modem Method of Merchandising
IHe
��RETAIL STORES
PIDLADELP IDA, PA.
OPERATO RS OF CHAIN DRUG STORES
RETAIL
STORES
LYNCHBURG , VA.
NORFOLK, VA .
STAUNTON, VA.
.FREDERICK , MD.
LEXINGTON , KT.
MUNCIE, IND.
COLUMBUS, GA .
ROANOKE, VA.
CHARLOTTE SVI LLE, VA.
HAGERSTOW N, MD.
HARRISONB URG, VA.
KNOXVILLE , TENN.
BLUE.FI ELD, W. VA.
FROM
EXECUTI VE OFFICES
PHILADE LPHIA
Harriso nburg . Ye•
STORE
Jan . 5th.1928 •
To the Cl erk of the Ciroui t Court. of Rocking ham Co . Va •
The followi ng is an Invo tory of all Alcoho l of' the Co-ope rative Drug
Co In;
o~ the date here in enumera ted.
On band Dec.lst .1922 .
1 Gal,
Puroha. s ed during Dec .
5 Gal.
Total.
l
6 Gal.
Used during Decemb er .
l Gal.
JJalance on hand Jan.ls t. 1923.
z.
l oz .
l Oz a
5 Gal.
I horeby certify that the above is a true and accu.ra.t e stateme nt of
all
Alcoho l reooive d . dispurs ed e.nd on hand on the abovo date .
Co-Ope rative Drug Co Inc .
Harriso nburg . Va .
Subscri bed to and swor n to before me this 5th. day of Jan . 1.923.
~
0
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CHA'. IN STORES -The Modem Method of Merchand ising
��RETA I L
STORES
OPERAT ORS OF CHAIN DRUG STORES
PHILADE LPHIA, P A.
ROANOKE , VA.
CHARLOT TESVILLE , VA.
HAGERST OWN, MD.
HARRISO NBURG, VA.
KL'fOXVILLE, TENN.
BLUEFIEL D, W. VA.
RETAIL
STORES
LYNCHBU RG, VA.
NORFOLK , VA.
STAUNTO N, VA.
FREDERI CK, MD.
LEXINGTO N, KT.
MUNCIE, IND.
COLUHBU B, GA.
EXECU TIVE OFFICE S
PHILAD ELPHIA
FROM
STORE
..,-
,. -
•
Cl
o •• c •
.::-ilf'r' in the
r-•
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R
1 '23
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CHAIN STORE S-The Modern Method of Mercha ndising
.
()' (,
~ti
CL
Jno .
o.
��RETAIL
STORES
OPERATOR S OF CHAIN DRUG STORES
RETAIL
PfilLADELPfil A, PA.
STORES
LYNCHBURG, VA.
NORFOLK, VA .
STAUNTON, VA.
FREDERICK, MD.
LEXINGTON, KT.
MUNCIE, IND.
COLUMBUS, GA .
ROANOKE, VA.
CHARLOTTESV ILLE, VA.
HAGERS'£0WN , MD.
HAIUlISONBUR G, VA.
KNOXVILLE, TENN.
BLUEFIE!.D, W. VA.
EXECUTIV E OFFICES
PHILADEL PHIA
FROM
STORE
:rf •:··•.,,..'
,..._):
t•c: r :.c·nd c"i t1ri!l~ £'01) .
·, 0 1
c.
----------------r_ ci,__
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0 ·1
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l . ..; . ., t .
-1 oz •
---~-----------~---
r'c.roby
CHAIN STORES- The Modern Method of Merchandis ing
�/
�RETAIL STORES
ROANOKE, VA.
RETAIL STORES
CO-OPER ATIVE DRUG COMPAN Y. INC.
PHILADELPHIA, PA.
•
STAUNTON, VA.
NORFOLK, VA,
HARRISONBURG, VA.
FREDERICK, MD.
PHILADELPHIA , PA.
HAGERSTOWN, MD.
CHARLOTTESVILLE , VA .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA.
LEXINGTON, KY ,
BLUEFIELD, W. VA.
HARRISONBUR G, VA.
'l'
f
h
the
irouit C urt of • ocki..,ghei.:m OoVi.
foll win: i3 ~n InTent cy •f .ll c•lol
~
the da t
h&
A ril.5th.1 23 •
~
th
o-0 er~.t
T\lt
D u:; Co Inc •
:i.n enumerated .
n 1'.and de.re • · 11t.
2 •
n •
5 gal .
Tat l.
·r
h .r
C
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u i ng
~nc
n hand
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RETAIL STORES
CO-OPERATIVE DRUG COMPANY. INC.
PHILADELPHIA, PA.
STAUNTON, VA.
NORFOLK, VA.
HARRISONBURG, VA.
PHILADELPHIA, PA.
ROANOKE., VA.
HAGERSTOWN, MD.
CHARLOTTESVILLE, VA.
FREDERICK, MD.
L~XINGTON, KY.
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG, VA.
BLUEP"IELD, W, VA,
,,..,
HARRISONBURG, VA .
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�RETAIL STORES
S T AUNTON , VA.
NOR F OLK, VA,
CO-OPERAT IVE DRUG COMPANY. INC.
R E TAIL STORES
PHILA D~LP'HIA, PA.
PHILADELPHIA, PA,
ROANOKE, VA.
HAR RI S ONBURG, VA.
HAGERSTOWN. MD .
CHARLOTTE SVILLE.
VA.
FRED E RICK, MD .
OPERATORS OF CHAIN DRUG STORES
LYNCHBURG , VA.
LEXING TON , KY.
·BLUEF I E LD, W , VA.
HARRISONBURG, VA .
_:~r·~ o~
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'111&1._.__ __
r ~~
0
'
�----~----~--------
•
�Ju~ aSth. 1923.
------------
Clerk of the
Te the Girouit Oaurt @f R ckinil:lUl. Co . Va .
V
The follovrin~ io an i ventory of Alcohol •f the
O -OperatiTe Drug C Inc of the date herein
enumerated;
On Hand June . lat . 1923
Purchase
2 Gal .
During June.
• None.
2 Gal •
Used during June.
. 2 Gal .
------~
Nm, .
On hand July . lst . 1~23 .
I Hereby certify thttt the o.boTe is a true d i
accurate ste.tem~nt of -'ll -'loohol rcoeiYed. dispursed and on hand n t he a~oTe date .
Ce-{}perative D~ug Co Inc
:farri sonbur g . Va •
Per~.
Q ~ - \(
/
Mgr .
Subscribed to and SW'orn to before me this 5th day of
£ ,d_ ~~'>1()/aMj (}'~
July . 1923 .
, :j
,
1110
, '-"-~ ;1 ,.,~
,,
t
r
I ~l
�.
-- ---~
-- ---
..
---- -.,
Filed -in th-e Clerk's
0-R,,ce
. Rock ingiM l ')9
-ty, iVa,
· fULS• _ ,
__ _ _ _ _
.
_ffle.rk
�RETAIL
STORES
OPERATORS OF CHAIN DRUG STORES
RETAIL
PIDLADELPHJA, PA.
ROANOKE, VA.
CHARLOTTESVILLE, VA.
HAGERSTOWN, MD.
HARRISONBURG, VA.
KNOXVILLE, TENN.
BLUEFIELD, W. VA.
STORES
LYNCHBURG, VA.
NORFOLK, VA.
l!ITAUNTON, VA.
FREDERICK, HD.
LEXINGTON, KT.
MUNCDC, IND.
COLUMBUS, GA .
FROM
EXECUTIVE OFFICES
PHILADELPHIA
Harr i acnburg . Ya •
sToRE
Aug . l ot. 1$23 .
To t h
lerk of t .e Ci rcui t
our t
or
ocking½am
. Va ;
The follovnng i s an I nv entory of' s.ll Alcoho l of t e CopOpern i v e Drug C
of t e dato he r ein numorated;
n hand July .,lst . J 23 .
Purc}iased during July .
5 Gal .
---------5 G 1.
Us
d
uring July .
l Gal.
. 4 oz .
--~--- ---~Pt--------
3 Gal .
On hand Aug . 1st . J. 23 .
i hareby certify that t1e above i s
&
12 oz .
true and accw•t&e at~t~ment
o f s.11 Alcohol received;dispur aed and on hand
0
1 P
-op
n t e •.h o o d to .
rnti ve Dru~ C •
rr i sonbu;i-g . Vs. .
er~l?):~
W1,1,,. •
Su' 11or ibe d to
sv,orn to
fU~ in tile Cl~rk's Offict.
R~king•( Olu t , Va.
•
...
n
,
·
•
.. .. • •
11'
afore
e this 1st . day of Aug . 1!23 .
Iv
'1• •·19~
-(/,1-:~tl..l~m
~
_ £~(
CHAIN STORES-The Modern Method of Merchandising
In
��RETAIL
STORES
OPERATORS OF CHAIN DRUG STORES
RETAIL
PHILADELPHIA, PA.
ROANOKE, VA.
CHARLOTTESVILLE, VA.
HAGERSTOWN, KD.
H.ABRISONRURG. VA.
KNOl..>'ILLE, TENN.
BLUEFIELD, W. VA.
STORES
LYNCHBURG, VA.
NORFOLK, VA.
!!!TAUNTON, VA.
FREDERICK, liD.
LEXINGTON, KY.
MUNCIE, IND.
COLUMBUS, GA .
FROM
EXECUTIVE OFFICES
PHILADELPHIA
Se t . lst,. L2 "
To tho Cltir
.e
o
the
ir,.,ui t Court o.,_ Roe ·in5
ollCA-vin•r is !ln I nven
' .erain enumera ad ;
1an!
Co . Ve.;
of • 11 l cohol •
017 a f' t 1e Co
rwrati ve Drug
c,,
I no . o.,_ tho da te
V
On ba nd Au.,. .ls t . l 23 •
urc haaed curing
ug .
Total .
On 1and - e t .. l s . 1
3
G
12
al . 1 p
OZ ,o
12
z.
J ne .
3
I her by certHy ',,hat the above is a t
oz
No e .
3 gal. 1
Used during A &1J.3t .
• l
3 ~e.l . 1
e and
cur te
le ho l receiv ed ;dti.spur:ie... and on hand on the a ove
t to
nt of
11
ate .
Co{' pera ti ve Dr u.-r Co •
Harrisonbure; . Va .
Subscri e
I
to and ~vorn to before me t.is 1st. day of Jept, 19 23 .
)
I
,
•3
1
l 0 ,..
r il~d ln th e i.,k, ·
~o ;klngham G1.,Mj uty, viJ.,
Sb ' .. 119
_ _ __ _ _ _C erk
CHAIN STORES-The Modern Method of Merchandising
��
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Liquor Inventory
Description
An account of the resource
Series III of the Prohibition Records collection consists of records documenting the inventory, sale, and transport of alcohol for medicinal purposes in Rockingham County. This series contains printed inventory records of the alcohol on hand of licensed commercial businesses during prohibition. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Identifier
An unambiguous reference to the resource within a given context
Pro003
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/6">Prohibition Records: Affidavits for Ardent Spirits</a><br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Liquor Inventory of Businesses: 2
Description
An account of the resource
(C-D) Printed and signed letters by a notary public reporting the on hand stock of alcohol of licensed commerical businesses.
Subject
The topic of the resource
liquor
inventory
commercial
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1920-1925
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-015
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
-
https://omeka.lib.jmu.edu/erp/files/original/a9e903088ec7d009fe022ceac07decab.pdf
035c37f57538acaa88e8e0c097542ad8
PDF Text
Text
•
Sta te of Vi rg i n ia
City of H rris onbu rg , V . To - wi t :
Thi s d~.y , John J . Re i l l y , Pre~ . & Mgr. of'
t he L . H .
Ot t Drug Co . , I n c , p erso n l ly
pp e·r ed befo re me, Ge o.
G. Gr tt .. n , Not ry Pub l i c , e nd mnd•
f i rst d~y of
o.-th th ton the
J nu~ ry , 1918 , the s~id Co r p o r atio n had on
h nd 7 Ga l s . 3 1 - 2 P i n t z or Pu re Gr
in
th t
t he
d i d n ot r c e i v e . ny
mon h of' Janu ary,
3 u-11 1 &0
.nd
th3. t
l c o ho l , ~ind
r d en t spir i ts dur i n g th e
~,:1ey h d on h .nd r'ebr u"'ry 1 ,
.nd 5 Pint ~ o f Pur e Gr:L in
Gi ven unde r my h nd
1
nd
918
lcoh o l.
eal thi ~ 1st d·y of F e b . 1918 .
~ 4~
. 7111
�'
C
.
')
,-
t ''
'-
'- -
...
~
�S uate of Vir gin ia
Cit y o f Har riso n urg To - wit :
Th i s c'lay , John J • .:1 eill y, Pr e s . &
lf.~r . of the L . H . Ott
Dru g Co ., Inc , per son al ly app ea red
bef ore me, J . E. L .
:'Iugh es , Not ary ?ub l i c , and mad e oat
h tha t on :.:1.e fir st
d a y of Feb rua ry , 191 C the sa id
Cor p ora tion had on han d
3 Gal s , and 5 Pin t !: of Pu::-ie Gi'a in
Alc oho l, and t h· t they
rec eiv ed 4 and 7-8 Gal lon s of Pur
e Gra in Alc
oho l dur ing
th e mon th of Feb rua ry and tha t the
I
y had on han d W.:ir ch
1s t , 191 8 5 Gal lon s 1 and 1-2 Pin
ts of Pur e
Gra in Alc oho l.
Giv en und er my han d and s eal t hi
s 1 st dJ.y of !\/'ar ch , 1 918 .
~ ~J
'u ~/~
�,.
• .iO
. .r
✓
..-
-,.
�~t :: !: ~ ,~_ ~ ,..
t:
Sta te of Vir g i n ~
Q. i
y i . a GE 1
1
2t
•
~
8 TO - W' i
Thi s d ay , J ohn J . Re i l ly , Pr es . & Mg r .
of the L. H.
Ott Drug Co ., Inc . pers ona ll y appe ared
be f o r e me ,
Ge o. G. Gra ttan ~ot a ry Pub l ic , an c1 mad
e oath t ha t
on th e fi rst da y of March , 1 918 t he said
Cor pora tion
hnd on hand 5 Gals . 1 a n d 1 ~2 Pts . of
Pur e Gr a i n
Al coho l, and that the y d i d n o t re c e ive
a ny a r de nt sp i rits
duri mg t he mon th of March , a nd that they
had no ne on
hand Apr il 1 , 1918 .
Giv en u nde r n y hand a nd seal this 1st
da y of
~ ~~
pril 1 918 .
u. R
�t •
r
�Sta te of Vi r g ini a
Cit y of Ha r ris onb urg To- wit :
Thi s day , J ohn J. Rei lly , Pre s. &
Mgr of the L. H. Ott
Dru g Co . , Inc . per s ona lly a ppe are
d b efo re me , J . E. L.
Hugh es , Not ar y Pub lic, and mad e oa
th tha t on the f i rs t
day of Apr il th e sa i d Cor por a t ion
d id not hav e on han d
a n y Pur e Gra i n Al c oho l; tha t the y
r ec e i v e dur ing t he
mon th of Apr i l 191 8, 27 Gal s . 5 a
n 1• 4 Pin ts of Pur e
Gra in Al c oho l, and t hat t h ey had
on han d May 1st , 191 8
24 Ga llon s , s ev en and 1 - 2 Pin ts of
Pur e Gra in Al coh ol .
Gi ven und er my hand and s eal t hi s
lat day of May R ~
�0
�St at e
f Yi rg in a i
r:r i s on bu rg To - wi t:
C t y of
Th i
d y,
;Jo
a, & M r . of th
L. H. Ot t
R.
a pp ea re d be fo re me , G.
lly
na
rso
pe
,
c
In
.,
Co
Dr ug
fi rs t da y of
ad e oa t t h to n
nd
a
C,
bl
y
tar
No
y,
Ma u ze
ga l s , 7 l; : ~ p . J-~ ,t;
nd
ha
on
d
ha
on
i
at
or
rp
co
Ma y t he sa id
r e ce iv e an ~~ ur ngc-{het
no
d
di
y
he
t
at
h
t
l;
?u re t'¾r a i n Al co ho
t 19 18 , 20 ga ls
e :r ha d on ha nd Ju ne 1s
h
t
t
a
h
t
nd
o.
y,
Ma
of
mo nth
ai n t coh ol .
a nd 2 Pi n s of pu re ~r
ne , 19 18 .
a e t h e f i r s t da y of Ju
liiv en unde r m~: ha nd se
�....
--
�This dey , John Reilly , Pres . ~ Mgr . of the L . H. Ot t Drug
o.,
I nth , persona lly appear e d before me , Geo .
• Grattanr
Notary Public , and mad e oa h that on the f irs t day of June
the s aid cor or ation had on hand 20 gals . ancl 2 _pts . of Pure
.oJ.,.•: . .1;
Grain Alco .cl: that they did not recej_ve anyr during the month
o
une , and t1at they had on hand July 1 s t , 11918 , 16 gals .
and 3 1 - 2 pts . of Pure Grain Alcohol .
G ven und •r my han - and
~
t h e fi rst day of J uly , 19 8.
~ ~~ -
'
-U6 9 f ' ~ Q_ .
��Stat e of Virg in :i.ii- .
Coun ty of Roc kingham. To-W it:
This day, Jol'Jn J. Rei lly, Prs . & Mgr . of the
L. H. Ott Drug
Co ., Inc ., pers ona l ly appe ared befo re me ,
Cha s . H. Mauzy ,
Nota ry Pub lic , and made oath that on the firs
t day of July
the said corp ora tion had on hand l6 gals . a
nd 3 1-2 pts. of
Pure Gra i n Alco hol : tha t they did not rece
ive any spir its dur ing
the mon th of July , and that they had on hand
Aug ust 1st, 1918 1
13 gals . and 2 1 -2 pts . of Pure Grai n Alc oho
l.
Give n und er my hand the firs t day of Augu st
, 1918 .
��tate o
Virg ini •
Coun ty of Rock ingh , m To - li t :
Thi
ay , J o_ n Reil ly, Pres . & Mgr . of t e L . J-I
. Ott
Drug Co., I Le . , pers onal ly
Hugh es , Not~ ry
o f Au us t
ubli c , ~nd m d e oat
h.:l ~ on the firs t
he sad corp orat i on had on han
2 1-2 p s . of
ure
.r a in Alco ho
any spir its duri ng the mont h of
on han
e f ore me , J. "t,.
ppea re
hat
13 0 Glso
, ey cl d not rece iv
UGUst , and that t_ey hnd
Sept embe r 1st, 1 1 , 8 gals . and 5 pts. of
~ur e
Gra in Alco hol .
Give n unde r my hand
�·..._,_
�State of Virgini&o
Cou..nty of Rockingham To-Wit:
Thim day , John Reilly, Pres . & Mgr. o f th!! L . H. Ott
Drug Co. , In0., personally tl p pe&red b efore me.,Geo . G.
Gra ttan , Jr ., Notary ?ublic, nnd mode oath that on the
first day of September the s a id corporation h~d on hand
8 gals . and 5 pts. of Pure Grnin Alcohol: that thoy did
not receiv e any spir its tiuring t h " nonth of Sf')ptember,
and that they had on hand October 1st , 1918 5 gals . and
5 pf.a. of Pure Gra in Al c ohol•
Given und er my hand t he fi r st d ay of Oc tober , 1918 .
~ ~~~1E.
~p~~ ,
�t •
l •
•.
�J OHN J. REILL Y,
PRES, AND
l\:[ox.
ES'l.~A BL.lSHE D 1850
INCOR PORAT ED 1 004
'\-V . C . R E T L.LY, S1tc•v A.N D 'l.'Rlil.A.
S,
TH E L. H. OT T DR UG CO MP AN Y
SODA
CIGAR S
8 '..I'ATIO NERY
FLASH LI G H T S
T OILET ARTIC LES
FINE PERFU MES
PATEN T MEDIC INES
SOUT H- EAST CORN lJ;R
I{:O D AKS AND SUPPL IES
REXA LL R EMED IES
PUBL IC S Q UARE
LIGGE TTS CHOCO LA TES
D R. HESS STOCK P R "EPARA rJ~TONS
G-R AFANO LAS A1'c0 RECOR DS
BELL PHONl< ~ 45
H AR.R ISO NBU RG. VA.
Sta t e of Vi rg inia .
Cou nty of Rock ingh am To-W it:
Th is da y, J o~J Re i l l y , Pr es. & Mgr . of the
L. H. Ott Drug Co., Inc.
pers ona lly appe ared befo re me, J. E. L. Hug
hes, Not&r y Pub lic, and made
oath that on th e fiss t day of 8eto ber the
said corp orat ion had on hand
5 gals . ~nd 5 pt s : of Pure Gr a i n Al coho l:
that thay r e c eive d 30 ga ls.
and 7 ptE• dur i ng the mon th of Octo ber, and
that tha y had on hand Nov.
1st, 1918 , 27 ga ls. and 4 1-2 pts. of Pure
Gra in Alco h ol°.
Giv en unde r my h ~nd the rirs t da y of Nov
~
, 1918 ,
~y~
zL
:L
,
v4 f~
<U-- <---< -~
-, £.
'
JJ--r1JC=~
~ V,
d--d
~
y_ -~7 ~
��J O HN J . REILL Y,
PRES . AND MGR.
SODA
ESTAB LISH.E D 1850
.INCOR PORAT ED 1904
w . c.
R E TLLY, Sxc•v
A ND TRIii.A S,
TH E L. H. OT T DRU G C OM PA NY
CIGAR S
n.~~Store
S'l'ATI ONERY
FLASH LIGHT S
TOILE T ARTIC LES
PATEN T MEDIC INES
KODA KS AND SUPPL IES
FINE PERFU MES
SOUT H- EAST CORN ER PUBL
IC S Q UARE
REXAL L REME DIES
BELL PHON E 45
GRAFA NOLAS AND RECOR DS
LIGGE '1'TS CHOCO LATES
DR , HESS STOCK PREPA RA'l'IO
NS
HAR RJSO NBU R G . VA.
Stat e of Vir gini a.
Cou nty of Rock i neha m fo-W it;
This day John J. Rei lly, Pres . & Mgr. of
the L. H. Ott Drug
Co., Inc. pers oma lly appe ared befo re me, J.
E. L. Hug hes,
Not ary Pub lic, and made oath tha t on the
firs t day of Nov.emb er th e said corp ora ti on h ad on hand 27
: ggi,J; s. :.-;. and . 4 1-2 pts.
of Pure Gra i n Alc oho l; that they d id not
rece ive any duri ng
the mon th of Nov emb er, and that they had
on hand Dec . lsb .,
191 8 ,1"9 gals . and ~ t s . of Pure Grai n
Alco ijol.
Give n und e r my hand this t he s econ d
��JOHN J. REILLY,
PRES, AND
Moa.
ESTABLISHED 1856
INCORPORATED 1904
'W. C. RETLLY, SEC'YAN"D TR.11:.49,
THE L. H. OTT DRUG COMPAN Y
SODA
CIG-A.RS
n.~e,c.a.U.s1ore
STATIONERY
FLASHLIGHTS
' TOILET ARTICLES
FI1'"'E PERFUMES'
PATENT MEDICINES
REXALL REMEDIES
SOUTH-EAST CORNER PUBLIC SQUARE
KODAKS AND SUPPLIES
LIGGETTS CHOCOLATES
DR, HESS STOCK PREPARATIONS
BELL PHONE 45
GRA.FANOLAS AND RECORDS
H A RRISONBURG, VA.
State of Virgini~ .
County of Rockingham To ...Wit;
This day John J. Reil l y., President & Mgr . of The L. H.
Ot t Drug Co ., Inc . perso~lly appeared before me ., JE.J,.
Hughe~ , Notaey Public ., and made oath that on th
second
day of flecember the said corporation had on hnnd 19 Gal .
6 1-2 pints of Pure Grain Alcohol;that they did not receive
any ardent zpirt3 during the month of December ., v.nd that they
had on hand January lflt 1919 ., 14 Gal and 5 1 -2 pints of
~ure grai n Alcohol .
Given under my hand this the
•
�t •
�State of Vi~~i ni a;
Ci ty of Har rison Jurg t o-wi t ;
This d ay , John J . Reil ly , P1~ c s . & lilgr . o f t'h"' L . H. Ott
Drug Co. , Inc . Pors ona1.ly ap pear e d. b GI'ore me , J . E . L . Hu,.~h e2 ,
Notary Pu . lie , and made oath that d>n th e first dny of Jan -
u ary , 1 919 th e sa i d corpo ration had o
pts . of Pure Grain
1
hand 1 4 gals . 5 1 - 2
lc oh l ; that they tlid not r e c e i ve any
cJu ri ~G t he month of Jan ua.c·y and th;-i_ t, t he y hrd on
1anrl
1-,< r:b -
ru2.. ry 1 s t ., 1 919, 10 gals . 4 1 - 2 pts of Puro Gr a in Alco;t0 1.
--6i-.r._
Gi ven under my hand s ·-0: J.8'1 th e !'.i..r.;t day of F'el)rm ~ry, 1 919 .
�Filed in the ('I ,rf ·
Rockinghanj :,Ju.1ty, "Va,
•
.
(
"0 ~
nJi~
-_,..,..~----Cler
�State of Vire inia;
City of Harr isonb urg to-W it;
This da y ,
John J. R~ :.Uly , Pr e s ,
&
Mgr , of !he L. H. Ott
ID'rug Co ., Inc . , pe rson ally appc nr ed b e :t'ore me , .J.
E .L.
Hu3h e s, Nota ry Publ ic, and r1ade oath t ho.t on the
firs t
d ay of F ebrua ry , 1 91 9 the said corp orati on had
on hand
10 gal s. 4 1-2 pts. of Pu r e Grain Alco hol; that
they
did not rece. i v •= any durin g the mont h of Febru ary
und
that th ey had on h and March 1 st . 1919 , 5 gR ls.
1 1-};
p ts. of Pu re Grain Alco h ol,
Giv en und -::; r my hand t h e third day of f1iarch , 1 919
1·
£, :t:~✓.~1
--
,
~
�•
�State OC Virginia;
City of Harrisonburg to-Wit;
This day ,John J.Reilly,Pres .& MgP .of The L. H.Ott Drug Co .Inc,
personally appeared before me ,J.E .L. Hugheo , Hotary Public , and
made oath that on the first day of Marc~ , 1919thc said corporation
had on hand
5 gals.1•1~2 pts . of J)ure Grain Alc ohol;that the y
received during the month of Murch 24 &. 2- 3 gale . and that they
had on hand April l st . 1919,2•1 & 2- 3 gals of PUl"f~ Grain Alcohol.
Given under my hand t h e first day of April ,19 1 ~
ct: ;t: . ~£-;
~~
X;a,<-<...AOC---V~
~ 7~
1 'f'- /
' '
'1 ,_ .........-
��State
f Virgin ia;
City of Harriso nburg to-Wit ;
This day,Joh n J,Reill y,Pres . & Mgr .of The L.H.Ot t Drug Co.Inc ,
person ally appear ed before me,J. E .L,Hugh es ,Notary Public and
made oath that on the first day of April,1 919 the said corpor ation
had on hand 24 gallon s & 2-3-of Pure Grain Alcoho l ;that they
did not receive a~y dur i ng t h e month of p r il and that the y had
on hand May the lst.191 9 20 gallon s & 1 -pint'sP ure Grain Alc oh olo
Given under my hand
�-,
...
�State of Vir~i nia;
City of Harris onbu rg to-W it;
This day, John J. Reill y, Pres. & Mgr. of th e L. H. Ott
Drug Co. , Inc., perso na ly app ear ed befor e me J. E. L.
Hughe s, Notar y Publi c, and made oath that on the first
day of May, 1919, th e said corpo ration had on hand 20
gal-
lens 2 pints of Pure Grain Alcoh ol, that they did not receive and durin g the month of May and tha t they had on
hand the first d ay of June, 1 919, 17 gal lons of Pure Grain
Alcoh ol.
Given und e r my
��,
State of Virgini a ;
City of Harr isonburg to - Wit ;
This day , J ohn J . Reilly, Pres and ign. of the L. H. Ott
Drug c o., Inc ., pers onally appea red before me , J . E. L . Hughe s ,
Notary Public, and made oath tha t on the first day of June ,
1919 , the said corporatio n had on hand 17 gallons of Pure
Gra i n Alc ohol , that they did not receive any during the .
month of June, and that they had on hand t h e fir s t day of
July, i l g allons, 5 pints of Pure Grain Alcohol .
Gi ven under my hand this first day of
�(
I.
�State of Virg inia;
City of uarrison burg to - Wit; This day John J . Reil l y , Pres. & Mgr . of The L. H. Ott
Drug Co ., Inc . , p e rsonally appeared before me ,
J . E. L.
Hughes , Nota ry Pub li c, and made oath that on the first
d ay of Jufu y, 1919 , the said Corpora tion had on hand 11
gall ons and 5 pints of Pure Urain Alcohol , t hci. t they
di d not r ec e ·ve any d uring the month o.f July, and tha t
the y had on hand the ftrst da y of August , 1919 5 gal l ons
3 pi nts of Pur e Gr ain Alcohol .
Given under my ~1and t h is
�•
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C
Filed in the Clerk's Offi ce
Roc kingham County, Va,
. .'.uG 2-.1_9 19
"'
Clerk
i
�Sta te of Vir g inia ;
City of Har r i sonb urg to - Wit; Thi s day , John J . n eill y, Pre s. & Mgr .
of t he L. H. Ot t Dru~
co . ,Inc ., p erso nal ly app eared befo re me,
J . E. L. Hugh es,
,~ota ry Pub lic, and made oath tha t on the
f irs t day of Aug ust ,
191 9 , the s aid corp ora tion had on han d
5 gals . a nd 3 pts . o f
Pure Ura in Alco h ol , tha t they r ecei ved
25 gal s . and 5 pt s .
dur ing the mon th and t h at t hey had on
hand t h e firs t da y of
Sep t emb er, 191 9,23 ga l s . a nd 1 pt . of
Pu r e Gra in Alc oho l .
Give n und er my hand
~
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�State of Vir ginia ;
City of ,_
Harrisonb urg to - Wit;This da y , John . J . Reilly , Pres . & Mgr . of Toe L . H. Ott Drug
Co . , I n c ., p erson a ll y appeared b e fore me , J. E . L. Hughes
1
ota ry Publ ic, and made oath t hat on the firs t d ay of September
1919, th e said corporat i on had on hand 23 gal s . a nd 1 pint of
Pure Grain Alcohol , that
fuey did not r e c eive any ~urin g the
month and that they had on hand the first day of e c t6ber , 1 919 ,
1 8 gals . of Pure Urain Alcohol .
Given under my hand this first day
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�Sta t e of Vi rg i n i a;
Ci ty of Harr i sonb urg to - Wi t;
This day , J ohn J . Rei lly , Pr es . & Mgr . of The L . H. Ot t Drug Co .,
I n c . , pe r sonall y app-,e.rned before me , J. E . L . Hughe s , No tar y
Pub lic , and •Tnde oath t hat on the first day of Octob e r , 1 919 ,
t h e sa i d c orpor ati on had on hand 18 gallon s of Pure Srain Alcoho
l,
thnt t hey did n ot receiv e any durin g t he month , o.nd that they
had on hand t he first day of No vembe r , 1919 , 1 2 gal l ons 7 pints
of Pure Gr a i n Alc ohol .
Giv n und e r my hand thi..., th i rd:
ay of 'J ovemb er , 1 919 .
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State of Virginia ;
City of Ha r rison~ urg to-Wit;
Th is day, John J. Reilly, Presiden t and Mama ger o~ The
L , H. Ott Drug Co . ,Inc., persona lly appea red before me,
J . E. L . Hughes, Notary Pub lic, and made oath thut on the
first day of Novembe r, 1919, the said corpora tion had on
hand 12 gals, and 7 pints of Pure Gr uin Alc ohol, that they
die not receive an y dur ing the month and that they haa on
hand the fjrst day of Decemb er, 1919, 9 gals . and 5 pints
of Pure Grain Al cohol .
Given under my hand t his 2nd. day of Decemb er , 1919 .
��State of Virginia.
City of Ha rris onburg to-Wit;
Th i s day, John J. Reilly , Pres. & Mgr. of The L. H. Ott Drug
Co ., Inc. , p ersonally appeared befor e me, J . E. L . Hu hes , Notary
Public, and made oath that on the fi r s t day of March, 1920, the
s aid c orporation had on hand 20 gallons and 7 pints of Pure Grain
Alcohol , that they d id not rec e ive any duri ng t he month and that
they had on hand the first day of April , 1920 ., 13 gallons and
6 pints of Pure Gra i n Al cohol .
Given under my hand this firs t day of April , 1920 .
�•
-~
�S tat e of Vir g i ni a .
!ii ty of ha r ri s onb:~rg t o - 1,7:! t .
Th
E
ch 1. y , J ohn J. Rei l l y , Pr s . &, Mgr . of The L . H . Ott
Drug Co . , Inc . , person ally a p peared b e fo r e me , J. E . L. Hug~ e s ,
Not ary Pub lic and me de oa t h
h~t on t he f i rst d a y of Dec e mb er
1 9 1 9 t h e s a i d c or p orat i on h na 01~·- hana 9 ga llons ana 5 Di n t s
of Pure Grain ~l c ohol, that t hR y d id n o t r ec eive any d u ri n g
t he month ari~ th ot
1 92 0 , 3 ga l lon s
f
he ..• ha 14 on wand t h e f jrst d a y of Ja n ua ry
Pure Gr c'.. in Alcoho l ..
Giv en u •.d er my h a nd t h is sixt h d,, y of Jan u ar y 1 92 0 ,
?f. t ;(~ ~ 7(/j,
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�State of Virg i n ia·
Cit y of & rr isonburg , to-Wit ;
This day John J. Re i ll y, Pr e s. & Mgr . of The L. H. Ott Drug Co .,
Inc., persona lly appeared b efore me , J . E. L. Hughes , Nota ry
Publi c , and made oath that on t he first da y of January , 1920,
the said cor porat i on had on hand 3 gals . of Pure Grain Alcoho~ ,
t hat they r eceived dur ing t he mon t h 27 gals., and that they h a d
on hand the f i rst da y of February , 1920 , 24 ga l s . 4 pts . of Pure
Gra i n Al cohol .
Given und (· r my hand t his t hi rd da y of Februar y , 1920 .
L
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�Si~ te of Vir gini a.
City of Har riso nbu rg to-W it;
The L. H. Ott Drug
This day , J ohn J. Rei lly, Pres . & Mgr . of
E , L. Hug hes, Not ary
Co. ,Inc ., pers ona lly appe ared befo re me, J.
of Feb ruar y, 1920 ,
Pub lic, and mad e oath that on the firs t day
and 4 pint s of Pure
the said cor pora tion had on hand 24 gall ons
duri ng the mon th
Gra in Alco hol, that they did not rece ive any
Mar ch, 192 0, 20 gall ons
and that they had on hand the f ir~t day of
and 7 pint s of Pure Gra in Alc oho l.
this firs t day of Mar ch, 1920 .
Give n und er my hand
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�Filed in the Clerk's omce
ockin~ham Courit v, Va,
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�Stat e of Virgin ia
City of Harr isonburg to -Wit;
.This day , John J . Reilly, Pr e s . & Mgr . of the L. H. Ott Drug Co .,
Inc ., Personally appeared bef or e me , J . E. L . Hughes , N~tary Public
anct mad e oath tha t on t h e
ir s t da,y of April , 1 920 , the s a id cor -
porat ion had on hand 1 3 gal lons and 6 p i nts of Pur e Grain Al cohol ,
that t h ey d id no t r ec e ive any dur i n g the mon th add that the y hat
on hand th e first day of May, 1 920 , 11 gallons of Pur e Gra in
Alcoh ol .
Gi v en und er my hand th i s first day of l1taY, 1920 .
�•
�State of Virginia
City of Harrisonb urg to -Wit;
This day, John J . Re i l ly,Pre s . & Mgr . of The L. H.O tt Drug Co.inc .,
Personally appear ed before me,J . E.L. Hughe,Not ary Public and
made oath that on the first day of May,l920, the said corporatio n
had on hand 11 gallons of PtireG~~in hlcohol,th at t h ey did not
receive any dur ing t h e month and that the y had on hand the first
day
of June , 1920 7 gallons of Pure Grain Alcohol .
Given under my hand th is first day of June ,1 920 .
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C.J,::,:·~,;s
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Rockingham CQunty, Va.
Jt: 1: - 2, i920
~ - - ---Cl erk
�State of Virginia
City of Harr isonburg to - Wit;
This day , John J . Re il ly , Pres . & Mgr . of The L . H. Ott Drug Co . Inc .,
Personally
ppeared before me , J . E. L . Hughes , Notary Public and made
oath that on the first day of' June,1920 the sa i d corporation had
o hand 7 gallons of Pure Gran A cohol , that they did not reue · ve
any dur ing the mont h and t hat they had on h nd the first day of
July , 1920 4 gallons of Pure Grain Alc ohol .
Given under my hand thi s fi r st day of July , ~
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��State o
Virgin ia
City of Ha~r sonburg t o - Nit;
Th s day , John J .Reilly , Pres . & Mgr . of The L . H. Ott Drug Co . Inc .,
Perso a lly a ppear ed bc i'ore e , ,J . E . . Hu g...hes , No tar Public and
made oath that on the first dsy of ~~ _, 1920 the sa ~;o.r_p ora tion
l c ohol , t hat t hey2'\n ot receive d.
h ad on hand 4 ga lons of Pure Gra·
any during t:'1e month and that they did no t have a..ny on hand_ the
fir s t day of Augus t , J. 920 .
G
ven u..nder
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�State of Virg inia
City of Harrisonbur g to - it;
Th is day , J ohn J . Reill'l' , Pres & Mgr . of The L . H. Ott Drug vo ,Inc . ;
Per s ona lly appeared before me,J . E .L . Hughes , Not ary Publ ic and
made oath t ha t on the first day of Augu s t 1 920 the said corpora ti@
d i d not have any J lcoh ol on hand and t ha t t h ey re c eiv ed during t h e
month thir t y gallons of Pure Gr a i n Al coh ol and that t he y had on
hand t he fir s t day of September 1920 27 gallons of Pure Gr a in
Alcoh ol .
Given under my hand this first day of Sept ember 1 920 .
�#'fled i\1:: ilthe 'Ctiertc•• 'Office
County, Va•
-.t 1i20
·;~titn
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Qerk
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�City of I~r ri sonbur g to - ~i~ This <.l.:.y , John J . 2.o illy ,
)l'N: . &
Pernono.l l y 'ppcarcu before
m~dc
I11U ,
Ugr . of Tho L . }-I.O tt Drug Co . I n c .,
J ~:C . L . HughoL , 1;otc..r
Publ:Lc [. nd
ath t hL t on the firLt uo., nr Sc ptcLlbcr 1920 ·he s 2. id corporo.tion
hoi c on hand 27 gal l ons of Pur e Gr ain Alcoho l , o.nd tho. t the y did not
r c ivc 2-11 li urin~ th r.1ont~'l 2.nc tk1t they h'l.ti. on .i:10..n t ho f i rst dr~ y
go.llon ~ and 7 pints of Pur e r a in Al c ohol .
of -ctob cr 1 92 0
Gi v cn v.ndcr my hand t h is first day of'
'
�.,
'
lled in the
Clerk'~ Y'ft1ba
County, Y
CCT 2~ 1920
__ __ _ __.,Ol@f
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�st~t c of Vi rg i n i a
City of Hr r ria onbure to - lit ;
Thi s cl, ~- , J ohn J . I:. il l y , Prcr . t· 1'1:::;r . of The L H, Ott Dru:::; Co . I nc .,
r:::on-~ 11y .. p·,c:c.r cd
~ fo l ' ,
111
, J . E . L . Eu,Sht i, , TTot~ ry Pu olic
~na
r1
octh t h· ton t he firct Ctc . y of Of Oc to ber 1920 t he s, i d c o rpor ... tion
h:: a on hL n cl 23 gc.llono r . nc oc v n p int s of Pnpr Grc.. i n _·:,.lcohol cm~
th t Uv · dicl no t 1· c civ · ny c'urL1 0 tllr month c.nl tJr.t they h· c1
on hc(.ncJ th
firs t (18.y of No-..iorJ -e r 1920 t ·.,c.11.ty onr .:~ llonr, · . n
p i n t ::; of Pu"- ,_y, n Alcol1ol .
iV t 11
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ncJ. thi:-- first c1 cy of 1-ov crnb r , 1 92O
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�S ~ate 01 Virgi ni a
Cit y of Harri sonbu rg to •-Wit;
'l'his day John J . Re i l l y ,,Pres . & Mgr. of 'l'he L . H. Ott Drug
Co . Inc .,
Perso nal ly
ppear ed befor e me , J . S . L . Hughe s , Notar y ~~bli cand made
oath that o t.le f'irf.:d.:. day of Novemb er 1920 the said
corpo ration
had on hand twent y o e gallo ns and f ive pints of Pure
(!rain Alcoh ol
and that they d i d no1 .:. rece i ve any durin g t h e month and
t ha t they had
on hand the :first day of Decem ber 1920 n inete en gal l ons
and two p i nts
of Pure Grain Alco 1 01 .
Given under my hand this f irst day of Dec ember , 1920 .
; ,r./ ~ ~
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�, iled !~, the Clerk's Offlce
nockingham County, Va,
DEC 2- 1920
_ _ _ _ _ _Clerk
�S t a t e of Virg 1a
City of Harri s onburg t o Wit ,
Thi s da John J . Re i lly, Pres . & gr . of t h e L . H. Ott Drug co . Inc . ,
Pers onall y appear d be fore me , J . E . L . Hughes , Notary Pub i c and made
oath that on t he f"tflrs t d ay c ... D oember 1 920 the sa i d coPpor a tion
had on hand n i neteen g
o s
d
nts of Pure Grai n
coh o.l
and that they did not rece i ve any auring the month and t hat they
h don hand the first day Of January 921 s ixteen gallon s and one
p nt of Pure Grain Alcoho l .
Gi ven under my hand this first day of Janua ry 1921 .
J--i
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�f \\i'~ in the C\er\<.'s Office
Ro~K°rngharn Cour:ty, \/a,
n
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_________c\er~
.,
�.
st~te of Virgi n i a
C ty of Hcrrisonburg to Wit ,
Thi s da J ohn J . Re i lly , Pres . & Mgr .of The L . H. Ott Drug Co . Inc .;
Persona ll y appeared before mc , J . E. L. Hughes , Notary Publ ic and made
oa t h t ha t on t he first day of January 1 921 t he s a i d cor pora t· on
had on hand sixteen gallons and ne pint of Pure Gra i n Alcohol and
t ha t they did not receive any uring the month and tpat they had
on hand the f'irst day of l•' ln·uary 1 921 eleven g£-tllons of
Alcohol .
Giv en under m hand this first day of February
ure Grain
lL
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ransfer $.-Total$tt
Admitted FEB 3 ... 19
_ _.;,.______Clerk
i Rockingham County, Val
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�W . C. R E ILLY, S E C. AND TREAS
ESTABLI SH E D 1 8 S6
JOHN J . REILLY, PRES. AND MGR.
INC ORPORATED 1904
THE L. H. OTT DRUG COMPAN Y
n., '7edL Stmv,
S ODA
S TATIONERY
C I GARS
FLASHLIGHTS
F I NE P ERFUMES
TOI LET A RTICLES
REXALL REMEDIES
P ATENT MEDICINES_
S O UTH - EAST C O R NE R PUBLI C S Q UARE
KODAKS AN D SUPPLIES
L IGGETT'S CHOCOLATES
H A R RIS O NBURG, VA.
March 1 , 1921 .
Stat e of Virginia,
City of Harrisonburg to Wit:
This day John J. Reilly, Pres . & Mgr. of The L. H. Ott Dru g Co ., I nc .,
personally appeared before me, J . E. L. Hughes, Notary Public and made
oath that on the first day of February 1921 the said corporation
had on hand eleven gallons of Pure Grain Alcohol , and that they did
not receive any during the month , and that they had on hand the
first day of March 1921 eight gallons of Fur e Grain Alcohol .
Giv en under my hand this first day of March 1921 . /
' ( cY, ~~, 11;(?
Fi ed In th r.1 rk's () ce
ocklngharn Co rnty, Va,
1
M~.R 4-192
alllf,!!:em_
Clerk
____
��St a t e of Vir g ini a ,
Cit y of l:iar ris onbur g , to ,.Ji t ;
This day John J .
per s on a ll y
eil ly , Pr es . & Mgr . o.r 'l'he L . l:i . Ot t Drug Co ., lnc .,
ppea r ed before me , J • l!, . L . Hu hes , Notary Public , ana mad e
0
oa t h that on the fir s t day of
pr i l 1921 t h e said c orp oration had
on hand six ga1lon s of Pur e Gra in
lcoh ol , a nd that t hey did n ot re -
c eiv e any during the month , and t h at t hey n a a on .tiand th e s e c ond d a y
o f May 1 921 t h ree gallons a nd f our pin ts of pur e grain
1 coh ol o
Giv en under my hand t h i s se cond day of May 1 921 .
��State of Virginia ,
City of Ha rr i sonburg , to Wi t;
This d a y Johh J ~Reilly, Pres . & Mgr . of The L . H. Ott Drug Co . , Inc .,
p ersona lly appeared b efore me , J . ~ . L . Hughes , Notary Publ i c and made
oath tha t on the first da y of' Mer.ch l;92J. the said c orpora t ion had
on hand r 8 ~a l l ons of Pure Grain Alcohol , and tha t the y did not rec e ive
any during the month , and tha t they had on hand t he first day of Apr i l
1921 six gallons of pure gr a in J lcohol .
Given under my h a nd t h is f i rst d ay of Apr i l 1 921 .
Fihi in the Clerk's Office
R ckin ham County, Va,
~~
- ) 1 21
_____ __Clerk
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-
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•
�St te of V rg i nia ,
Jity of F&rr i s onbur , to
Th i s aa
Tit:
John ,J . Re illy , Pres . & Mgr . of
The L . H. Ott Dr ug Co ., I n c .,
perso1al ly ap peared b efor e mt~ , J . E. L . Hughes , Ho ta y Public , and made
oa th t ha t on thc- second day o f I-f ay 1 921 the sa id c orporat ion h a d
on hand t hree ga llons and four p i n ts of P1u~e Gra in Alcoh ol , and t ha t
they did n ot re c e iv e any dur i n
t h e f · rs t d ay of' Jun
Alcoh o l .
th
mo n th , and tha t t hey had on hand
1921 · one gall on anc1 one - ha l f p i nt o f pur e g E. in
�.,,
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�St a t e of Vi rg ini a ,
City of Harrisonburg , to rit:
This day John J . Re illy , Pr e s . & Mgr . of The L. H. Ott Drug Co . Inc .,
personally appear ed b efo re me , J . E. L . Hu ghes , Nota ry Public , and made
oa t h that on the firs t day of J une 1921 t he s aid corpora tion had
on hand one gallon and one - ha lf p int of Pur e Gra i n Alco hol , a nd t ha t
t he y d i d r e c e iv e t en
gall ons of Grain Alcohol du r i ng t he mon th , a nd t hat
th ey h ad on hand th e fi rs t da y of July 1 921 sev en gal l ons and sev en and
one - half p ints of Pur e Grain Alcoh ol . [ 1-,_1rt..c..,~
~
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Giv en u...>-id er my hand this fjfth da y of J'C:3:;- 1 921 .
J-g~~
r , _ofl\ce
a,
f\led i t e \e
county,
\,\ cr\...arn
ROCl'-.lfl t,11
-
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C\er
�1,
'
�Stat e of Vi rg i n i a ,
City of Harri filonburg , i o fit :
This day John J . Re il ly , Pres .
&
Mgr . of The L. H. Ott Drue; Co . I nc . ,
per s onally appea r ed be fo r e me , J . E. L . Hughes , Nota r y Pub li c , and made
oath that on t he fi rst day of July 1921 t he said corpor a tion had
on hand s ev en gallon s and sev en and one - half pint s of Pur e Gr a i n Alcoho l ,
and that t hey did not re c e iv e any dur i ng th e month , and t ha t t hey had on
hand th e first day of August 1921 fo ur ga l l ons and seven and one - hal f p i n t s
of Pur e Grain Al cohol .
Giv en under my hand t h i s e l ev ent h da y of Augus t 1921 .
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�S&ate or Virg inia,
City of Har risonburg , to Wit:
Th i s da y J or..n J •
. eilly,
Pres . & Mgr . of The L , H. Ott Drug Co . Inc .,
personall y appeared before me , J . E. L . Hughes , Notar y Public , and made
oath that on the first day of August 1921 the said corporation had
on hand f our gallons and seven and on e half pints of Pure Grain
lcohol ,
and that they did not receiv e any dur i ng the month , and that t h ey had on
hand the first aa y of Sept ember 1921 one gallon ana thr ee and one half
pints of Pure , Gr ain Alcohol .
Gi.ven under my hand this third day of September 1921 ..
I
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.
�State of Virginia .
City of Harrisonburg to Wit:
This day
John J . Reilly, Pres .
&
Mgr . of Th e L. H. Ott Drug Co . Inc .,
personally appeared before me, J . E.L . Hughes , Notary Public , and made
oath that on the first day of Septembe r 1921 t he said corpor at i on had
0
on hand one gallon and t hree a nd one - half pints of Pur e Grain Alcohol
and they receiv ed ten gallons during the month and that they had on hand
t h e first day of Octob er 1921 nine gallons and four pints .
Given under my hand this fifth day of October 1921 .
��s~ate of Vir g inia .
C1 ty or .Harrisonbur g t.o ~\ 1 t:
Tn i s day Jonn J . He il.Ly , Pr e s . & Mgr . of' tne L .
rt .
Ott Drug C-o . Inc . ,
pers ona ll y appearea be ror e me , J . i:; . L . 1:1ughcs, No tary Public , and made
oath t hat on t ne firs t aay 01· November 1 921 the said cor por ation had
on hand e i gh t gallon s ana t wo ounces or Pure Grain AJ.cohol and they
did not r e c e ive a n y du rin[j t ne mon t n ana t.na1.. t noy had on hand tne
fir;:,t ctay of De cember 1921. !'ive ga.Llons ana eighty on e ounc es .
Given under my hand this thira day of December 1921 .
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Rockin., m Co
D C6- 921
_ _ _ _ _ _Clerk
L------o~
�J(J
.
)
�State of Virginia .
City of Harrisonburg to Wit:
This day John J . Reilly , Pres .
&
Mgr . of The L. H. Ott Drug Co . Inc .,
personally appeared before me, J •.
• ughes, Notary Public, and made
oath that on the first day of October 1921 the said corporation had
on hand nine gallons and sixty four ounces of Pure Grain Alcohol and
they did not receive
any during the month and that they had on hand
the first day of November 1921 eight gallons and two ounces .
Given under my hand this fourth day of November 1921 .
C\er 's O ce
d n bne
\ ham County, \/a.
} " -5192\
-----------
_C\erk
•
�t •
I
�State of Virgin ia .
City of Harr i sonbu rg to Wit :
This day John J . Reilly , Pres . & Mgr . of the L . H. Ott Drug Co . Inc
.,
pers onal l y appea red before me , J . E. L . Hughes , Notary Public , and made
oath that on the first da~ of Decem ber 1921 the said corpo ra t ion had
on hand five gallon s and ei ghty on e ounce s of Pure Grain Alcoh ol and
they did not receiv e any during the month and that they had on hand
the first day of Januar y 1922 one gallon and sixty one ounces .
Given under my
Filed ,n the Clerk's Office
Rockingh, rn County, Va.
~N
.':?-
-- -- --
Clerk
�I
�Stat e o f Vi rg i n i a .
City of H rr isonb ur g to Wi t:
Th i s day J ohn J . Re ill y , Pr e s .
&
Mgr . of the L . H. Ot t Dr ug Co . I n c .,
Publ_·ic , and mad e
per s ona ll y a ppea r ed befo re me , J . r.L . Hughe s , Nota ry
c or pora tion had
oa th tha t . on th e fir s t da y of Janua ry 1 922 th e s aid
i n Al coho l and
on hand one gallo n and s i xty one ounc e s of Pure Gr a
they flid n ot hav e
they d i d n ot r ec e iv e any durin g the month and that
an y on h nd Febru ary fi rs t 1922 .
Giv en unde r my hand this s i xth day
J· r:
,;C
Filed In th Clerk' Offlc,
Rockingh· m County, Va.
FEB ·6 L2
__ __ __ _c.r
r
�j
�State of Virg ini a .
City of Harr isonburg to
it :
This day John J . tieil l y , Pr es . & Mgr . of the L . tt . Ott Drug Co . Inc . ,
p e rsomally appeared bet·ore me , J . E . L • .tmghes , Notary Public , and made
oath that on t he f'ir s t day of February 1922 they did not hav e any
Pure Grain Alcohol and that t hey r e ceived t en ga llons cturing the month
and that t hey had on han d e i gh t ga l l on s and se v en ty nin e oun c es
Mar c h rirst l 922 .
Giv en under my hand t h is third d ay of M:a rch 1922 .
J , t:. ~ ~ ~,7t(fa.
~• __:__ 14~
,.
u _
j- 11
-I/~
�JOHN E. JACKSON, ! st Vice Pres ..
Tazewell, Va.
GEO. M. FARRAR. Presi dent.
Clifton Foree, Va.
P . H . MADDUX. 2nd Vice Pres.
Chase City, Va.
JOH N J. RE ILLY, Sec.-Treas.
Harrisonburf, Va.
E. L. EVER SOLE, 3rd Vice P res.
Coeburn, Va.
TH~ T~l~STAT ~ IR{~XAILIL C ILJUB>
VIRIGilNIA, MARll!bAli'Uli, DEl!.,!;1:WA!Ui:, DIS"lrRlle.'li' 011" e.@11.UMeJIA
OFFICE OF THE SECRETARY-TREASUR ER
C L UB M OTTO
• •THE. BEST IN DRUG STORE MERCHANDISE ,
T H E FINEST IN DRUG STORE Sl!:RVICE . "
HARRISONBURG, VA.,
�State of Virginia .
City of Harrisonburg to wit :
This day John J . Reilly , Pres.
&
Mgr . L , H. Ott Drug Co . persona11Y
appeared before me , J . E .L . Hughes , Notary Public , and made oath that on
the first day of March 1 922 they had on hand Eight gallons and
Seventy Nin e ounces Pure Grain Alcohol and that they did not r eceive
any alcohol during the month and that they had on hand Fiv e Gallons
and twen t y four ounces April 1st 1922 .
Given under my hand yhis third
FilPd ln the Clerk's
u in ham
in:,· ,
ounty, Va.
,M ..2 9??
---===-----Cler
�JOHN J. REILLY, Sec.-T reas.
Harrisonburr, Va.
W. L. LYLE. 1st Vice Pres.
Bedford, Va.
FRANK LARRABEE, Pres ident.
Phoebus, ·va.
MELVIN L. KING. lrd Vice Pres.
Westminister, Md.
D. G. LUCKETT, 2nd Vice P res.
Washington, D. C.
T'IH IE "f~l~ ..,ST'A T'IE ~llEX ALL CLlJJ 9
VIRGINIA . MARYII.AN D. DELS:WAR E. DISTRl<;;' f 01" <;;OLUM!;I\IA
OFFICE OF THE SECRETA RY- TREASUR ER
CLUB MOTTO
- TH~ BEST IN DRUG STORE MERCHAND ISE.
THE FINEST IN DRUG STORE SERVICE ,'"
HARRIS ONBUR G, VA.
.>
~
.~
- \--~~
~ ~
~
~~~
1
•
�Stat e of Virg i nia .
City of tlarri s onbur g t o wi t :
Tni s ctay John J . Re i lly , Pres . & Mgr . of L . H. Ott Drug Co . , p ersona lly
appear ed befo r e me , J . E . L . Hu ghes , Notary Publ ic , ai1u uiade oath t hat on
t he :t'i r st da y of April 1922 they had on nand Fiv e uall ons and Twenty
Four ounces Pur e lira i n Alcoh ol an a t h a t tney d id no t r ec e i v e any durin
the n1on t n an d t.na t t n ey nad on nand 'l'hree Li-allons and Sevent y ·1wo
oun c e s the rirst a..ay of May 1922 .
Gi v en under my nand t h is tni r d day of May 1922 .
---
Cle,,
�.'f ·.·
·! .>:.
�S tate o f Vrc ginia .
Cir.,y o f Harris onbur g r., o wit:
'l'nis aay J ohn J . tto i J. l y , Pres . & rvi gr . o f L . H. Qt,r., Drug Co . , person al l y
appear ed b e for e me , J • .t: . L . I-Iughes , Notary Publ ic , and made oath tna r.. on
the r•irs t. d a y o f May 1 922 t h e y n a u on nand ·1·n r ee UaJ..L ons and Se v en t.y Two
ounces Pur e Ur.a i n AJ.c onol and t,ha t tney diu n o t r e c ei v e an y u uring 1,ne
month anu tha1, t h ey naa. on n and Two Gail on s and S eventy ounces tne 1·1rst
day 01' J une
J. ~2 2
.
�I
-
..
.J
,
�State or Virgin ia .
Ci t y or Harrison burg
o wit;
'l 'hi s aay John J . He1.u.y , Pres . & Mgr • of L •
.l:i .
Ott Drug Co . , personaJ .ly
appearea before me , J • .l:!i.L • .tiUghes, .Notary Public , and maae oath that on
the fi r st a.ay 0.1:· Ju.ly 1922 they haa. on hand One UaJ.lon and three ounces
of Pure Grain Ai. coho.1 aua that tnt)y aict. no t r ecei ve any aur1ng t he
month ana tna t tney had on hand F11'ty One ounces the first a.ay 01·
August 1922 .
Given uncter my hana. this seconct. aay or Augusi 1922 .
�..
0
I
1
�Sta t e 0 1· Virg inia •
City or Har ri s on burg to wit:
This a ay John J . rtei.1.l.y , P1~es . &.
gr . 01· L • .H . Ott Drug Co .. , perso naJ.. Ly
appea rea bet·o re me, J . ~. L . .t:iughes
Not. ary Pub. Lie, ana macte oatn tnat on
tne I irst day 0.1 A gu
u a
n han
922 they had
Al coh 1 and the y rece 1 ed i.•
1-'ift
One ounc es 0 1· Pure
e uall ons ct.ur ing the mon t
they had on hand ihre e Gall ons and
e Hunct red an.a S vcn
and th t
en Ounc es
tne fir t ctay or Se temb er 1 922 .
i ve
unu er my hand t.hi. tnir a aay or
Filed ;n t he /erk' ( ·.
! am Ct unty, · va,
Rockin h
r.
trlr.1
utP 7- 192?
- -- - --CJ r
·e t,em ber J.~B2 .
��St.at
City
1' Virgi nia .
1'
Harris onburg t o wit:
Tni s a a y J ohn J . Rei.L.LY ,
res . & Mgr
ap pearea . be1· ore me , J . E • • Hugnes ,
n
o f L . H.
try
tt DruG C •,
ers on l.ly
uol.ic ., and maa.e oath that on
tne rirst d a y 0 1' Sep tembe r l 922 t.ney baa on n a na Tnree Gn..Ll
ns
Hunctr ea and Seven teen
unc s 01·
ure gra n
1. c oh oJ. and they r c ,ivea.
Five Gal1. on1;; aur i ng the month and tnat they nua
and Twenty
ne
rl
n h nd Tw
Ga1.1 ons
unces the first a y 0 1' Octobe r 1 922 .
Given under my hruw. this r ourth day of'
cto ber J.~22 .
e
��State of Virgin i a .
City of Harriso nburg to wit :
Thi s da y John J . Reilly , Pres . & Mgr . of L . H. Ott Drug Co ., person lly
appeare d b efore me , J . E. L . Hughes , Nota ry Public , and ma de oath that on
the f ir s t day of Nov ember 1922 they had on hand One Gallon and Thirty
Seven ounce s of Pur e Grain Alcoho l and they did not receive any during
the month and tha t they had on hand One Gallon and Eightee n ounces of
Pure Grain Alc ohol the first day of Decemb er 1922 .
Given under my hand this fourth day of Decemb er 1922.
Filed in the Clerk's Office
Rockincham Ct unty, Va,
DfC 5.. 1 ??
ffl~ ~
��State or v1rg1 nia .
<; 1 ty
or Harri::s onbur g to vri t:
·i •ni ~ a a y John J . RelJ..L y , Prets • & Mgr • of L . .l:i . Ott lJrUG Go
., p r on .1ly
ppea r a orrore me , J . b.: . L • .l:iugne s, No'tary PubJ.ic , and made oath
tn ton
tne rir s t ua y or LJ emb r .L~2~ they naa on nana One Lra.1.Lon and
eighte en
ounce s of Pure ura in A.Lcon o.L and the y aid not receiv e any auring
th
montn and 1,na 't tney naa on nana S e venty .c;1 gnt ounc es or Pure u-rain
Ai.coho.L tne r irs t. u y or Januar y 1923 .
Gi ven unae r my nand this rourtn a a y or Januar y J.~20 .
ril11rl in the (:!? ~'~ Otnc
Roi.;kiw ham .-unt ,, ,
IAN 8 1923
~
~,.#~
�;
.fJ
ruJO
Urrorr
.).ciO~i
.,
�State of Virgin i a .
City of Harrisonburg to wit:
This da y John J . Reilly, Pr es .
&
Mgr. of L. H. Ott Drug co., p e rsonally
appeared before me, J. ~ .L-Hughes, Notary Public, and made oath t hat on
the first day of J anuary 19 2 3 they had on hand Seven ty Eight ounces of
Pure Gra in Al cohol and they did not r eceive any during the month and
t h at they had on hand Twenty One ounces of Pure Grain Al cohol the first
day of February 1923.
Give n under my hand this fourth day of February 192.
�l
'I
�s t a te of Virginia .
City of Harr sonburg to wit :
This day John J .
eill y,
res . & Mgr . of L . H. Ot t Drug Co . , persona lly
appeared b efore me , J . E .L . Hugher , Notary Public , and made oath that on
the first day of February 1923 they h~d on hand Twenty One ounces of
Pur e Grain
lcohol and that they received Five Gallons during the month
and that they had on hand Four Gallons and Ninty Seven ounces of Pure
Grain
lcohol the fir~
day of March 1923 .
Given under my hand th s <>econd day
-J·
C ; ; ( ~_
�•.
L
�·ta te o f Virgini a. .
ity o f Harrisonb urg to wit:
-ohn J. Re lly , Pre3 . & Mgr . of L . H. 0 t Drug Co o
Thi3 da
p ersonally
apre"":rc before m , , J . ,,_, .L . Hughes , Noteiry Public , and ;nad e oa th that on
the firs
dre
a
of
r- · 1
and T·1enty One oun
.923 they had on hand three Gallons and One Hun P.S
of P re Gr· in .· 1cohol and that they did not
rece ive any during the r1onth
<
nd tl a i they had on hand Two Gf'llons and
F fty Three ounce~ of Pure Grain ' lcohol the first day o
in the C\ ,rk' 0 c
m c. uoty, a,
4
- ------
C\er
May
923 .
�,
�State of Virgih ia •
Ci ty of' Harris onbur g to wit :
This day John
. Reilly ,
r.s .
a .Jeared before me , J . ::-i • •
:r. I!ir;r . of L. H. Ott Dru
1
Co . ,
ersona 11,
iu 6 lles, Iotary Public , and:na de octth that on
the first day of May 1923 the• had on hand Two Gallon s and Fiftv
Three
ounce s of Pure Grain
cohol and that they did not rece ve any
month and that the~, had on hand
Seven ounces of Pure Grain
n
n.a1 on and
ne H ndred ~n1. T,ven
.lcoho l the first day o f June ,
Given under ~y han
urin
923 .
this four h day o f May 1923 .
r: ~ ✓~b
the
�I
.'
l
, f
�Sta t e
f Vi rginia .
City of Harris nbur~ , to wit:
This d y John
a
. Reilly.,
H.
res . & E 0 r . of
eared before me , J . i= . L . Hughes , No tary
t t Drug Co . , persona ly
ublic
and made o o.th that on
the fi r st day of J une 1923 they Lu.rl on hand One Ga l lon and One Hundred
and Tr1enty SC'ven
unces of
ire GraL-1
lcohol uncl that they d i d not
rece ve any during the T"lo rit.h and that they hc.d on hand
ne nundred ard
ne ounces of
r e Grain
ne Gallon and
l c ohol the fi ll!it day o f Jul y, 1023 .
even unde r my h and this aihird day of
J uly 1 92 3 .
��State of Virginia .
,
\
City of Harri sonburg to wit :
This day John J. Reil l y, Pres. &. Mgr. of L. H. Ott Drug Co . , peraonall y
appeared before me, J . E.L . Hughea, 1~otary Public, and made oath th at on
the fir • t day of July 1923 they had on hand One Gallon and One Hundred
and One ouncea of Pure ura in Alcohol and that they did not receive any
during the month and that they had on hand One Gallon and Ei ghty
Three ounces of Pure urain
l cohol the firat dat August 1 923 .
.r: ~~sn:er
Given under my hand this third day of Au gu3t 1925 •
1/~
��flied I the ,lerk 1 ~ l lf1kt
ocKlng am County, ·1 d.
OCT 9.. 9
,~~
GI
State of Virgin ia .
City of Harriso nburg to wit;
day John J. R illy , Pr s . & Mgr . of L. H. Ott Drug Co . , p reon lly
appeare d before me , J . E.L . Hughes , Notary Public , and made oath that on
Thi
the first day of Sept mber they had on hand One Gallon and Eighty hr e
ounces of Pure Grain Alcoho l and that th y did no r eeiv any during
the month and that they hac on hand One Gallon and Thirty nin
of Pur
Gr in Alcoho l the first day of Octobe r 1923.
Giv n under my hand this sixth day
f Octob r 1923 .
ounces
��State of Virginia,
City of Harrisonburg to wit•
This day John J . Re il.Ly , Pre:i .
&.
Mgr. of L. H. Ott Drug
co . ,
pe rsonally
appeared before me, J . E. L. !:Iugheis, Notary Public, and made oath that on
th e firs t day of October they had on hand One Gallon and thirty nin e
ounces of Pure urain
lcoho~ and that they did not receive any during
the month and that they liid not have any on hand the firflt day of
November 1923.
Given undsr my hand thin fifth day of November 1923 .
~ ~ ~~1"L/ ,
(I
~ e--zty~
flied In tne Cl ,r ·'i, Office
Rockin h m Count , Va,
ov ,.,
2
��State of Virginia ,
City o f Harrisonb urg to wi t:
This day John J . Reilly , Pres .
&
Mgr . of L. H. Ott Drug
co ., personally
appeared before me, J . E .L. Hughes, Notary Publ ~c, and made oath that on
the firs t day of No vemb er they did not have on hand any
ure Grain Alco-
hol and that they did not receive any during the month and that they did
not have any on hand the first day of December 1923 .
liiven under my hand this fourth day om' December 1923 .
��State of Virgi nia,
City of Ha rrison burg to wit;
nally
This day J ohn J . Reilly , Pres . & Mgr . of L . H. Ott Drug o . , perso
on
appea red be f ore me , J . E .L . Hughe s, Notary Public , and made oath that
Alco the fi rst day of Decem ber they did not have on hand any Pure Grain
did
hol and that they did not receiv e any during the month and that they
not have any on hand the first day of Januar y 1924 .
Given under my hand this thi rd .ay of Januar y 1924.
I
H
'
d \n th C18 ,
\t..H vnarn County, \Ja,,
~
?.."(
~
-------I
\,._
C erk
~
.
�J.
,I
�State of V rginia ,
City of Harriso nburg to wit:
This day John J . Reilly , Pres . & Mgr . of L. H. Ott Drug Co .,
ap eared before me
the firs
and tha
ersona lly
'
J . E. L .Hughe s, Notary Publ c, and made oath that on
day of January they did not hav , on hand any
ure grain Alcoho l
they receive d five gallons durig the month, and that they had on
hand four gallon s and eighty six ounces of pure grain Alcoho l the first
day of Februa ry 1924 .
Given under my hand this fourth
day of Februa ry 1924.
�JOHN J . REILLY, PRES. AND MGR.
ESTABLISHED 18l'll6
Vl , C. RF, 11.LY , SEC. AND TREAS
INCORPORATED 1904
THE L.H.OTT DRUG COMPAN Y
SODA
STATIONERY
n.:;te«.atts-.
CIGARS
FLASHLIGHTS
TOILET ARTICLES
FINE PERFUMES
PATENT MEDICINES
REXALL REMEDIES
KODAKS AND SUPPLIES
SOUTH-EAST CORNER PUBLIC SQUARE
HARRISONBURG, VA.
LIGGE.TT'S CHOCOLATES
�State of Vir ginia ,
City of Harri sonbu rg to wit ·
his d::iy John J . Re illy ,
res . & Mgr . of the L . FL
tt
rug Co . , perso nally
rrade oath that on
ape red t-efor e me , J .:: : • •!!U[;!H~s , .re ary -~,,_bl ic, ::t'l.d
gallo ns and e_;ht y
the f'jrst day of' F€~ru c.ry 1924 they :tad on httn d f o ur
:>CCP:!.ve any
six o unces of urs Li-r ain .rtlcoh ol and that thPy uid not
and seven ty tvrn
dur i ng the month and that U:ey nad on ho.na t'our gal lone-
ounce s of
urE ..Jruin _ le t,ol the first da)' of t,b.rch 1924 .
1
i ven under !:!lY ho.no tli is fourt h do.y of "arch 19 ~4
In the Cler 's Ofr!
Rockln .h County1 V ,
FIi
AR
1.?
___ ___ _Ger
�J
�St te
f Virg i n i a ,
City o f Herr sonburg to wi t :
Th s day
oh..11.
. Re i l ly , Pr·es • .: r-~gr . of L . 1-1 . Ot t Drue Co . ,
_ersone.ll y
&.p eared b e for"' me , J . E . L . Hu 0 hf's , no t"'.r:• Publ i c , un '1 r,~o. 4s oath . that on
!.a rch 1924 t 1c, la 1 on h nd four c:nllons and sev en y
he f i rst de,,r o f
wo oun ~s o f
rF Gra i n
he month 8nd t'1a
l coho l
nc1 t :::it they did no
hf'y h9.d on hand three
.,illo s un<i onP. hundred nnd
.::;ht o un c es of pu re Grain _ lcohol the f irst dp
o f :.:)ri:!. 1g24 .
pril
~
£. ' ; ( ~
J
G v en und er my hand t'iis fo•1rth dn:; of
J·
re~e i vc an:' during
J
�Jl'tut
m,v, Va.,
I
'\PR8· t9?4
�tate of Vi.sinia ,
1• +,
of Harrison burg to Tilt:
This day John J .
eiL. y,
r-L, .
: r1:Gr ·
or
T . !-i . Ott
rug co .
persona lly
a pearEd before rr· , J . L . L . Hughes, Uotai·:,' Public , .... nd rm .e oath that on
he fj rs
day of
pril they hud on l'u.ncl thrf c 6 allon s and one hundred
and eight ounces cf
aYJ.7
during the month
urc- Gr, in 1~lcohol and that the~· r1 1 d
~
ot receive
nd tha-:-J they had on hand thrt'e gallons and fifty
ei:·ht ounces pure Urain .. le hol the
Flied In the Clerk's Offill
Rockli:.ghaPl County, ~1,
1AY 5· 19?A
----S AMk
-=--..
1
i1-.st
·ia:·
of t,,,ay 1924 .
�..
�State of Vi rginia,
City of Harrisonburg to wit:
This day John J. Reilly, Pree. & Mgr . of L. H. Ott Drug
co .,
per~onally
appeared before me , J.E.L.Hughes , Notary Public, and made oath that on
the firat day of May 1924 they h ad on hand three gallons and fifty ei ght
ounc es
or
Pure Lira.in Alcohol and that they did not receive any during
th , month and that they had on hand three gallons and two ounces or
Pure Grain Alcohol the second day of June -1924 .
Given under my h a nd this fourth day of June 1924.
��state of Virginia.,
City of Harri sonburg to wit:
This day John J. Reilly., Pres. & Mgr. of t he L. H. Ot,t Drug c o . , pe r sonall y
apPeare·d before
me, J.E.L. Hughes., Notary Publ i c, and made oath tha t on
th e first day of June 1924 they had on hand three gallons and two ounces
of Pure Grain Alcohol and that they did not receive any during the
month and that they had on hand two gallon s and ninty eight ounces the
first day of July 1924.
Given under my hand this fourth day of July 1924•
c/' ·E:. c<, ~
,
1
tied th Clerk'
ockfo~aot Coullty, Va.
' · I,?,
J
~
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I
_ ______CM
I
!
•
�HARR ISONB URG ATHLE TIC ASSO CIATIO N
HARRISO NBURG, V I RG I NIA
I
�Sta te of Virginia,
City of Harri ~o nburg to wit;
Thi ~ d a y John J .
eill y , Pre:s o & Mgr . o f L . IL Ott Drug Co., per 3onally
ap peared be t ore me, J.E . L . Hughe s., lotury Public, und made oat h th
the fir :s t da
on
of J uly 192~ they had on hand two gal l omi and ninty eight
ounces of Pure ijr a i n Alcohol ancl t h at the y did not rec ive any during
t h• month a nd t hat t hey had on hand one gttl lon and nne hundred and four -
teen ounces the f ir:s t d·y of Augu~t 1 92¼•
Given und e r my hand this fourth da y of
q , E:.
~r· .:
_.,-------tart
(
ugust 192~ .
dL_2 ~
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J o
h
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! A
~' 11d
t
..r
ITO
·ll ... 1 1
.L
vJ
.,
'l
o't '
' :·
) rj;, · •
b '1DJrnrl
'1
lb \:- LJ'
Jon
n o o.
H
j
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. '1
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j
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... l
n
1.o
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0
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l·u1b
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'11
ln.t tJ
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i ..,
0
.JO
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�State of Virginia,
City o
Ha r ri 8onburg to wit:
Thi s day John J . Heill.y , Pr
appeared
for
S•
& ~gr. of the L . H . Ott Drug Go . , per~onally
me, J. L . L. Hught~ 3, No tary Public , and made oath that on
the fir~t d a y of Augu 15t 1924 tlw ~; had on hand one gallon and one hundred
and fourteen ounc ~ of Pu re ch·ain .Alcohol and that theJ did not receive
an y during the month and t h ey had on h and on· gallon and ninty nine ounce!!
th
fi rl5t d yo
Septemb r 192~.
Giv n under my hand thi5 fourth day of September 192, o
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�tate of Virg · n a ,
City of Harri sonburg to wit :
res . & Mgr . o r the L . Ii. Ott
Thi s day John J . Reil y ,
before me ,
J . E . L. Hughe s , Notary
first day of S ptembe r , 1 924 ,
day of
ad
ad
oath that on the
they had on h u rid o np gall o n and nint~, nine
ounce s of Pure Lrrain . .LCohol and that
the month a n d they
bl i c , and
:::-ug Go ., appeare d
they did not r ece ive any during
n h a nd one Gal lon and n i nty n-nA munce s the first
cto ber 1924 •
Given under my h a nd th is four h d ay of
fi\ed in the C'•- \ Cf
Rockingi.c1r·1
C,T . °Q
ctober 1924,
�t
.,
"
r
...
�S
· 7irgin a ,
ate
o wit:
City of Sarrt on urg
Thi
Jo hn J . Reilly ,
c1a
"pp a red be fo Y'('
fir s
ay of
ounce s of
;n?,
re s.
::..C
rtigr . of t he L . !I . Ott
J . 1i:.L . Huglrn .,, Ho o.r y
ctober , 1 924, thG J hv.c
lc o h ol and tha.t
'rP Gra n
month and t h~t th
hr d
rug Co ., p rsonnlly
ubl ic , J.nd ma e
a t h tha
o n the
u'1 h u ml one ~allon ancl n i nty ni~
he~, did n t receive any durinG th .
n n .:...1d one [; ..tllon and fort'
five ouncP- s the firs:.
day of Novemb er 1924 .
Given under my hand this fourth day of Nov embe r 1924 •
J;t: ;{: d~ L
/L--dl~~~--
~~
Fi! d in the Clerk'~ Offic~
Rocki ~h~ f11 Gvunty, Va,
MO'• _ll 1924
--- Oierk
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-
)-~ ~I/
1;,. l
, r0I',
��St ate of Vi r ~i r i a ,
o wit:
i ty of Harri son urg
Th is da y J oh n J . Re illJ
a p eare a be for
me , J .
Pres ,
!r,
t\3 r . o f t h , L . H . Ot t. Dru~
.lcoho l
1
he f ir st dn;
the
c::11d f o rty fiv e
~m tl t ha rJ t h8 y cl i d no t rec e i ve n ny duri nc: the
.or-. h and t hat t hey ho.d on 1w rn1 o~, E~ h u n dre d anc1 1, ..,c, ou•1(W 8 o f
Llcc h ol
pe r...,o n a l l~r
. L . !I [:h<"'s , · .fot a ry Publ i c , a n il n cde oath that o r
fL s t day of Nov embG r 1 92·1 :-118,'. r,:..:.o on lwn<l one g c1l l ~
oun c-.e s of pu r e Gy,a i n
;O • ,
.P1rc Gr ai n
f De c e mb ey, l! 24 .
'
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------
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��Sta te of Virgi nia ,
City of Har r isonbu r g to wit :
na l ly
r . of t he L , H. Ott Dr g Co . , per so
Th i s da y J ohn J . Re i l l y , Pr s . & Mg
the
ta r y Pub l i c , and made oa t h t hat on
No
~,
ghe
Hu
L.
.
E
.
J
,
me
re
o
brf
ed
r
pea
ap
on han d one hun d y,ed a nd two oun ces
fi rs t day of De cem ber 19 24 the y ha d
th
d id not r e ce iv e an y dur i ng the mon
of Ptjre Ura i n Al coh ol a nd t ha t t he y
oun c e s of Pur e Gr a in Alc oh ol t he
a nd tha t t hey ha d on h a nd s i x ty f our
fir s t day of J a nua r y 1 9 25 .
of Jan uar y 192 5 .
Gi ven u nd e r my h and t h is th ird day
l
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��State of Virgi n ia,
Ci ty of Ha r r i sonbu r g to wit:
Thi s day J ohn J . Rei l y, Pre s . &
a ppeare d befo re me, J . E. L . HUghe s,
gr . of t he L . H. Ott Dru g Co . personal y
O&a ry Publ i c , and made oat h t hat on t he
fi r st day of J anuary 1924 t hey had on h an d s i xty fou r ounces of Pure Gr ain
Al cohol and t ha t t hey d id no t re ce i ve any du ri ng the mon th an d t hat t h e y had
on h and s i x t een o unc e s t h e f i rst day of Feb r uary 19 24.
Gi v en und er my h an d this t hi rd day of Fe bruar y 1924.
's Offtce
a
fl \ed \n the C\er k
Rockingham County, V .
fiB 6 a\925
--------···
C-\erk
�L
o-!:-
�Stat ~ of Virg inia ,
City of Harr 1.son burg to wit :
This day John J . Re i lly , Pres .
&
Mgr . of the L . H. Ott Drug
co. ,
pers onal ly
app ared befo re m€ , J.E . L . Hugh es, Nota ry
Publ ic , and made oath that on
the " econ d ay of Febr uary 1925 t e y had on
h and sixte en ounc es of pure Grai ·
Alco hol and
that they rece ived five gall ons duri n g the mont
h and that they
had o hand f our gall on one hund red and twel ve
ounc es of Pure Grai n Alco hol
th seco nd day of Marc h 1925 •
Give n unde r my h and this four th dey of Marc h 1925
.
7 .G c X :~ ~ ~
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~~
/:'7 ~6
�...
)
�3ts ta o
Vi ~i~i a,
City of Hit.rr i z.n b u r g t o v1i t ,
L. E . Ott Dr ue: Cc • ., p e r· ·on ....Jly
This d~.y John J . Re illy , ? re l:i• ~ Mi.;r ~ of
ic , and made oath tl:att on
a ppe ll.r ed befo re me , J . E . L . Hu ,)1 P ~, No tc.ry Pu
a n d f our 3 0.llo n l::l :..n d o n
the fi rst d y o f Apr il 1 9 2 5 the y h a d on ~
u r e Gr uin 1..l co l1 1 .,.rd. tri ;.,. t. t.!'" e ~r cl id not
hund red ;and twel v e ou n c e ~
&d on 1.~d f c1..1 r _:: ; al l on t. :;r1d
rece ive any d u rin e t he mo n th a n d t h ~ t t ey h
1
• even ounc es the firs t d a y of
Ll. y 1 9 25 .
- -- - - ---------····· G-1.trk
��•
State of Virg inia,
City of Ha r ris onbu rg to wit:
This day John J . Reil ly, Pres . & Mgr . of L. H. Ott Drug
Co ., perso nally
apPe ared befo re me, J.E . L . Hugh es, Nota ry Publ ic, :,.nd
made oath that on
the firs t day of May they had on hand four gallo ns and
seven ounc es of
Pure urain Alco hol and that they did not recei ve any
durin g the month ,
and that they had on hand three gallo ns and ~ne hund
red and three
ounc es of Pure Grai"x'i°' Alco hol t h e l'iis'ts tday of 4une 19
25 .
.
' •,;,
Give n unde r my hand this fifth day of June 1925 .
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no
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lo aeorwo nevee brus anol.Ls~ 'Iuo1 bn.srl nob rl v;erlj v;sM 1o
,ri.tnom erlJ ;gnl'Iub v;na evleoe'I jon blb v;erlJ' j.srlJ bn.s Io.cioolA
eS'Irlj
brus
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-
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anoIIna ee'IrlJ bn.srl no b.srl v;er.fj j_erl.t bn.s
enuA 1o v;sbjasn erl.t lorlooIA nl.s'ID e'I.u<l 1o a sonuo
enut 'lo
v;.sb
rlJ-111 e.trfj bn.s.d \:ID
rie bnu
nevlO
�State of Vi r ginia.,
City of H rrisonbu r g to wit;
This day John J . Reilly , Pre s . & Mgr . of the L. Ii . Ott Drug Co . , perso n lly
appeared b rfore me , J . E. L . Hugh es, l'Jotary Public , and mo.de oath that on
th e firs t day of Sept~mber t h ey had on h and three gallons and three ou nce s
of Pure Grain Alcohol , and that they did no t re ceive a ny du r ing th~ month
a nd that they h don hand two gallons a nd one hund re d and e1even ou nces
the first day of October 1925 .
Given u nde r my l and this third da y of Oc tobe r 1925 .
FU- _in thr Clerk's Of I e
R ck1ngham County V
CT ~ II' 2
-----------
-···
' a.
rk
��St te of Virginia ,
City of Ha rriso nburg to wit:
'T'hi s day John J .
eilly , Pre s . tc ,L r . of th~ L. H. Ott Drug Co . ,
a peared befo r e rue ,
er ...<
'~-
ly
J . • . L . Hughe , Notary Pu bli c , and ma d e o a th t hat o n
t b , fi r s t day of ocyo b~ r they had
eleven ou P- c e ~ of Pure Grui n
1
l cono
0 11
h .: d t wo t:al lo 1 s and o ne hundred a.n d
a. d t hat t hey d id no t
rec ei v e a n y
du ri ng t he mo nth a nd th t t he y had on ha ~1d t wo. g all o n s and ni n ty ou nce
first day of ~ove mb r 1925 .
the
�.
~ ~
...
�State of Virgi ni a. ,
City of Harri enburg, to 1(i t ;
This day J ohn J . Reil l y , Pres. & Mg r . of the L . H. Ott Drug Co ., p ersonall y
appe a red befo r e
th
me, J . E• . L • Hughe s , Ifota ry Public , and ma.de oath t hat o n
fi r s t day of Nov ember t h e y had on hand two gallons a nd ninty ounces of
Fure Gra in Alcohol a nd tha t they did not re ceive
ny du r i ng the mont h and
the y had on hand two gallons and sixty six ounc e s the f ir s t da y
or
Dec ember, 1925 .
Given unde r my h a nd thi s fourth day of Decembe r 19 25 .
Filed in the Clerk's Office
Rockingham County, Va,
liE-C f 1925
-/2_f3
--..•··-----·------·------ ~rnerk
{ ~--··-. lcu10
.......
�l
•
•
�S~a te of Vi rgin i a ,
City o f Har riso nbu rg t o wi t :
This d ay John J . rte illy , Pres . &
gr . of L . H. Ott Drug Co . , pers ona lly
appe ared befo re me , J . E . L . Hugh e s, No tary
Pub lic, and made oath that on
the fi rst day of Aug ust 1925 they had on hand
thre e gall ons and thir ty
five ounc es of Pure ~rai n Alco hol, a nd t h at
. they did not rece ive a ny
duri ng t he mo n th , a nd that t h ey had o n h a nd
t h ree gall o ns and thre e ounc e s
t h e firs t day of Sept emb er 1925 .
- ...
Give n und er my hand t hi
fogr th day of Sept emb e r 1923 .
I
�✓
.-
.• .
.. <-.;• .
�Sta t e of Virgi nia,
City of Harri sonbu rg to wit;
This day John J . Reill y, Pres .
&
Mgr. of L. 1-L Ott Drug Co., perso nally
appea red befor e me, J . E. L . Hughe s, Notar y Publi c, and made
oath that on
the first day of July t hey had on hand three gal lons and sixty
one ounce s
of Pure ~rain Alco hol a nd that they did not recei ve a ny durin
g the
month and that they had on hand three gallo ns and thirt y five
ounce s the
f irst day og Augu st 1925 •
Given u nder my hand this f ourth day of Augus t 1925 .
�-
;,,'
�State of Virgin ia,
City of Harriso nburg to wit:
This day John J . Reilly , Pres. & Mgr . of the L . H. Ott Drug Go ., person al ly
appeare d before me, J. E. L . Hugh s, No t ary Publ ic, and made oath t ha t on
the first day of June they had on hand three gal lons and one hundred an d
thr ee ounces of Pure Grain Alco hol , and that they did not receive any
during the month , and that they nad on h and t h ree gallon s and sixty one
ounces the fir st day of July 1925.
Given u _der my hand t h is third day of JUly 1925.
.'
.
�JOHN
J. REILLY, Pre,.
& Mrr.
W. C. REILLY, Sec. & Treas.
ESTABLISHED 1856
INCORPORATED 1904
THE L. Ii. OTT DRUG COMPANY
SODA
STATIONERY
TOILET ARTICLES
PATEN T MEDICINES
KODAKS AND SUPPLIES
The REXALL Store
CIGARS
FLASHLIGHTS
FINE PERFUMES
REXALL REMEDIES
LIGGETT'S CHOCOLATES
SOUTH-EAST CORNER PUBLIC SQUARE
HARRISONBURG, VIRGINIA
.;J .
�State or Virgi nia,
City of Harri sonbu rg t.o wit:
p e rsona lly
This day John J . a.ill y , Pr·es . & !gr . of' L. H. Ot t Drt,lg Co.,
t h that
appea red befor e me, J . E. L. Hu hes, Notar y Publi c, and made oa
engag e 1n the
afte r J une 30, 1925, the s aid L . H. Ott Drug Co . would not
.i"..rl'ther, busin ess of Wholes ale Narco tics, undor Class 2 .
Given under my h and this thirt ieth d ay of J une 1925 .
• ~ •
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Liquor Inventory
Description
An account of the resource
Series III of the Prohibition Records collection consists of records documenting the inventory, sale, and transport of alcohol for medicinal purposes in Rockingham County. This series contains printed inventory records of the alcohol on hand of licensed commercial businesses during prohibition. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Identifier
An unambiguous reference to the resource within a given context
Pro003
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/6">Prohibition Records: Affidavits for Ardent Spirits</a><br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Liquor Inventory of Businesses: 4
Description
An account of the resource
(N-O) Printed and signed letters by a notary public reporting the on hand stock of alcohol of licensed commerical businesses.
Subject
The topic of the resource
liquor
inventory
commercial
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-017
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
-
https://omeka.lib.jmu.edu/erp/files/original/20458ffb4bb9f8702bd74f5eeb78eefb.pdf
f16b24493b2738cdeeb035f5edcfa96f
PDF Text
Text
FLETCHERS' PHARMACY
Harrisonburg, Virginia.
R port of
le teller Br os . of r;e.rrisonburG , Va . in a ccordance \' i th ':'he Prmrision of Sec . 14
of ChaptP.r 146 of The A ts of the i.ss ,rih ly of Yirginie 1916 .
AJ11 01J.nt of Grain Alcohol on hs.nd Ja.ny . l, 1918 3 Fints .
P."!': 0111,t of Grain Alcohol rece ivl'!d during Jany . , 1918 4 7/8 Gallons .
.-!mount Grain
lco ho l or hun d Feby 4th . 1918, 7 Pints .
- - -- - - - -- -- - - - ---
-
-
-
- -- --
-
-
State of Virginia, Rockingham County, to-wit:
I
c . D . B E A,:8D
,
;;J? -Jj~
a Notary Public in and far said County,
~ ,' ,:·-
do ce~tify that
p er ~ appeared befare me and made oath that the above account . . :
of ~
UJAA/4r kYfhro
vs _ _ _ _ _ _ _ _ _ __
for $ _ _ _ _ _ _ _is just and correct mtti #~e
SRHUJ
is ,bw and
1Mtptti-d,
the best of his knowledge and belief.
Given under my hand this
1--/--:
trr
·_ /
~
~
L l . L ~ ~,;c--- - - ,
191L
-
,
�FLETCHERSt PHARMAC
Y
Harrisonburg, Virginia.
Re po rt of ?le t he r Fro
:;; . of 1:, rr:i son bu r , ~Ta
. in acc ord anc e Yi th
6
':'he Pro ri ion of Se c .
14
of Ch 8p tPr 1% of Th e
A ts of the ss .r'J.hly
of 'lir gin ie. 191 6 .
I 0•1 nt of Gr in lco l-io
l on r.an d Jen y . i, 191
8 3 Fin ts .
r::om,t cf Gr ain Al co ho l
rec ~i Vt')d du rin e; Jan y .
, l91 8 4 7 /8 Ga llo ns .
mo unt "ra in lco ho l or
ha d F by 4th . 191 8 ,
7 Pi nts .
.J{}~ ~
-
��FLETCHERS' PHARMACY
Harris onburg . Virginia.
Ft"por t of ...,.letc her .Dros . of P rrison hurg,
of Sec . 14 o
e . in rccordo .nc,.. v·ith T½e Provis ion of
c1,rte r 14G of the .cts oi.' th~ .sse-nb ly of "irgjn i
A.."no':nt Gr in f_lcoh 1 on h r..d :!<'eby 4th . 1 18 7 p:i.Pts
.Amount ,r in
lcohol r cei v~d dur:ilmg
fomoun t Gr in
lcchol
eby . 1918 4 7 /8 G lli)n;:.
State of Virgin ia, ,R ocking ham Count y, to-wit:
I,--- - --,-,--='--'-- ._,/.~
do certify that -',,;,L_- -=-- ~'......::'...!~~::1.L.~=-= - - - --rti~ ':----=
cr--p ersonal ly appeare d be.fore me and made oath that the above a6coan
of
vs _ _ _ _ _ __
for $ ___ ___ _ is just and correct a11d thB &ame ir ,lite o1ud amfJ61id.
, to
the best oj his knowle dge and b e l z " e f . !
f= day of- ~ 1f , 191 7
~ ·---'-La-"---" "'Q, __,~ ~~~~
~ -N. P.
Given under my hand this
m
~?-t)
1//X>
1516 .
�FLETCHERS' PHARMACY
Harrisonburg, Virginia .
. enort of -,letcher ""ros . of H rrjsonbuq; , v
of f: c . 14 o
mo~nt '}
Cr pter 146 of the . cts oi' th
ir. ;.. lc oh 1 on hi.cl !<'eb,
lcoho l re c eiv~d d ur ilm g
.Ar:sount Gr in
lcchol
hand , re
ccord ncP with The
0
rov;~ion of
. sserrbly of 1 'irgi n-i~ 1516 .
•1th . 1 18 7 n:ints
Amount ,rain
1.
i:
eb,, . 1918 4 7/8 Gal)i)11::;
�i
•.
�FLETCHERS' PHARMACY
Harrisonburg , V irginia.
Report of Fl Atcher Brus e of &>rr isonhnrE , VG. . in a.ccorcl,i; n~"' with ThP. Provision of Sec .
14 of Chapter 146 of the Acts of -:;1e Asse;,.,hly o~ Virginia. 19lr5 .
Ga:
Amount Gra.in Alcohol on hand } arch lst . 1918 - 3
m
7JPint"' .
ount ,re.in Al ohol t·t•'!Aiv"'d during 'arch 1918 ...o
State of Virginia, Rockingham County, to-wit:
J,
c.
,
D . B E ARD
;f
a Notary P ubl£c i n and far said County,
~
:;l-~
otf~
(ii'
do certify that
p ersonally app eared befare me and m ade oath that the above "te660U P~I.
•
o.f-- -- - -- - - - - - - - - vs _ _ _ _ _ _ _ _ _ __
for $ _ _ _ _ _ _ _ is just and correct and th r 1 nr c is fH r
the best of Ms knowledge and belief.
Given under my hand this
..!J
J Co ,
..
1
Hiip&z'J, to
�FLETCHERS' PHARMACY
Harrisonburg. Virginia.
Report of FlAtcher Br . ., o
Herr.i.sonh uq:, V• . jn a. corcl.e.n ° ·rith The Provision o
14 of Cha.pter 146 of the Acts of the Asse hl
of Virginia. 191A .
Amount Grain Alcohol on hand } arch lst . lQl8 - 3 Ga, 1 :ms 7}Pints .
l"JO
nt r, a.in Alcohol t·t• ~eiv,::,d d1 ring fa.rch 1918 - 0
mt Gr ain Alcoliol nn hand April I s t 1918 -
o.
Sec .
�•
�FLETCHERS' PHARMACY
Harrisonburg, Virginia.
Report of rletcher B
Charter 146 of +he
Mount
rain
Amo•·n
Grain
M
.
of rarrisonlmr-g,
'£ .
cts of The Jlssen'bly o"
ir: &.ccorde.ncf with 'Ihe Frovif,ion of Sec . 14 of
iq;in
a
1\'.JJC .
lcohol on he.mt April 1, 1918 0
1
cohol. recl'3iVPd dtrine; Apri J 19lR 4 7/8/ Gfllons .
State of Virginia, Rockingham County, to-wit:
J,
c . D.
,
B E ARD
a Notary Public in and for said County ,
;{/4~
do cer tify that d < P
p ersonally app eared befa r e me and made oath that the above
0/-- - - - - - - - - - - - - --
f l ~
-
vs _ _
for $ _ _ __ _ __ is just and correct a,iti
f.hB M;im c i s
due and u npaid:, t-e-
the best of his knowledge and belief.
Gz"ven under my hand this
I
day o.f/4
•Y
m mi
2w'3;:o/
,191L
~ ~ N . P.
c;I/-ijd ?-0 ,
~ If re>
�FLETCHERS' PHARMACY
Harrisonburg. Virginia.
Fe po rt of Fle che r :S
cH:i .
of
-a.r ris onb urg ,
Cha yite r 146 of +he J.c ts
of The l\as ew bly
fl aun t
,re. i
.J"
r€. .
ir, r,-c cor de.n ce v ith ' The
Fro viR ior , of Sec . 14 of
,.ir gin
a rnH; .
lco ho l on },an d Ap ril 1 ,
191 8 0
t Ge .in "lc nh ol rec eiv Pd dtr
ine ; Ap dJ 191 8 4 7/8 / G&
l)o rs .
:i n A coh o) o"'l. han d ; ay
1 , 181 8 1 3/8 Ga llo ns .
��FLETCHER'S PHARMACY
HARRISONBURG, VA.
Report o·
Fl'°'tcher Br os , of Ha.rrisonbur g , Vf'l . i
Cha. t~r 146 of th
Acts of The Asse~bl
ccordance with The Provision of Sec 14 of .
of' Vi gin:i ·- HHS .
Amo .v1t Grein u~ohol on ha.nd 'a.y 1 , 1918 - 1 gall. 3 pts .
Amount, Grain Alcohol rE'lc~ived dtu·i.ng :ira
1S18,
- 4 ,:;•. 11. 7 pts .
State of Virginia, Rockingham County, to-wit:
o.f-- - - - - - - - - - -- - - vs _ _ _ _ _ _ _ _ _ _ _ __
,rJ.
for $ _ _ _ _ _ __is just and correct ffl'IIUl t-be-3am·e--zr ifite
the he,f of ki, knnwledge and belief.
Given under my hand this
..
Co
'=f
n,.
dnyo.f~
~
In
atJtk---tctJpaid,
·
to
, 191L
~ ~ N . P.
d.tfl- ?-o 1 7 ?--r?
�FLETCHER'S PHARMAC
Y
HA RR ISO NB UR G, VA.
Re po rt o Fle tch er Br
os . of H• rri son bu rg , V~
. iYJ acc ord an ce wj th 1'h
Cha. t~ r 146 of the Ac
e Pr ov isi on of Sec 14
ts of he As sem bl~ , of
of .
Vi gin i 1~ 18 .
Arn.o 111 t Gr ein l\lc oh ol
on han d "a.y 1, 191 8 - 1
ga ll. 3 pts •
.A.mo,.n ,t, Gr ain Al co ho l
rec l"' ive d dw :·i ng ~!s 1S1
. 8, - t.. ~J.1 1 . 7 pts .
_ _ _ _ _ _ _ _ __.!..c= =
~ - int Gra .in Alc ll> hol on
han d Jun e 1 , 191R 3.t:;i'' 11
.
��FLETCHERS' PHARMACY
Harrisonburg, Virginia.
R port of
l"'tc
C pt r 14n of
,f'!
&o
he,
•
of Ea.rr:isonbu
f
. ir accorda.ncf with ThP. Provlsi n of Se . 14 of
,'
he Assem lu of Virginia 191P, .
of
A foohol
A:rou.
A 6uni. Gr &i
.• . ,·.
A cohol r
11
A.lcoho
e i ved d.,1rin
J ··.
191'
U' l lons 7 pints •
, = - ~ - - -, -"-~'--'o n he P.dt__.!,JL!J.J1l..i-~~ L.;o::i.._ -,,,__ :~:...-=-
-H--
-H-
State of Virginia, Rockingham County, to-wit:
, a Notary Public in and for said County,
of- - - - - - - - - - - - - - vs _ _ __ _ _ _ _ _ _ _ _ __
for $ _______ is just and correct and Ht"tJ
.M!inC
a·r
fi.i
iz "
i
11
1q,zzi1P; to
the best of his know ledge and belief
Given under my hand this
.:z.;
G. ••
,'.
'
·.
- ;'\
�FLETCHERS' PHARMACY
Harrisonburg, Virginia.
Report o.,.
1 tchP-
Chapte r 14.6 of
Bros • of Har i onbu g , 1
loe Acts o:£'
he Asserr
1.u
,
ir a.ccordancf with Thr-i Prov isi :"ln of Se • 14 of
of Virginia 1918 .
Awm+ .-G 5.n.Alcoriol on he.nd Jme 1 , 1918 .. 3 O"pJ.lons -zpirts
Arrou!1"
ri ,,, . ,,
A cchol,. ~f' i ved d..r i ng Jure ]9)6
, 191
-
7
.-.
Gallons 7 pints .
g llors .
G. ,
'
.'
-_
•' \
��FLETCHERS' PHARMACY
Harrisonburg. V irginia.
R"'por L of FlAtch
r
Bro<= . of
ct
ChaptRr 1 6 of Tt-ie
""1()1lnt
t1r in
iU!lOUl1t
flin
i
of T1
rrisorhure; , Va .
r·
s :'"''rnh 1., of
o>· ,
oiri
!"I"(>
i U t,' e ")rovL io
l!:}16 •
A)cohol on hond J ly 1, 1918 . 3 gallon
aunt lrre i..,
coh 1 roceiv d ,T ly 1918 . 4
gallons 7 p
ts .
lcohol on h"nd Aug: . 1 , 1918 , 3 gal 1 ons , _ 7 pin+s .
/~,
State of Virginia, Rockingham County, to-w it:
J,
c . D.
BE A RD
,
a Notary Public in and for sazd County,
ef:(f- (JC-~~
~ ._
do certify tftat
p ersonally appeared before me and made oatft tftat tfte a b o v e ~
o.f- - - - - - - - - - - - - - vs _ _ _ _ _ _ _ __
-!''(I
o1ud 1,.,,1,j;>o1a·d.; to
~
, 19~
for $ _ _ __ _ _ _ is just and correct eemi /Mo 5tmui a·s,
tfte best of !tis knowledge and belie.f.
Given under my hand this
,n
2...
dayoj:
<-dz.I -- ~ N . P.
0-qvt-~ ( 'f 7o
r/
of Se . 1 ~ of
�FLETCHERS' PHARMACY
.
Harrisonburg. Virginia.
Repo
of P'lt=itc er
Chapt.f>r 146 of The
ro" . of
ct
Al'l"cunt 11'" in A)cohol o
1
arrisorhurg ,
ra , ir.;.
cw an-~e
ith +,'e :,rovLion of Sec . l
of T
h" rJ. . : ly 1 , 1918 . 3 gallons .
, aunt" r.i.n lcoh 1 rP-ceiv d ,Tnly 191R . 4 gallons 7 r · nts .
mourt '}re i..,
lcohol o,, hand Aug . 1 , 1918 , 3 gaJ l.ons , 7
r ·n
s.
of
��I
,i
FLETCHERS' PHARM~ CY
H arrisonb urg, V irginia.
Report of F'l tc~tf!
f~
• 14. of
Bro • of Hn:rr· son burg ,
h pi. r l4S of 'ih
lr1101nt Gr, ln ALo ol on han
cordenoJ
e. . in
_. ts of the ./.l'l s embly of' v;.rginia 19lfi .
Sept . l
~18 ~ JE...llons
c p.:.nts .
1918 0
State of Virginia , Rocking ham County, to-wit:
do certify that ---"-'--«----'-'-_ _.~~o.LJ...L1-L L:..1.e::'.':::3.. ,c__ _ __ _ =:Afb)':;:.= ==-'--personall y appeared befare me and made oath that the above ~
o.f- - - - - - - - - -- -- -
vs _ _ _ _ _ _ _ _ _ _ _ _ __
for$
-is just and correct and t he w me -is due and unpaid, to
the best of his knowledge and belie.f.
~
Given under my hand this
I
dny o.f~---'- ~~-U--- - - - , 191_%_
,, ...
LG
ith the Prorisio n o~
N.P.
¢Y-<j4- ;l-0 F{
;J-.c)
�FLETCHERS' P H A ,l
RM~CY
H ar ris on bu rg , Virgin
ia.
F .po r t
~~ c . L
f f'l t c •·1 .r l1r c •
of Hnrr·· on tm rg ;, '
.. . • in
of ,h
ri.
r 1.. 5
lrH 01:n t ~r, in A l ...
o ol on
3:r&.in Al c o .o l r c
f ~'h
an
cor rlenc,
it h b
. ts of th , J. .. s m
bl y of -..-;. rg in ia 19
6.
Sl 8
..e.. lo ns :: p.:
ve d !l iri ng fe p •
19 18 0
Gr i n •. l,; 01'10 1 on
he.nd 0c t .1 1918 0
.nts •
Pr or ia io n of
�•
�FLETCHERSt PHARMACY
Harrisonburg, Virginia.
Report of "'"' l t .h r -rc,s . of
of C
OU
~O l
nun
r
pt"'r l C c-"
t .,r1:1 i n
Gr ir
cts of Th
I
l ohol on I ncl
r: ~ r",
t ''rai"' •
l
ho
r-rrr · so l rv- ,
r
on
C
ve
,
f' S l
,
'- .
'
dur·!l.
nd s--pt . J. '
1"11
17
i.n
c-nr
l ., ~f 'i 0 g;jn~A l" l
3 G l1 , 7
uo . 191
1'.'}l
•
p.:.
4 Gflll. 7
in
i:;
4 (i,All . 0
't.,J
el ~ (/"YU _,'/.
~ ~
{!,/fCl,~ J ~o~ , /J~
��.1 £) J
KTON, VA,, __
d._4_ ___ _/_ _______ 19i/_
~~$a-
__ J !__f_;JYU( ________________ , Clerk
Cir~uit Court of
Rockingham County, Virginia:
ALCOHOL
On
han0 .___ __ _ _
(/
Be ing ba la nce
Purchased dudng ~
(JJ~
,c
j
__
;!-o.f' __
2,_(Zffl "i9'·---
191!(___
om last mo nth .
V ,11
--- __ _.. _.. _19:tJ': ___ __
,,
_?f_~
~
_. ____________ __
La/
.
. Total ______ ____ __ _____ ____ ___ ____ ______ ____________ . __ ___ _
~
Balance on hand __
;J.~ _,__)__ ____
_jJ/y_ _____,gr!__
19£ . __ _
(/
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above me io d , tes.
______ _a_ __,_
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO -WIT :
Subscribed and sworn to before me, in the Count~ockingh am,
191£", by_f.-..,{:f;,_ __________________ _
this ___ / _______ day
d4..a______ ,
��l,
J.
VA., __
.r_~_Lft __ t
I I
o",___ ,
C
_l'!/Q______________
/l/_,u_L J ____ 19if
Clerk of the Circuit Court p f
.
Rockingham County, Virginia:
ALCOHOL
{I
tp✓-« ~
On hand_ ~ ~--- ··-/_ ____ _________ _19Jtf ___ ____L{ f
Pu rcbased dudng
t/1~
I/
Balance on band __
___ _
1/-7 -- j/'
iance from last mont h.
n~
_::f.~ _•___ .._. ___
;l"~--- ____ ------.::.:.:.:.:_
~7 , ~
191/f. ___ _
I/
'I'otaL ___ __________ ____ ____ __ ____ ______ ___ ____ _______ __ __ __
2lf_t?::!:
4L______
J9 _____ ------ ~ --- ~
"'
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburseme nts and quantity
of Ardent Spirits on hand at the above me~ ned dat
------
,.,
-
~~~
. o(.
- ---- - -------- ---------, -----------------·
��!l_k_c!I_ ___/_ __ ___________ 191f ______f3-:___z;;---)c_~--------
On hand __
Bein2 balance from last month.
Purchased during_Z!((½~c!{ ___ _____
191.f __ !_/_
!!;______ ~~----------
Jf'¼I ,,
1
</JA__,_/ ~Jtl.=,f-1!'/f // . '
Total _______ ____________ ___ __ __ _______ · __ ______________ . __ _
~ I::191L .. / l_
Balance on hanL .....
.& ...'!...........
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursement and quantity
of Ardent Spidts on hand at·t·he..~: ;: rz ~.s .. ········· ·········
��I
J :;]JI,, ;lTON, JA., ... &.4r .J _______l9£
--, Clerk of the Circuit Court of
·_( ______~_/.. ___ :f t {~ _J~
Rockingham County, Virginia:
ALCOHOL
On hand ____
ayt'.;~_<_~/_ ___ / ________191f
Pu rcbased during
t1/--t ____~
___ __
t ~nce from last month .
---~d_ ___ ____ 191 t_·_____ .){_~______________ _
Balance on hand ____
_}J_(~__ ____/______ 19-J:'____ ______f/,_ _____~
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburseme nts and quantity
,
of Ardent Spirits on hand at the above mentio~ / 4e~
STATE OF VIRGINIA ,
,,
=~ 7~ ~-
COUNTY OF ROCKINGH AM-TO-WIT :
Subscribed and sworn to before me, in the Co nt
this ___ / ____ __day oL2 _ ~--- ---, 1911:, by -- -~ "-
ckingham,
_________________ _
I ,------------- -~ ~ -- ------------- --My Commission ex'f)ires-~
- --~(_£ _____ 19 __ ./
��of
Rockin gham County , Virginia:
ALCOHOL
----- ______(_ __ _ ___ ______ __ 191~
--
- ✓----~-----
Bein2 balan ce from last mo nl h.
Purcha sed d
urlnt ~ - --. _ _
! 91
J:__ _}f_________ _
11
_______ _____
��J
~
L '
VA,, _
-~
To __ : ____ : ______________ __~ -------- ------ , Clerk of
Rockingham County, Virginia:
'8
-_,2-________ 191£
Circuit Court of
ALCOHOL
c__M_____ /_ __ ___________19uf __ ___
_i:___ ~~-
On hand __
Be ing b'!il a nce fr o m l ast mo n th.
Pu ,chased during- r-- ... __ _191,f
._..f
lc_______.__"_ _________ _
/o&
Ir _____ ____ _
Total ___ ______ ______ __ _____ __ ___ _______ ___ ___ ____
%--r-1 ~ ? ~
Balance on hand _______ __ _ ___ _/
~ J ~L
________ 191f ___ __z_
f __ f(_,?: ____ !(.. _______ __
/7/f
1
'
I h ereby certify tha~ the above inventory of Ardent Spirits is a
tru e and accurate state ment of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above mentioned da~
_________ __.f.
_-t.__ J _ ---r
----
��1 ~
E
~- __ !_/;)Lit._~
TON, VA., ..
-------------,
J-eM_. ..,/..19✓
Clerk ~{~:~-~ircuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand ____
~~ ___ _/
~ - - IJ~
l~nce fr om last month .
Purchased dur;ng ...... ¥
__ __
/L;____ _
_t____ _____ /f:_-U_
19lf__ ___ _J?tk
191
f ......?!..~...............
1 & /2 ~
~
-t&f~ --------?--i ------------;;----j ___ __191f ___ _
.,,.2_]2__f~ _____((__ ___ _
Balance on hand___
_____ ____ __
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements nd quantity
of Ardent S ph•; ts on hand atthe above m~ ~ dat __ . . .. .. . .
_. . ....
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO -WIT:
Subscribed and swor t-0 before me, in the Co n
'/
this ___________ day oL ~
f
-~
ockingham,
-------, 19L __ , by __ , _ -"-------~
~
-----
:Z::::: , /
/
---------·-----------· ~
----------------- 1tf ~
..071, k,r
My Commission extiiresf- ___~ __t_ _____ :-=::-:-::-:19 ~ ~ /
��J /) /J
---~_o!_ _,__
ELz.:__ lfo_'._/ /______ 191f
A,, ____
{~«6 _________ , Clerk of the Circuit
Court of
Rockingham County, Virginia:
ALCOHOL
{!)a_ ____ / ___________191-f
On hand __ __ ___
__
Bein g; balance from las t month .
.
~
f
/tJtfq~
Purchased d ur mg _____ _____________ ___ __ _19L _____ _______ ______ _________ _______ _
7~ r/
lf'/tf
~ ~'Peta]{J2
______ ____ _____ ___ ____ __ --- ----- -- -- ------ ---- ------ -Balance on hand ____
}i_d_ __L______ 191 F._ __ _____d__~ ______:_~-------
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Mdent Spidts on hand at the above me~ ~
------Ls..<:A--::::::::::::,::----- ·-·-- - ----
�'
�8 tf
, ;,\!LKTON, VA,,-----~
-'--- --~------[~M --~ ~------, Clerk of
Jl..,______J91/ '
-{!,:_: __ _
the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand___
?rlQ1'_/ ________
x~-___ _
c:{_~
3__,2 __v--
191_. f_ __
Being: ba lance from last mo nth.
191_ ___ . ___ __ ___ ______________________ _
Purchased during _____
Jlt:/7/- /~//
/ tz_
//
'I'otaJ__ ___ ___ _____ __ _____ __ __ --- ---------- ----- --- ----- ·---
Balance on hand ___
~___ [
Q(_(?_ _________ !(_____ __ __
____ __ 191 X_ __ __
I her eby certify thab the above inventory of Ardent Spirits is a
t r ue and accurate statement of all r eceipts, disbursements and quantity
of Ardent Spirits on hand at the above en i ed d ~
----.------,_____,---------------- y ·-- ---------p
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
this_~~~
~:a:n:/ ~4;::~~~~-: ::• ~ : : -~f . ~ ~ ~~i-n~~~-~-•--/ / / "Y'. .
- -- - ,.- -- ,, ---L ~ - - ___________________ ., ______ _
My Commission exyiire~
- : /f . ___ _19::>.,-/
��Rockingham County, Virginia .
ALCOHOL
k
. /
c:?C l ~
F' ___ __ _______ _______ ____ ______ _
On hand ____ ___ ________ ___ __ __ ___ _____ _____ __ 191 ______
Bein!? balance from last mon th.
Purchased during ___ ~
-~ --- --- -- -191 ~ --- _____________ ?:!_~----
J. ~
f
~ ~ ~ 'C9tad _____-____1r1
____ __ ___ __ ____ ---- -- ---- ------ ---- -- --- - --- ----- ____ / ______ 19y7 -- -- / f ------- //____ .--I hereby c tify that the above inventory of Ardent Spirits is a
true and accu te statement of all receipts, disbursements and quantity
of Ardent S pfrils on hand at .th•.•~ove .
2:;~. .
te . . . . . ....... .... . .... .
STATE OF VIRG !NIA,
COUNTY OF ROCKINGHAM-TO-WIT:
Subscribed and"swor~
this ..... ~ .day
~efore me, in the C<;Jnty of Rockingham,
u ==···: :.1.~~ ~:: : :
My Commission exf)ires~
_L c
_______ 191;J..,. /
��. J
To ___
j~
KTON, VA,,_____________
-'-----~--&a«r!.z::;,,_____ ,
___ pf
_________ l91.f'
Clerk o · he Circuit Court of
Rockingham County, Virginia:
ALCOHOL
Cl
On h and _~
/% __({~
____ !_ ____ _____ _____ _1919 ____ _
7 -·
lleinpalance from lasr month .
Purchased durinr ?-------- ___ -_191 f
--- _------------_
?!_~_--
/r -- - ------ ---- -- ------ - -
~ ~
/9 17
(!__ __ -
/ f
~
-
J_~_____ /_ _____ 191 7-__ ___ ___ ________ _(?_~--
Balance on hand ___
I h ereby certify that the above inventory of Ardent Spirits is a
true and accurate state ment of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above men~i:Z,:¾
----- -----
STATE OF VIRGINIA,
COUNTY OF ROCKIN GHAM-TO-WIT :
. S~✓ed and s~ dbefore me, in the 7 ~ckingham,
th1s ____ __ ______ day of_ ______ ______ _____ , 191
bY- --~----' --------- ___________ _
~
My Commission expire,~
/
r:_: ___ 19 _7-:c /
��J, 8 ;J
.E»'TON,
VA,, __
!lft:1&&! _4-___ l9ijl
'f:,1_ _l f ~-- --, Clerk of the Circuit Court of
- ~ ____ _t_ _____
Rockingham County, Virginia :
ALCOHOL
J _~_t_·_ _ _/ _ _ _ _ _ _
On hand ____ _
191 '?_ ___ ____ ____
/
Bei ~ orn l ast month .
---✓4-
Pu ,chased ducing
---
19~
)1~
------
--
--- ___
q{_.f_,' f_j_rd
'I'otal ______ ______ __ ___ ______ _ ---- ------ ------------- -- - -- --
!Jit!_4d__/_____
Balance on hand ___
i __t_[.J_ ___
l91 _____ __
__'!:( __
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Acdent Spirits on band at the above mention d•~
____________ .f ___ ' -----====----- ---- -- --- -
��, /] ~K~~
j'
V
A,,- ~
_! ~ ( ' _ ~~ i ( ~
__
Zc:_ ______
19f?
Cl~1l -~~--~~~-~ircuit Court of
Rockingham County, Virginia:
ALCOHOL
}Jf_M~ __/ __________191 ? __ _ __ _s2_/:i __Ez____
7~d
----
On h and __
Bei n~ balance from last month .
Purchased during ____
/
--
lf(~~-----191,1----______ ___________ )f__~_
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT :
Subscribed and sworn to before me, in the Com~
this ___,j______day of_~
, 191J,i, by_ ~ ~ -~
__5.Pckingham,
-----
-------~M ------ ------------ -----My Commission ex'f)ires_ -~
__
L!_______ 19 _'7.: /
��I :1
/),?
EL~ VA.,-$.o/----~--------197 '
-~ d ( ! _ ~ ~-----------,
Clerk /( the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
~ ____ __19lf
Purchased during __
CJ/AJ ~-- ~ ~
~
Balance on hand __
-- - ____ } 1 ~----------
II
c3ff'
1/
/PE.
--- ---- ----- ___ _______ ___ ___________ __ ___ _
~
ta~
_m__ __ _(_______
(/_£_ __________ ~~-----
191 ________
I hereby certify tha~ the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above enti ned d~s~
__ ________
__.______ '-- ______ ?.:-/2_>-Z/ _____
/
��J. f7t y,J ______________,
'l1o _ __t_ __ __ ! __ f_J_c __
~
-------------✓- ---191
VA,,---
k of the Circuit Court of
Rockingham County, Virginia :
ALCOHOL
~ ---/_ ___ _ _______
JJ1~
19l~ ___
On h and __
eei p
·• •ce from last mont h.
Purchased during ____
/ ·-
m_o/----_--
. 191/ ----
<JI~___,_;,,_ ;,ff/
d/Y
d£ __t{~ -----~-----------7t._~------
3h (2k
T ot al ___ ___ __ __ __ ___ _____ __ __ ____ ___ __ _______ ______ _______ _
��J qt,
-----J .-------1~17
JykTON, VA., ___: - ---_______ . : 6 ( ~, ! ~--- , ;C!drk of the C1rcmt Court of
Rockingham County, Virginl /
ALCOHOL
On hand _____ _________ ______(_ _____ _____ _1917-'__ _ _______
r - -_
q_~~-
f ____
Being balance fro m last month.
1911 --- _j__c:!__1____ _____ If__ __ ----·
Pu ,chased dudng __ _
b _________
1 1 ___ ___
~
I/
TotaL ___ _________ __________ / / _
~ ~ ~
~
AA,,<./\../'-?
____ . /
___
191_ ----
J_.
__
. Jf( ------ // ---------
��.J:::::•
-:'J /) j
___ ___'!::_ ______ 191'j_
VA,,-----~
__ cf!__ / ;}__~/,_ _______________ ,
Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
t?;z!_ ___ (l__~_
On hand ___ _ --- ------ _______ /_ ___ _______ _191f ___ __
Being bal nee from last mon th .
/
---- --___ }!~
Purchased
-- '
----------------------------------
// - A., 11ldv~ta] jl - -----_3_ -----'I ---------\. t aL _ i . .
B•l;n:r:::::.::f:Mt:~:~~--,: :~:~-~~:,::~:- ~~i:i~:-~~-:-
of
abo? t~-- - - - --- - -
true and accurate statement of all receipts, disbursements and quantity
Ardent Spirits on hand at the
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
Subscribed and sworn to before me, in the Co~ t ~ : : U , ~m,
this_
0_-::::-__ day oL~
- ----, 191~
✓~7"---
-----
My Commission expires
_if:./.K/,f.'.
' ~
- - " - - _, __ _____________
194.-/
77
____ _
.,(___ ,__ -------.
��.J (it:«_(i~
v ... ,_ --lf)(~----~ ---191f'
____________
___ , Clerk
- ~---- ! __ f'::-:f-.. ___
of the Circuit Court of
Rockingh am County, Virginia:
ALCOHOL
On band ___
~ ____ _( _ ~ _____ _19l tt1-___ __b tJ ____ ~
p · alance from last month.
Pu ,chased dudng __
/ · •
~ ___ _. 191 f
-- - ____________ _?,{_~ -
~ ~ ~ -·____J _r_t'_______ ~~--------~- --
��Rockingham County, Virginia:
{t
On hand __ __
ALCOHOL
(Q_t;_}:__ ___! ____ ________191~
Be i ng ba lance f rom last mo nth ,
(t1_ ___ ~
Y--'
--- ___!
{!)_q_ ___________ 191_f __ _ ------- ---------~ ~--
Purchased during ___ _
'a-
l'y/f7
;Jt
~~
Tot ct ___ ___ ____ __ ___ ___ _____ _ ---- ------ -- --- ----------- ----
~~ ____ ./ _____ l9L~ --- __ L_~ _________ !(.. __ ~-----
Balance on hand _____
I h ereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburseme nts and quantity
of Ardent Spirits on hand at the above rnentio d dates.
��/J/J ELK;?N, VA,,--~
__J ~r'__l~ . / _ ~ Clerk
---- ~
_____ 19i:(;
of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On h and ____
lJJ_~
__ _/ ___ ________ mi-I:,_ ________ ___ __j/_~------
n ein 2: balance fro m l as t mon th .
)/f~ ______19-v__k ____________ }1_~------
Purchase d during __
Total ____ ___________ ___ _____ _ ____ ______ __ __ ________ __ _____ _
I h er eby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Mdent Spidts on
hand
at the
abov2e7.ds?z:----·· ---------
��ELK ON,
--L_________ l<J:B?..
VA,,---~
__l~c !/JI ~-,
Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand __
ll_ry___ / __________________19~-- -
_____ .2_/_f~ __
Bein2 balance from last month .
Purchased during ___
£'_q£_
/
Zl_ry___________l ~ - - - _________,?(~--------Tota] _______ ____ ___ ____ _____ _ ---- ---- ---- ---------- --- - ----
~ L_____ l9
Balance on hand _____ _______ ______
2-/ f'tV/
______ -------------- ---------- ------
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburseme nts and quantity
of Ardent Spirits on hand at the abov~ men ti~ -- d d~
~
-}- _
STATE OF VIRGINIA ,
COUNTY OF ROCKINGH AM-TO-WIT :
Subscribed and sworn to before me, in the Co~n~_!,,R ockingham ,
this ___ }l ______ day oL __~
,f)- - " - - 4 - - 1 ~ - - - n - - - - - - -
My Comml,sion oxpi"" '-~-
_/_f::_ ______ 19_7,J
��l
O
~
.4
ELKTON, VA., . .~ ~··· .......... .. 19 .
------- -, Clerk of the Circuit Court of
~
_ __.. _ _~
Rockingham County, Virginia :
ALCOHOL
/!-f!Y__ __/____ ._________
/!/_____~~~~---
~_& _-!!___
)!~
On hand __
191 ___ __ ___
Bei ng ba lance from l ast mon th.
Purchased during 'J(_d_ __
al~ '--- -
B alance on hand ... ...
191 ____ _ ______ __ _____ __
f -- c) __ __ ---- - S- --- µ-tr,,. -- --- -
•~&~c..L...
19 ..... .. .....CZ. .........!!.. ...... .
I her eby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above _. ent:__ •e d --- ~
--- --- ---- -----
STATE OF VIRGINIA,
COU NTY OF ROCKIN GHAM-TO-WIT:
this.~~~2~~~~~::n:/~~~~~~-: : :~
,th: . ~ ~-- ~~~ ingham,
��7' ;{) ,f
To _ __t_ J
I
~
· v ...
_<:_~ y ~---------------•
,_Jit-ud L___ 1!Ji:b.
Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand_~
(!~
} : _____/ ____·_ __ __ _______ 19i0 ___ _________ (2 ___
~
Purchased during __
~_____ __ ____ 19
'I'o~a] /
~~
7-
alance from last month.
L_t}__6_ __________'1_ ______ _
__-I?___ _
/ / _.S _____ ____ 1 1 __ ___ _
____ __ . ___ ____ __ _
d-~-
17'-2 o
Balance on hand_} 1 1 ~__ L_ __ __ 19 _/2.~--
/
11
L__~_/.z __________ !!__ _____ _
I h ereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursement s and quantity
of Ardent Spirits on hand at the above ment· ed
te .
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM -TO-WIT:
��.
On hand ___
l2/~ ____( ____________ 19142__ _ ____ /
0
6 __ (}zz-__
Being balance from last mont h.
Purchased during ___ ~ _____ l9L --~-- _________ ___ _____ ) ( _ ~
~
11/4~ -- ~--- -------- ---- -- ---- -- -- ------61----- -----{l;zz------- -
Balance on hand ____ _
- ---- _____4J- --- // _______ _
I h ereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Mdent Spirits on hand at the above ~zed~ ~----------STATE OF VIRG !NIA,
f
8
this ~r'.be:;n::,::r:: ::~,t:e:;~::_: ---------------COUNTY OF ROCKINGHAM-TO -WIT :
My Commission ex'f)ires~
- -- ---- __-#_ _19 __ ..
��(' ~
"· VA.?ll~-- 4=-_____
19
To ___ _'- --- -'---- ------- --- --- ------ ---- --- ---, Clerk# f the Circu
it Court of
/
Rocki ngham Count y, Virgin i a:
----,--- -L - - - ALCOHO
V
/_ __ _____ _l ~
-- __
//J\ _____ ~
Purchasedduring __~_____11lk,____ _______ _______ ___ )f_ ~
~ ~ T<fJ o/'? _7_ ~---
L~-
_2:_ _Z:_____ _~
Bal;n:r:::•:::~~ l~ -i~::n;~:,-~;--::~: :-~;i:i:: ;~-~-of Ardent Spfritson band theabovem.
-~.::z·-- - -
true and accur ate s tatem ent of all receip ts , disbu rseme
nts nd quant ity
at
��~ & ;t
ON, VA,,._
Yµ«L--/ '.'2!_19i?iJ!
-~- -~•-- ---- -- --· _______ ----- --- -- -, ~ -~~--~~~-~1rc mt Court of
Rockingham County, Vir ginia :
ALCOHOL
On hand __
/llf!:j{. ____/!!(-_____ ____
·--~-~-~--fk-~
7_
-,_ _
L_,f1_} -~-- _____ ~, ____·__ __
Beilv
19U)___
lance from last month.
1!]_
Pu rebased du ring __ ___
.
19M_ __
/ 2&
//
/ J....__
//
Total ___ _______ ___ _______ ____ · ··· ·- -- ------ ---- ---- ----· ·--
a
I hereby ert' y that the above inventory of Ardent Spirits is a
tru e and accu te s t ate ment of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above menti a d
---------- _.___ _., ____
------ -- -----
---· ····-- ·----
STATE OF VIRGINIA,
COUNTY OF ROCKING HAM- TO-WI T :
this s:;;crib~:. : ~ efor_:
My Commission ex•fr•s~
7~
the , . . . . ~-kin~~ -~•---
__ /_ ____ -----~
~
�fi led in tne Cit- rk' ' d:tl ce
.Rockin gham County , a,
j/JN
J-4920
- - - ~------- Cferfc
-
�.J. fl. /J
e,/(t:::_OI<, VA,, ___
_ ____,_Ly__{~------ -------------------,
U-,____
2_..________ 19~
~--~~--:e Circuit Court of
Rockingham County, Virginia:
ALCOHOL
on ban
/
___ __ ________ ____ _____ 19b
I ~/'J
___ __ / /______
.-;----
lance fro m las t month .
----___1912± _- ------- -------
Purchased durfor
-~
() .I J'J'-~
~~
Balance on hand ____ _
'
g/~
------ ----------------
---- -
___1 ____ __ 191%> ___
--
_21__~
I
tJ ~ _________,,_______ _
tha~ the above inventory of Ardent Spirits is a
I hereby cer
true and accurate . tatement of all receipts, disbursement s and quantity
of Mdent Spirits on hand at the
J~ 7_':;t;
d-- es.- -------- -- ---
__ ._
��:J /J.Jj
~
TON,
VA,, __ lA<1~r,,-r.
___~
__V'
__, _____ _k:-:__ l9~
__ cl..~-~ 4 ___________________ , Cler
f the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
..l _r J . . 3 ~
I hereby certify t a~ the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand atthe abov1 ? ",d • __ e ···-- ____·___ .. ···-----
��M r:,A·,--~~-:-L--l!JP?
.
(
)
'1
1
_.__J_~--- ----- ---.r::://i_______ ____ _,
Clerk
Rockingham County, Virginia:
the Circuit Court of
ALCOHOL
On b and __ _~
---··-L__ _____ ________19~ - -
____ _C?/!_ ___
~:££~
7 --7 --
Bei fbalance from last mont h.
Pu rch ased dur ing. ~
- __ ____ ___ __19,;:l,:;>___ _____ _______21_~
____
eµ__J. ~ ~~/:7_~ _ ---~-- _f~
Balance on hand
J#_
_!_f._ _______
j_ ____ _1!!i2,1__ __
1 /_ ________ _
I h er eby certify tha~ the above inventory of Ardent Spirits is a
t r ue and accurate statement of all receipts, disbursements and quantity
of Ardent Spir its on hand at the abo e mp ion )ii~
e:·, ~
------__.--\.l-------==-7=------------------STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
Subscribed and sworn to before me, in the County of Rockingham,
this ____ __ __ ____day of_ _____ ____ ____ -- --, 191 __ _, by ____ __ ___ ____ __ ___ ____ _________ _
My Commission extiires __ __ __ ____ __ ________________ 19 __ ..
��Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
Purchased during __ ~
q I
~
I
~
~
Balance on hand ____
'-
--- ___ __ 191 -- ____ ___
)'!_~---___________ _
/l £
)I.
)1n,,t_,(_
t~-:-:.
_____ ______ --------------------------- --
.
~___ __/_____ __19 ______ ____fj_ _____(l~
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the ah'' :J;(eut· ~
• -
srtl.u.n-u.;,;,---
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
Subscribed and sworn t.o before me, in the County of Rockingham,
this ____________ day of_ _____________ ----, 19L __, by ________ ___ ____________________ _
My Commission expires __ ____ ___ _____ ________ _______ 19 __ ..
��1 ,;) ,P
.
.
»KTOlf,
VA., . .
/:),&<!- I~~
To __ --'- -------- ---- -- --- ·------------
_l/_-r!7)_ __ j_ __ , _______ 19iZ.{l
J,_
.
. .. ...-.
------, Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
~V-1
On hand ____ ___________ ______ ____ __________ _19
Be in~ balance fro m last mon th .
(P__q_ ____________1910?.'.'__________ ____ ___!f_~
---
Purchased during __ _
Tot~
Balance on hand ____
.1 ___ tl_a_~ -
__ /?° 7P ___ __ __ _
)f_l[J/_ ___ l_ ____ __ 9-i!c;_ ___ ___ f J__________ ~~---------l
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursement s and quantity
of Ardent Spidts on hand at the abo1
cmtJ, --- d
d~ - 6,(-
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM -TO-WIT :
this_~~~/~~~~~:a:n:/~~~~~-~ 7e, i~ t::_, r . ~ ~ ~k ~~0
am,
��L TON,
!JI,,.,
To
lj
V....
_::J__.,,L_ ___ L_ ___ ______ 19f?-c /
:_J L~------~( __________________ , Clerk-~
~ Circuit Court of
Rockingham County, Virginia:
--------------ALCOHOL
Purchased during _____ __ / [~
___ _191 ____ _________ ________ ______________ _
Tota] ______ ___ ____ _____ ______ ---------- --- -- ---------- -- ---
c/,h---L-------1 /_ _ _ /l'.6 _________
Balance on hand __
fl _______ _
I hereby certify tha~ the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above
enli~ -- d dz
C?a-p¢,----
_
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-To-Wrr:
this_su; rcr'.be:.:n:f•z ~
~ef:r_:
Lj,/✓-\.M,
,
My Commission expires~
:~;:;?-7Jt.Z;t.;m_'_ _
__
:r:______
~19'.7c~
-. -rA }:(''fi?
-
�Filed In the Clerk's W"
ockingham County, v
FEB '2- 1921
_ _ _ _ _ _ _ Clerk
�J,_
-- ~ -
I
~
:§',KTO!f, VA., _____
I~
---- - ----" - - - -
____ ____
~- 7
__ ____ : ·_,
;!JJ_~
___j____ t'Ji'.£ ·
., -- ·. ·
Cierk· of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
J_!______ _/ ___________
On hand ____ __
f:'k____ R_~
19 _(__ __ ___ _
6
___
B e i n ~ ~ m las t mon lh .
Purchased during __
Z~___ .Jf~
191 ___ __ __________ _____ ___ _______ _____ _
~~
:J-~
Tota.I. _____
_____ ____ __ ______ _ _ .
I
"
s ·__ _ _____ ____ ____________ ___ _
Balance on hand ___
JJj__~
___ / ____ 19¥:-L ______f[:"_ _______ ~~----------
I hereby certify thab the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Sp;dts on hand at -the_•~ove me ~
0
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
tes. -
? z·------
��~
? ~. -
_
.
· EL
Z
T:
N, .
VA,, ____
To__ __ _______ _____ __ ·--~_}j
fZ-k/
7 -~---~; ___ (_ ______ 19 __{
_____ _:- ___ , Clerk
of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand ___
/l1t'0:& ___[ ___________ l9K/___ .----f _L
Bein~ balance from last mont h.
_~ ~1
Purchased during ___l # ~-~ - ----- 1~ /'__ _ __ _______ ____ ) (~
j(~~
_
~ ~---1 1-~[ ____ __ __ __ /_ ___ __~
--
/f/'_ ______
__{L_ __ _____ _
Balance on hand ___ ~
--L ____ J 9i'.L_____
I hereby certify tha~ the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburseme nts and quantity
of Ardent Spldts on hand at the above ~ e
tl;g-•· ~ - -
STATE OF VIRGINIA ,
COUNTY OF ROCKINGH AM-TO-WIT :
8
thls_ ~•t~:a ~:fs~r :~-~~~~ ¥ €~:m:,:::
My Commlsslon exp;re,_~
_/ i ______ _____ __ 19?,:-/
7
�fi\ed in tile Cl · ··
Roc\<.ing\1arn County 1 "a,
j.,'i'?i d1 \9'2\
....
�./4 Bl,LK:Z.:,•.,P.!T· -k_________1~!
~ ( t ___~~----------,
Clerk of the Circuit Court of
_ ! ____
Rockingh am County, Virginia:
ALCOHOL
On hand ___ _
---- ~--·- ---! __ __ _________19?/
ff?/____4 .! _Ji,; __ _
-- __
Purchase d during __~______ ______191?:f_ __ ______ ___
! { ~---------
~ ~ ~-lr '.2:L ____ _&_ __ __~
Balance on hand __
Mo/ ___/ _______ -l-'--~-----'1
! g;"._L__
____ ______ _
I hereby certify that the above inventory of Ardent Spirits _is a
t r ue and accurate statemen t of all receipts, disbursem ents and quantity
of Ardent Spirits on hand at the above ent· e
a ·s.
c:·---------
7
STATE OF VIRGINI A,
COUNTY OF ROCKINGH AM-TO-W IT:
8
this_
~~~~.::,•j;n.;;t':: :::in:~ ! ~~:~:': :
My Commission exf)ire _ __
__ / _ --~
-19 .. ..
��.1 ~-
. /)
,4~~~z_:--A,_
=-...J.~(__(d£~~--- -- ----•
Rockingham County, Virgini
erk of the Circuit. Court of
ALCOHOL
On hand ___ _.
.Pt..~ ----L ----------- 19JZ_( __ ___7_f ____ ~~a ein2 b;l~~{e fr~m last mo111h .
Purchased during ___
~
~
o/_
Jt~ _
19J?cf_ _______________ _
_____ _____J'_~
ta1 Pl_7u_'f'_y____
JJ_____~
Balance on hand ___ ______ __ ___ _/____ __19,ZL_ __ __
I hereby c r · y that the above inventory of Ardent Spirits is a
true and accura statement of all receipts, disbursements and quantity
of Ardent Spicits on hand at the above___ en.''
7--t;,.
_
��J /:/ /J
To _ __ : ____
~--~
~•
VA., ...
~ 2c........t9i!c/
....
-«(:._ ________________ , Cler,~; $ i i~
Circuit Court of
Rockingh am County, Virginia :
On b an
,,
'
I~
ALCOHOL
____ ___ _____ _!___ --- ---~ ---- 19 ____ __ ___ __
Being alance fro m l ast mo n1h .
Pu rcbased during ~
~~
~
'f"!_{
___
'
_____________ _
-·
........ 191. ..... ........... .. . . .
/!~ -
., ~.. .... ...7......~
Balance on hand .. ........ ....
L......1912,/__ ..../ /......~ ..
I hereby certify th the above inventory of Ardent Spirits is a
true and accurate state ment of all receipts, disbursem ents and quantity
of Ardent Spirits on band at tbe •b7 4 y ~ a . . 1 : -· ....
STATE OF VIRGINI A,
COUNTY OF ROCKINGH AM-TO-W IT:
this.S~
r'.~•:a: ~ :for.: .::•; :he
My Commis,!o n
exph-es.¥
.A....
.
C
:n,Z ,
2-/.i9 .. ..
7
��To __
z:;.
_J ,J, I)
·,---¥---J-.-------19~/
--~---~--/4. __~,!_c
_________ ____ , Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
7/ ___~ -
On band ---~~~--- - --/__ ________ __ _19e._/ __ ___
L✓- _-B;~;
7,~ce from las t month .
Purchased during _____ ~ __ __ ___191 2_!._ ___________ ___
lf._~----
/Cf)- /
f/
i/ 4d....,,l..A~al ______
_________ ___ __ ____ -- ----------------- ------- ----
Balance on hand..4.... _
{_ - -I912.f-- ____J'/.--------'.!__ _____ --I hereby certify thali the above inve~ry of Ardent Spirits is a
true and accurate statement of all receipts, disbursement s and quantity
of Ardent
Spfrits
on hand at-the-"747:fr __________ ________ _
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM -TO-WIT:
this_s~tri~e:.;n:J¥z"for~ ;~;::e
My Commi,sion
-~'~j;-m_'_ _
expire,.$ ,_., _ '£__~_,;~/ 7
�Filed in the Cle 's fl A r ,
Rockingham o nt , \ .1,
P8- 1921
_ _ __ _ _C,leit
�, / ] /)
E
TON,
V ,, ____
(Q_e__X_:__,1_______
19
/
qr!_fj_f'a.Yr_! __ r·--------, Clerk of the Ci~cuit Court of
Rockingham County, Virginia:
_ _'rJ._ ___
-+-+---------•;;.___, - - - - - - - - , , - - - - - - - - - - ALCOHOL
Purchased during __ _¥
~
Balance on hand ___
/4rf,(oi ___
------19 _/_ __ ------ --- ~ ~ -- --
¥-_::__ _ - -
_l ' ~ ---
@_~ ____ / _______ 191._L_ _ ___71_ __
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the abov~
ned dates.
�filed in the Clerk's 01'ict
Rockingham Count , Va,
CCT 3- 1921
_ _ _ _ _ _Cl rk
�&,,✓,L
(l J
T
1 -~
"·
l1_r,p_ ___
,$_=-----19~__(
VA., ____
Clerk of the Circuit Court of
Rockingham County, Virginia:
~-------_____0____________ ,
ALCOHOL
/J&!:_~_____ /___ ___ ________19i?-:/ __ --J_/_ ___Q ~_
On band ___
Bei ng ba lance from l a!H mont h.
a?_u_________ ____ 19:i,?_l __ _______ ______ /1_~
Purchased du r ing ___
--
a£ --____/ 'f },./----------------------- I I -- ------
,ZJ_ry ___ / _____ 19 __/ __ - l
Balance on hand ______
-----
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
ates.
of Ardent Spirits on hand at the above me tione
------- -' .:/4_______------ -
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO -WIT :
_
Subscribed and sworn to before me, in the Co nty
thi s ____6 ____ __ day oL~
~
My Commission ex"f)ires( -
-7
l _ , b _ --~
----, ~
kingham,
-' --~ --- __ __________ _
1)_
- ___________ ,r7 .-------7J ---------'ffev-7
E-- ---
1
-- - - ______ 19
::?.J
'
�Flied in the -Clerk's Office
Rockingham County, Va,
NOV ·71921
_ _ _ _ _ _ _Clerk
�J,'.
.
/),?
ELKTON,
V A,,----~
L _// _________ 19'(!./.,
To_ ------~ Y --~ ~C lerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
77HI-
1 __ _____ __ __ 19
On hand ____ ---- ------- -·- -------
1
Be i ng ba lance from las t mo nth .
Purchased during ___ ___
____71 _~
Jl__ry_________19 __/ _______ )1 r ~ ________ _
~
?1C7?J -
7
/92-/
I/
Total ______ ____ ____ ___ __ _____ -- ------- -- ---- -- ------ --- -- --
Balance on hand __
~__ __/
t__i_ _______ f!_ _______ _
_____ _19 __l __ _____
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disburseme nts and quantity
of Ardent Spirits on hand at the above ment· e da es.
' .
STATE OF VIRGINIA ,
r,,7 ~•
COUNTY OF ROCKINGH AM-TO-WIT :
Subscribed and sworn to before me, in the Co~t~~
~
this ___ / ______ day oL-Q_=
------, rnYL, by -· -- ,; _,
____ /~
My C-Ommisslon "''"'--~
-,
-- ______ 19 .?
7
.f\
_:; _ ~P-,ipfp-£ __ _t_~, -
-----
��&dl..TON,
To r -
VA,,__ _
-~l::: _______________ ~ ----,
/L--U:f _____.?3/ _______ 19i?:.z.-.------·
erk of the Circuit Court of
Rockingham County, Virgini .
ALCOHOL
&._~____ /_______________
On hand __
19 _[ _. __
Being balance from las t mon1h .
Purchased during __
& _~ ________
C:, .'/ . ~
19;?/_ __ ____________ _, / ( ~----
�Filed in the Clerk's Of!kt
Rockingh~m County, Va,
JAN 5" 1922
m
~-Cler "
�_ 'J
ELK
N, VL,-----~ ~____
__;_.;t~ c_~cj _ ______ ____ , Clerk
;3_______ 19 __ ? ,
of tlie Circuit Court of
Rockingh am County, Virginia:
ALCOHOL
__?: ________ ___
Purchase d dnrin~
f;lJ-e.-)
~
__.-<..A.,A_
d &z__
'""7---- -- _19 __": _ __l f ~ - --- --- ----- --- -
I
Tota l7
1 9' z_
2-
/ /'
I'/
_____ ___ __ __ _____ __ ____ ______ ___ ____ _____ __ __ __ __
(
I her eby certify that the above inventory of Ardent Spirits is a
true and accurate statemen t of all receipts, disbursem ents and quantity
of Ardent Spirits on hand at the above
ioned dates.
�,.,
Filed In the Clerk's
o,,,
Rockingham County, \ta,08
FE,'1
""4 1922
"'------- - .Clerk
�ELKTON,
To __
J _ _
VA,,-- --- ~½._~ _-:: __ !_ _____ 191,?__?-
t_~(_ fJ?q_ (~---,
Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
J--:_
e _-~___________
~c----/
a! ~
j/4_ __________
19! ~ --- ____
On hand ___ __
from las t month .
19 -- 2
----
Pu r chased during ___
9 ___ c/!u-___ _
..J7--.
------ ------- ----- ------- --- --
TotaL _____ __ ___ ____ ___ ___ ___ ____ ______ ______ ______ ____ . __ _
_}ji~ ~
Balance on hand __
J/------~ --------
-- L ____ l9 _d--___ __ _
1 hereby certify that the above inventory of Ardent Spirits is a
and accurate state ment of all receipts, disburseme nts and quantity
ue
r
t
entio··· ~ -d•~ s.
of Ardent Spi.-its on hand at .•h~ a~
�ilt•d in the C\P.rk1 s
r,
1
•
Hockingbam Coun y, •' t,
~, .. n2- 192~
�/
.f
/.JJJ E_LKT9 N,
VA,, ___
t~0~«t~_:f':.-Y-_,
I :::____ 19
~ _____
___2-__,,,
e Circuit Court of
Cler
Rockingham County, Virginia:
ALCOHOL
On hand _m ~_____ !_ __________ _19
2-
__________
9'______________
Being balance from last mo nt h.
Purchased during __
22!..._~--_____19~ ?___ _ ------ -------- ~~~--------
~,,
Tota'ff_ ____ ___ __ ____
Balance on hand---- ~
rf ______ ___ _______ __ ___
- f_ ______ J9 -_2-___ _____ J_
.)1~
£ ________________ _
I hereby certify that; the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above ment· ne, d ~es.
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
-
��ELKTON, VA,,
_-/
_,)J.f_o/----/_ __________ 19 --
--~~~Clerk
of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
___ 37 _ &z-___ _
Purchased during --- ~
----- -- 19~ ?:-:__ _______ ___ ___ if_~
----
TotaL ____ ______ __· ___ _____ __ . .. . ____ __ ___ __ ___ __ __ ____ _...
Balance on hand __
)li__ _____ ( _______19 __?--____ ___ ./!_,f_ __ R._4_ _______ _
STATE OF VIRGINIA,
COUNTY OF ROCKINGH AM-TO-WIT:
�r iled in the Cl0.rk' Offlc
Rocking
County, V ,
~AY4~ 1 ?
- - - - -....,,. . ! ~
�On hand_1JZcz-- -- ·· ---/_- ___________ 19].{_f:: _ ____ ;3_'?____
p·g
balance from la,i month.
/
/!_~
),r'_~_ ---
Pu rcbased durln. . 1 r r--- -- --- --___ 19~ le: __------------ _
Total __ ____ ____ ____ ____ ___ ___ ____ ______ __ ___ _______ ____ ____
.____ /
:3q
(}~
________ rni?-L __ ------/------ ~ ------ ------
I hereby c tify that the above inventory of Ardent Spirits is a
true and accu te statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at the above j ~ ~ ~ ates.
---------f~:~1 ----------------------STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
Subscribed and sworn to before me, in the County of Rockingham,
this ____________ day of. _________ --------, 19L __ , by ___________ . ___________________ _
My Commission expires ______ ____ _____ ______________ 19 __ ..
��g'J ~
ELKTO
V.A.,, ______________________________ 191_ __
_...±_~t! .__·~qr (_ _____ __ _, Clerk of the Circuit Court of
RoGking ham County, Virginia :
ALCOHOL
-r~.........
. .. . . .. . t9f.?c .. .........
Purchas ed dud ~
Total ____ __ _________ __ ___ ___ _ ---- ------ ----- -- --------- -- --
____ / ____ __19? 2- _ _
3 f -___c{l ~
I hereby e ify that the above inventor y of Ardent Spirits is a
true and accu e stateme nt of all receipts , disburse ments and quantity
d ates.
·
of Ardent Spirits on hand at the above r
STATE OF VIRGIN IA,
COUNTY OF ROCKING HAM- TO-WIT :
Subscrib ed,,:n~
this.nf -. ...
My
dat 7 ~
~
m
72l·py·
_to before me, in the / 2 t ~ a m ,
.. •.
Commission expi"•·¥ -··'1···· ......1,'J:
�Flied In the ~e<k's Offlc€
Rook.Ingham Ceunty. \/a.
JUL 1.- 19'1'
_ _ _ _ ___Cler~
�]
EL~ON, VA,,----~-------_____ (_-=-: ______1~_?--
/]
1
--~11J&.~1~.
Clerk
the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
{,I ;.;,;;~;. ,... '"' ......
On band_ ~ / ~____ /__ ____________ _1912_7--::
-----~_?'____{/_~
_
-r-
-- -------- ____ _____ 19 _-z_ _____________
,)f~
----
ti
1/
f/
Total ______ ____ ___________ ___ ----------------- ------ --- ----
Balance on band ___ _
I hereby certify th the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spidts on hand at the ab] ? ~·6Z==.
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
this_su;s~,i~~:.::,•~~efo~-~~ E-'--My Commission ex,ire~ - f-------!9?s
�Fi11•d in the Clerk's Offlct
Rockin£ham Ceunty, Va.
·WG 1- 19~ _
_
Cle
�. :) tf
/ .J
ELKT
,
V ... , ___
e;f~1.-__ ___ y ___
:d)f~ ( _ ~_(!./(0_______ __, Clerk
I
19'JL _
o/th: Circuit Court of
Rockingham County, Virginia:
ALCOHOL
a~ ::___/ -: _ ________
On hand ____ _
19{ f: ____
aein;.b'i'fa ~;e fromlast month.
Q~-39
1 -- __
7--- - ._ _
Purchased during __ ___
19¼ be ______ __ ____
Jf__~
--___ _
TotaL _____ __ _______ ______ ___ __ ________ ___________ _____ ___ _
Balance on hand ___ ~ - : : _L __ __191;;'_~ _ __
,;J_l---~--
I hereby ce rtify that the above inventory of Ardent Spirits is a
tru e and accurate statement of all receipts, disbursements and quantity
of Ardent Spirits on hand at-the· ~ -d~ = ~/
----- ----
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT :
Subscribed and sworn t-0 before me, in the County of Rockingham,
this ____________ day of_ _____ __ ___ ___ ----, 191- __, by __ ________ ______________ _______ _
My Commission expires ____ __________ ______________ 19 __ ..
��J~ ,/ {¼,)Z::...,., V•·•·····(!)_t,:j_·~··: J_·-,l-···l<,i!_.V
_____________ ____ ___ -------------------, Clerk of the C1rcmt Court of
Rockingham County, Virginia:
ALCOHOL
On hand ____ ____ _ _____ _-:-_____ / __ ______ ___19f_?::_
B m2 balance from last month .
Pu ,chased d u,i ng ...
-----~_'7-?__<!_~
-
Itµ. . ......rnic-.2s... .....lf.~..........
Total ____ __ ___ __ __ _____ __ ___ _ ---- ------ -- ---- ---- ------ ----
Balance on band ... .
&rfl:..L.......
19;?.?cc. ....
.3.J....(!~
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spicits on hand at the above m•
ates ~.~
:Zd
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO -WIT :
Subscribed and sworn to before me, in the County of Rockingham,
this _________ __ _day oL _________ ____ ----, 19L __ , by ___ ______ ___ ___________________ _
My Commission exF)ires ______ ______ __ ____ __________ 19 __ ..
�Flied in the Clerk's Office
Rockin ham C unty, Va.
JCT 4- 19?'>
---- --- .I
rt·
�1
","/P·· ___ fllfll_ _ j ______
~
a ____
1<d_-,._.-·
~ - Clerk of the Circuit Cou; t of
----- ·------ ----~
---~
Rockin gham County , Virgini a :
ALCOHOL
On hand ____
@(0_______! ___ ___________ 19~] -__ ___d_J:_ ___ ~ 4 __
nein2 balan ce from last month.
@q ___________ l~?:-:-- _______ __ £~ -----
Purcha sed during __ _
I/
2J.- 2Y. _____ ____ __/9'
{!lfTotal_
_ _____ _______ ____________ ____ ___ _
_________
Balance on hand__
/I
3 '
Jjo-v
_____ _____I_______ __ 19:i-?.:-____ ---- --- -/-- --------- ------- , ---
I hereby certify that the above invento ry of Ardent Spirits is a
y
true and accurat e statem ent of all receipt s, disburs ements and quantit
of Ard.ent Spidts on hand at the•7z y~ s.~-----STATE OF VIRGI NIA,
'.
thisS;••te:.;n::~ef:r~ ;:~:e Co __
COUNT Y OF ROCKI NGHAM -TO-WI T:
'
A ?, ---------- .---
~~ - - -
1/U/
J -"::_'.
My Commission exf)ires<--7A'1 -.- -f------ ------1 9/..J
~
;-11-·
_7"7'---;r;fi)
•
��-~---:?f =_1gj!;_J
:l~✓-l¼:;_;z;~·;--;-
of tf{.ie Circuit Court of
Rockingham County, Virginia:
ALCOHOL
___ / _~________19t_J __
f q_____ ___
On hand ____
Being b·
n ee from Im
t
Purchased d u d f
'J)__._J
~
Balance on hand
__ ___J / __ ~
month .
·. . . rn/.
J.__ ...
.Jf~...... ····
1.Z.-J ... ..
./f........ !.'.... ...
To/7 . ....... /,) . g__z;;-
-:t&, .J ...
!'7li'
.. . ..
I hereby certify tha the above inventory of Ardent Spirits is a
tru e and accurate statement of all receipts, disbursements and quantity
of Ardent Spldts on hand at the a b o f
~
STATE OF VIRGINIA,
COU NTY OF
Subscribed and sw
thls . .
_,;if··•
My Commission
of. .
OCKINGHAM- 'I'O-Wl'l' :
t,o before me, in the C~t
~ ....... , J ~ I (.
kingham,
. ;·····
.
M7 q f(?'!!?Y7 ......... . .
extlir1es7J!Z --'7--"]-:____ _
·· ,
��$i
!
:z:
-- - - ~ -________ 19£3
,- _·,~
V~
-------------- , C rk of the Circuit Court of
-'----~---~
Rockingham County, Virgin .
ALCOHOL
On hand ___
/J1_~-----L_g_ ________ 19i3 ___
neing f l :rnce from la.st month.
Purchased d ur; n g __
~,(
_________
/L 12:ti--
mo/ __________ gi,J___ __________ __j,;1~ ___ _
1
,,
ti
.
~~
TotaL ___________________ __ __ ____ __ ____ __ __/:/__~------- ___ _
___ _/_ ____ 19iJ __ ______//::__~
I hereby e ify that the above inventory of Ardent Spirits is a
true and accura; e statement of all receipts, disbursements and quantity
- - b----------------of Ardent Spfr;ts on hand at_t_h•_•':RZY
�.
�/]
1
~ELKZ:,
A-,--~---!l.------- --1~
- ' - ~ ' - _ / ~ ( / ( _ ___ ___ ___ , Clerk
Rockingham County, Virginia:
f
the Circuit Court of
ALCOHOL
{If)._4____j__ _ _ ________ rnQ:J___ __/_[lli:F __
On hand __
Bein,ance from last month.
Pmhased duri7J:~ - _____ ___ 19Jd __ ___________
)f_~--__
'I'otal ___ ___ ____ _____ ______ ___ --- ---- --- --- --------- --- - ----
Balance nn hand __
9::l.,__
L ______ 1gr,J __ __/__/L___ - ~_____ _
I hereby certify th b the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
nf Mdent Spirits nn hand at the a ~ 7 4 , 7 ~
My Commission oxpires_ J~ , - - - - - ------19~
~
_
��(1l_,,,,E~
--~
., ____ Z/6i't!__
~__/__ _______19,!cf ~
f:-______ ____ __ 0_ ________ ___ , Cle rk
of the Ci rcuit Court of
Rockingham County, Virginia:
V
On h and ____
ALCOHOL
~ ____ /
_~ __ _____ ____ 19g.:-f__ _
Be ing balance from las t mo nth .
.·
(J)e:;;<,.
-
s
_____ _/
6____~
)1
.7 ____ _____ ____ ___ ____
C(..«.,(__
Pu r cb ased d ur m g ___ ____. . ___ ______-__ __ __l \H':
____ __ _______ __
T otal ______ __ __ ___ __ ___ _____ _ ---- -- ---- -- ---- ---- ------ -- --
//Jt:z!__-:-_ __ / ____ 19J_?___ ______ !__6___~
Balan ce on hand ___ _
I h ereby certify that the above inventory of Ardent Spir its is a
t ru e and accurate st atement of all r eceipts, dis bursements and q uantity
of Mdent S picits on hand at the abo1
z •-~
-
&P
7
__
�ftt.i , ·
,IU-•n
17ov1-192?
jJ
Va ,
.
__ _ _ _ ___ 1.;
�I], ~ , , _____
JiM:__f- ____19/3_
,./~<:::----~ ------ ------,
To __ __
Clerk of the Circuit Court of
:
Rocking ham County, Virginia
ALCOHOL
l/~ ____/_ __ ___________rniJ___ ______ / b ___ ~
On hand ___ __
Bei ng balan ce from last mo nth.
}f_ry_ _____________19i-J___ ______ __ ____ !(_ ~---
Purchas ed during __
~~
Uri
~~ Tofuf.!
---------________---------- ---------______________
~___ /
____ __19i_~--- _____ /_/:___
Balance on hand __
~
I hereby certify tha~ the above inventor y of Ardent Spirits is a
true and accurate s t ate ment of all receipts , disburse ments and quantity
ate _·
of Ardent. Spirits on hand at the abov! men~ J
~-~ c/.-~--~
---~
------
STATE OF VIRGIN IA,
COUNTY OF ROCKING HAM-TO -WIT:
~:23E:::
this_s~~~be:.~::21=or: _~~ ,
My Commissi on expire~
-
-j-------
----19 _r.!>'-
��ELKTON, VA,, ____
&.,v___ .3_/_______ 19-t._,3
~ Clerk of the Circuit Court of
~ -~
_]_~
·'
Rockingham County, Virginia :
ALCOHOL
On hand __
~___ __ _/ __
_____ ____ __
1.9~:-:3___ ___ ___/0 -- ~
Bei n~ ba lan ce from last mont h.
~ ___ __19~ __t ___________!(~-----
Purch ased during ___
~
- --------------_________I ___ ~
I h er eby ce ify thab the above inventory of Ardent Spirits is a
tru e and accurate state ment of all receipts, disbursements and quantity
of A rdent Spirits on hand at the above men~ ed ~ , -
~-4---
_______ f,_,<_,_J
��!]/
.1
ELt~N, VA., ..
2.-L:.k.......19i!.7"
---~✓------~~ Clerk -~~-,~-~ircuit
Court of
Rockingham County, Virginia:
ALCOHOL
{,I ?··
On hand _Q ~
L_r-_ __~
___ l__~ _ _____ __ ____19Jt~-- _____
/-
balonce fr om last month
7·......
Purchased duri f
7,µ.J.__
1rJ!/............. . .
x~...
~·/?::<I... .. . ... ?!.~ .
:t_____ ____/._ ______ l91'f_~_ __ _/J_"::_ _________________ _
Balance on hand __
I hereby certify t b the above inventory of Ardent Spirits is a
true and accurate state ment of all receipts, disbursements and quantity
of Mdent Sph-its on hand at the ab:x zn~ ~ ~ ....
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM- TO-WIT :
·
Su_b/ ribed and sw!??' to before me, in the Cou tY-
T ____ day of~------- --, 19~
by _ __
this __
----~
My Commission ,x.ire~
/
--
_
;_::.:_ -~-
-----
=-!f~
�__ __ __ _Cler
�fl_#
ELL-A,, _ 221_.~_j____19J£!/
J_~,t(__r~~----------•
To ____
Rockin gham County , Virgin ia:
Clerk of the Circui t Court of
V
ALCOHOL
•
A/~:_ ~_
On band __
JC ..~
_j_ _________ ___19{:_~- - ______
~-~; ~ nee fr om last mont h.
',;t:1- -_____
19'lcL/_______________,1' ~-- -
Purcha sed durlng __
~
1,
Balanc e on hand ___
11
b
II
(lz; ;-
Total ______ __ _____ ____ ______ _ ---- ------ ---- -------- ---- ·---
M .~__ / __
19"J2_'/-- ______
f-'-_______'!_ __________ _
. I hereby certify that the above invent ory of Arden Spirits
is a
true and accura te statem ent of all receip ts, disbur semen tst and
quanti ty
uf Arden t _Splrlts on hand at the
•:itLJ~~----
STAT E OF VIRG INIA,
COUNT Y OF ROCKI NGHA M-TO- WIT:
thls8 2c:ib e:.;n :/~;~ tr_~ _
ZZi:7
My Commis sion expicoo_
7~~; ;;. ~~ ::
.
r -,--1--- ---"~--16
~
~;r__::z
��'f D~
c__TON, VA,, ___ y~ _ y
_____ 1!1£J-
-~LJ;!ft'!_(. /<L ___ ______ (__ __ __ , ~-~fl.fue Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand __
~ ____ /
__________ _19~t_1/_ ___ __
Being balance from last mo nth.
a__ ___ {lz;;- _
t
Purchased d u r i n g _ ~-------- --19~-~(- _________
~~
~
i(_~ --
--!f~_f_ _______ __ _/ ________
---- _ __/ ____ ___ 19~~-- _____ __/
{??!_
_________
!!_ _____ _
�filed in the Cle rk's Office
Rockingham County, Va.
JAN 3 .J1925
· -- -·--·---········•·················· ... C-lerk
�E~_,_)Jjr«d._ _J_= __ 1[]¥.J __,,
/J /
__J~r!_f;!fe!._(LJ ___________ ,
Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
___ _/ ____ __ ____ ____ 19i-:_L~_ ___ ___ /
14_.- -
Purchased during ___
~
If
I(
-- - - ~-------
----19~-C, _______: _______
2(~
)1~
1/
Tota l ___ ___ ____ _____ _______ __ ---- ------ --- ---------- --- -- --
Balance on hand ___
✓-W~_#__ L ___ J9
__I_-:_
(l_,_ _______ _
____ ./_ _______
?=-_. . . _ __
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spi cits on hand at _the-abo:J t Z : d
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM-TO-WIT:
this_s1s=rih~:.:n:,•~efor-~ ~n~e
My Commission exF)i e
-O
°;i{
•=f;:;;1--
�,:
i
I
I
�..c::.-•
/ll__~------'- ______ lgf_,f_V
flt_
-- J ----------«~ -------------------, Clerk ovZ'he Circuit Court of
A,, ___
Rockingham County, Virginia:
ALCOHOL
Purchased during ...
~ ..... mile/_~ ______________ Jf_~--
~ d~--,../!/--!__/f__~~--- -- ------~~Balance on hand.. ..
mr__.(_ _ _
19,?_-!_::-: _______ ('_ ____
~
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spfrits on hand at tbe a ~ o v 7 n Z J ~ - - - - -- --- -----
��-J. -L./.)/4. ELVA.,. dp. _ _ be _____rni/F
----~------ _____if_,_ ___________ , Clerk
of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On hand ____
~__-_ _____ (
__ _______ __ 19if:___
_______ _}1~------
n ~ a n c e from last month.
~
Pu rebased d urmg --- ~-- -
Jt~
-r--.--------
1 J'19f::""_---- ------ ------ ----------- -- -----
Total ______ ____ ·------------- --- ------- ------- --------- --- -
Balance onhanL
.4/-!:-_
.-r~-- - -
j_ _____ l 9>f_f_': ______ ____
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of Ardent Spl dis on hand at the abov1n7~ - -- -- -- ----
STATE OF VIRGINIA,
:°:~lfti::
COUNTY OF ROCKINGHAM-TO-WIT:
8
this_
0
L'.b~:.:
:1•1-?_e'.or:~_:~~-e
My Commission e x p i c e ~ --,-----------19,' ,1
��,'] ;J ELK,,,, VA,, __
,f
}l_<TJ(_____ '/. _________ 19£,L -
- ~c_ _ / ~ ( ~ - , Clerk of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
______ / ______ ___19-i?~~- ___ ___ }1~ _____ _
On h and ____ ---~
B ei ng balance from last month.
Purchased during __ __
~~0!2f.__________
19"J2-_J ___ ________
/?_~------
'l'otal ______ ____ __ ___ ___ ___ ___ _____ _____ ____ __________ _____ _
Balance on hand ______
1l__ry_ ___/_ ______ l9U_L.. __________?!~---
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
of
Ardent Spirits on hand at above 7i7~_. . .. - ---the
STATE OF VIRGI]S'IA,
.
COUNTY OF ROCKINGHAM-TO-WIT:
thisS~✓~'.~e:.;n:1s~:for~~:m:,:::
"2_/_~'--------••-;
My Commission ex,;,-e, __
·
�fil~~ !fl
ti, ~
Clerk's Office
,,.-, .. r'r " 'l ❖, ,
,h i1:;_:. :11...tt!f \..J LU, LJ J
Roe.!,:.
I· •
!'. V°•
\ta
V c«
. ,, ·<"
l~i!:l
--·--·-·-········--··--···············. C--lerk
�_j2~ ___ k, _______ l91".!G
E ~ VA,, _
_ J ~t_- ~ 0 _ _________ ___ , ~
k of the Circuit Court of
Rockingham County, Virginia:
ALCOHOL
On h and ___ ~ _____ / __ _______ ___19£c/-:: _ _____ _______
)1~---
ne in2 ba lance from las t mo nth .
~____ ______ 19.k. __ _______ ____ ___ ________ _________ _
Pu rcbased during _____________
..,,-
Total _____ _____ _____ ___ ____ __ ____ ______ __ __
Balance on hand __
)'J~ '
}1~
---
______ ___ I _______rniZ-:0 ______________ )1~ ___ _
I hereby ce ify that the above inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursement s and quantity
of
Mdent Spidts
on
hand at the
•b1::o:~¼- ·- -
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM- TO-WIT :
Subscribed and sworn to before me, in the County of Rockingham,
this ____________ day oL __ ____ _____ __----, 191 __ _, by ________ _______________________ _
My Commission exF)ires ______ ____ __________________ 19 __ ..
��FLETCHERS' PHARMACY
Harrisonburg, Vir.ginia.
.., ,
rcY- 4 of i'letc- ,, r fx ) •
ch
'"'
0
1
- _r
~t
.1
.,.,
• J
,
,. •
o~t ~
y
•
1'
1'11
o.,... • r
nr-,
0
l _'
•
C
1" ' '"' - - - '
'1.C'O'd
..
l
l_
•
or •
---" , 11
1 ..
. , 1.
.l H
,,,1
-J
Subscri bed a nd sworn t o b efore me t his the 7th day of Novem.1.J er J 9J 8
·--
I
~
-
1f/,,.,
,d/r-t'hlt
. -~----..--/ .
----LOf_t__ /t 1 I~
I~ (.tJ
....,.., , /
�C
"
�FLETCHER'S PHARMACY
HARRISONBURG, VA.
Dec . 3 . 18 .
Report of Fletcher Bros . of Harrisonbur g, Va . , in accordance with the Provision
of Sec . 14 of Chapter 146 of The Acts of The Assembly of Virginia 1916 .
Amount Grain Alcohol on hand Nov . 1, 1918 3 Gallons 2
State of Virginia, Rockingham County, to-wit:
J,
c.
D. BEARD
,
a Notary Public in and far said County,
eJ_ {fJ- - ~
do certify that
1
p ersonally appeared be.fore me and made oath that the above acce~nlt ./)~
o.f- - - - - - - - - - - - --
vs _ _ _ _ _ __
for$'
is just and correct t'fflti tbe same z'r dz, g ~f'MI tmpaid,
the best of his knowledge and belief.
Given under my hand thi's _ _LJ=
__,__ _day o.f
~
m
, 191 .f_
,
~~~N.P.
·.,!.iOM eXS:ffeS
fZ>'f,-t•
,----0
/
r ?"-0
quarts
��--· /
FLETCHER'S PHARMACY
HARRISONBURG, VA.
Repor t
t'.}' \o r
ros . of JTa rrir; onbur t: ,
Ls pf:..or L v
of
l! r..oun t G in
'I
, ct
of T .e
If
State of Virgi~ij l,~
~
,v, /, 1'
e. D . DEA.iffl
,
i ns
V
v·i t -1 t h
ccord nc
in
s er1hl y of " i r 6 i niL l 16 .
r t r.
, 1918 , 2
l e l,o l on lad 1 c .
tl
I
F,
•r1:, .
c . 1918
l{~ .
~'
,I
moaA ty, to-wit:
.
. .
ii'~ Norry Public in and far said eu:mn
~
~if)J~
'
,d~
·
'
do certify that
~
""•m~
above
the
that
oath
made
and
e
m
p ersonall y appeared be.fore
vs _ _ _ _ _ _ _ _ _ _ _ __
of.- - - - - - - - - - - i '1--jrt- rt ,w i ..,' n&t=t1?Jtil---t-he :1ame is dne and unpaitl, to
c__~ '
the best of his knowled ge and belz'ef. /
, 191_!/· . ,.C4t.d.· =-~- d ay 0'J-r
Given under my hand t h is._
y /2--- /:-f} 1~
f t....uvl ~ P .
~
far $
__; -r
·
d.
Jl.Lt.~
a.z;.1111.:;s
,:~ -.:'ll .ll. .. c,.:llull
'-', ~,,,,~
>ro .r i io
of
n . 14
��FLETCHER'S PHARMACY
HARRISONBURG, VA.
Report o_ F e tch ,P, r Br os . o f Ha.rr:is o n urg , Va.
146 o f Tlw Act!: o f T e A~s e::n
Amou."lt
re.i
_.mo 'mt
II
II
II
y
of
v· r gir•ie.
Q
i n a. co rde.n ce wi th t ,e
19 6 .
A. c:ohol on han, March 1st, . 1920 , 4 Gal. 1 p i r.t .
II
II
r e ce ived during :r.:e rch , • $20 , none .
on h1;1.nd Apri
1st.
920 , none .
~
Stale of Virginia, City of Harrisonburg:
I.
certify that
personally appeared before me and made oath that the above ~ t
-----
~f=.=========~---==--------=- vs
best of /tis knowledge and belief.
,1
Given under my hand this
2~
day
ef.
ov .sion of Chapter
��FLETCHER'S . PHA RM ACY
HARRISONBURG, VA.
Va . in acco rdan e with the Prov iison
Re.po rt of Fletc her Eros . of He.rri sonb urg,
14- of Chap tt,r 146 o
The Acts o
The Asse nbly of
ir {:; inia 1016 .
. 2 ga llon s , J,_ pint .
Amo, m.t Grai r Al coho l on hand Ja ny . 1 , 191.S
1919 . None .
Amou.l'lt Gre.i n /_l c ohol recei ved durin g; Jany .
.
Amou nt GrRin Al c oho l on hand Faby . 1st . 1919
State of Virgi nia, City of Harr isonb urg:
I,
_1· ),, FL ;~••rf"'lary
Publi c;,. and/ " ,a;d oily, d,
~~- ---- ---.- ---;==---- {
:~~
-¥--~
=-~~..:::
==U=::..
certify th at - ~6L ..;::, ,c.--..==~
the above ti ,ue
that
oatlz
made
and
me
before
red
Perso nally appea
_ _ _ _ _ _ _ _ _ __
~.f. _ _ _ _ _ _ _ _ _ _ _ _ _ _ vs _ _ _
O
d
s ;; cc i, i c cnei n,npairi , to the
for $ _ _ _ _ _ _ _is ;w.rt ~#ti correct em• J k
best of !tis knowl edge and belief.
, 191 L .
day o.f.
Given u11der my hand tlzis
J
~--?:=1I\
;( :7, ;:~ ,
- - - - . - - - - - ---=--~-=-__:_::........::==::::...!-N. P.
f Se
•
�j
;'.
I
�FLETCHER'S PHARMACY
HARRISONBURG, VA.
Re port of Fletcher Bros. of Harrisonburg , Ve. . in e.c corde.nce with the Provision of Sec .
14 of Ch&1.pter 146 of The Acts of The As s erubJY of Virginia 1916 .,
Amount Gre.in Al cohol on hand Fe by . l , 1918, None .
Amoun t Gre.in Alcohol received durnig Fe by . 1919, 4 7 /8 Gallons .
Amount Gre.in Alcohol on hand Me.rch 1, 1919 , 2 7/8 Gallons .
C. ff.MAUZY
Notary Public
&tatt nf 1!fir9tnta, ltucktn94am C!!nnnty. tn ttttl:
/
_---- -- -- ------- ---------- -· ·-- -------- ____ _____ __ personally appeared b
the above account is just and correct to the best o
re me and made oath that
is knowledge and belief.
_ <l_d____ _
My Cuunutsslon expires Septe1nbeF 22, J 9 1 8,
r,1, Ccm mission Expires Septemb
��FLETCHER'S PHARMACY
HARRISONB{)RG, VA.
Repor t o
Fl t h r Bros . of H11-hh i son urg, Ve. . tn accor ance r-dth the
P:roTi ion o·
c . U of Ch pter 1~6 of The Acts of Th
Ass mbly ot
i:rginia . 1916 .
Amo uni:. Grain Alcoh ol on hand Ma rch 1 , Ul9 # 1 7 /8 Gl,.llon s
Amo
t
If
I!
r e oeiTe d D~ing March 1919 , ~ 7/8 Gall .
S. D. MYERS,
Notary Public.
that the above account for $ 1ZI,,'L-b--,~ ~
,
£._ _ _
and belief, thi s __ ______ __ _
. P.
�\
�FLETCHER'S PHARMACY
HARRISONBURG, VA.
Report of letcher Bros . of Fe.rrisonb urg , Ve. . in accordencE : witt. t h
of ha ter 146 o The Acts of The A sembb of irgi:r.ia 1516 .
Me.,
A . .' ,L , 1919 . 23/4 Ge.llons .
hend
on
lcohol
P
Amo.mt ra.in
II
II
II
re(:'ei.._ed d,u- ..rg 1e.y
II
June
.
919
4 7/8 Ga Jons .
~19
, 1 ,,.,.,,.
..lt,..'- ...- -"·...,
2 7/8 r.~
. D
a
,_
Prevision of .. c 14
��FLE TCH ER'S PHA RMA CY
HARR ISON BURG , VA .
R~.or · o Fletc her Bro
o
of Harri sonbu r g,
Th~ Assemb
of Ch!.p t r l 6 of Th~ Acts o
Amount G ain Alcoh ol on fl..?.nd Jun
"
a. . n accor danc e w.'._-t,h the
of Virg n ~ 1916 0
1, 1919
r e cieve d durin g Jun
~
ovis ion of
2 7 /8 Gallo ns .
4 7/8 Galo n~ ~
July • • 19 9 on hand 3
~~ ~
j •&~
~~
~
I~
'
°' '°'
~ - U\0
~ ~ ~~
-
~ ~ ~ 1\,(y
~ . \~- \ °\, C\ ,
1
ec a 14
�y
�FLETCHER'S PHARMACY
HARRISONBURG , VA .
Re port of Fletcher
he te
Amollt1
J.mour.
Amount
l
of
ors. of
he Acts o
~risonburg ,
.e Asseribly of
Grain Al cchol on •. n
41
,I
re ~e ive
,Tuly 1 1
a o in eccord~nce w th
irginie 19le •
9 9 , 3 3/8
.
ons .,
during ,Tul · 4 7/B Ge. Jons .
on hBnd AttJ . l
l
9, 3
.e
ovis i_o _ of .ec . 14 of
��FLETCHER'S PHARMACY
HARRISONBURG, VA.
Report of Fletcher Bros e ot Ha rrbonburg , Va . in aocordanee wit.h the Pro.. ision o! Sec .. U of Chllpte-r U:6 of The Acts
or
The Assc111bly of Virginia 1916 ..
Amotmt Gra it1 Alcohol on hand Aug . l , l91S , 5 O.. llom. 6
Aaount
It
hount
n
"
receiTed during Aug. l9lS·, 4: 7/8 Gallons.
"
on hand Sept . l , 1Sl9
3 Gallons
...
State of Virginia, City of Harrisonburg:
/,
L . T. F L I C ~ Notary Public iu ana
/5,
e~
certify that
~::>,personally appeared before me and made oath that the above ~
(If
½pint.I! .
~ ~ ~
Jft"'fJ,,,,.,.,$~=========-is :fa,st
(;ffl,(f
bes t of his !mowledg e and belief.
Given under my ltaud this
===============
v ·S""'.
·
correct cwui tfJc rnmc iJ
✓
ti:ree tmll
day of_~KltJ'-----t--U_
. ;t:7.i
�~ I ,
-
�FLE TCH ER'S PHA RMA CY
HARR ISONB URG , VA .
R•por t ot Fle tcher Bro8 0 of H,.rri onbur g, Va. in a ccord ance
with t
14 ot Cha.pt r 146 ot The Ar.,a of The Assembly of Virgi nia
1916 0
Amount Grain Alcoh ol on h!t.nd Sept. 1, 1919, 3 Galls . ~}
pints .
It
"
"
r oeiTe d durin g S pt . 1919, 4 Galls . 7 pi nt, ..
State of Virgin ia, Rocki ngham Count y, to-wit :
do certify that ...A:::2'.'.:i~~~'.. t!U.L ~'.__- LL~ ~ ~~ ~~~ ~+."
"'."':-----:-~ ~
person ally appear ed be.fore me and made oath that the above=itt't~fft:..
o.f.- - - - - - - - - - - - -- vs
for $ _ _ _ _ ___is just and correct 12~eti the stmte e·s th,,e tm.i
ttJtpairt, to
the best of his knowledge and belief.
Gz'ven under my hand this
~
, 191.f_
~ ~ N. P .
2=.
II
y
dnyo.f.
9
,,
-
'1
? I)
~~
~~ .
��FLET CHE R'S PHA RMA CY
HARR ISONB URG , VA .
Repor t
or
Fletch er Bro8 G of Harris onburg , Va . in accird& nce with the Provi~
ion of Sec . 14
of Chapu ,r 146 of The Act& of The A8eembly o! Virgin
ia 1916 .
Amount Grain Alcoho l on he..nd Oct, 1 . 1919. 3 gallon s
Amo8n t
Amount
tt
"
ti
"
½pin.t .
receiv ed during Oct. 1919 4 7/8 Ge.llon s,
on hand Nov . l , 1919 3
State of Virgin ia, City of Harrisonburg:
/,
L, T , F LICKL J _ - C r y
e} 0- -t~
Public in andfer ,aid <i(y, da
.
d,~
certify tlzat
persona lly appeare d be/ore nze a11d made oat!t t!tat t!te above tM;€fJ~.<nt
vs __:'.___ _ _ _ __ _ __ _ __
('_f
for $ _ _ __ _ _ _i.s ~ correct ami ~la atemc iJ due and rt •t/Jteifi , to tl1e
bes t of !tis knowled ge and belief.
Given under my !tand tl1is
��FLETCHER' S PHARMACY
HARRISONBURG , VA .
Report of Fletcher Bros . of f;?.r risonbur g , Va.. in accorde.nce wi ·h t he
Cha pt e r 14.6 of The Acts of The As s embly o f
Amount Gre. in Al coho_ on hs.nd
ir~inia
ov a 1 . 1919 3
Qg_ l
9 16.
l ons 7½
State of Virginia, Rockingham County, to-wit:
I,
c. n.
BEARD
,
a Notary Public in and far said County,
e:f Pd-../, ,(,~
~:
do certify that
p e~ l 1 j appe~red be.fore me and made oath that the above~
oJ_- 8 " ° ~ ~
vs _ _ _ _ _ _ _ __
for $ _______is just and correct and i1'e
the best of his knowledge and belief.
Given under my hand this,_ ~k-==~
' '_ dayof-
"My Commi
7o
ivn
saffUJ
is
lfltfJ
.ut.i ttnpaid, to
~
, I9IL
r/29:af ~
xpire
e
2C, 1920
N . P.
ints .
ovis i c
of
��NOTICE OF .I\PPLICATION FOR UCENC E TO PURCHASE AND STORE
ALCOHOL
'
Manar-i ng
,., .
f'd , ,:-,
r,dl or ~f Daj y
N O'rl CE is h e r i'bY glv!'n that th ,; und ersig nPd , 1. L. 11 lorv , do·ing 1Ju :-1i ness .J 8
1he ] clk ton r,i,thla Bot tlin g Comp:,ny, r,t 1(
g]kton, V i r gini a , w.Jll in co11forrni ty to
the proy,ision s of an A c t of th P G en eral
\ ssi>rnibly or Virginia, approv ed
10, ,,
•
1915, appl y to h e Oirc u i t Cuurt March
of Hockingham County , V i !'gin i a,
on l\foncJay.
l\fay 20, 1918, at 10 A. l\L o' clock of lhal
<lay, for a licen se to purchase, Slore a n,l
u se al cohol n ec es.sary for t h e ma nufaclurin g o f flavoring extracts, at h is said
place <>( buAinesa.
l Ars1,...n
.
• · 8.. ,
r1sonb urr- , \7 ]• rrinJ
Doing b1rni ne!l!I
BoUling Compa ny.
· ~
NAVIS -
CiO A. . . ere
I'
Record publish ed
b y c er t l· f
y t h at the
not,i· ce of App11· cati· on f or Li' c ense to pu.r -
a./'th~· :f:k?!y·Llth Ja l and store a l c ohoJ_ , by I. L . F lor y was p u biished
Apr. 23-24 May 7-14
- ··-
-
-
in said paper four succes sive weeka , commen cing
April 2
,
1918 ,
��FLETCHER'S PHARMACY
HARRISONBURG, VA.
Re ort of Fletcher Bros . of Harrisonburg , Ve. .
in accorde.n e with the Pr ov i s i on o ~ Chapter
146 o f The Acts o f The As~embly of Virginia 1916 .
Amount. Grain Alcohol on hand Dec o l , 1919 none
Amo unt Grain Alcoho l re ceived during Dec ~ 191) , 8 Ga l lons , 14p ints .
�.
)
�FLETCH ER'S PHARM ACY
HARRISO NBURG , VA .
Report of Fletcher Bros . o f Harrisonb urg, Vs. . in a.ccorde.nc e with the Provis ion of Chapter
146 of The
cts of The Assembly of Virginie. 1916 .
Amount Gra · n Alcohol on he. d Ja. ny . 1 , 1 920 , 5 Ge.l. 6 pints
"
It
" received during Jany .,, 1920 3 none~
...
,
" ...
State of Virginia, Rockingh am County,~to-w it: '
f,
o
c . D.
BE A RD
,
.
a Nottmy Public in and far said County,
,i 'IP :£ ~
•
~~
do certi_fy that
p ersonally appeared before me and made oath that the above ~ -
of-- - -- - - - - - - -- - - vs _ _ _ _ _ _ _ _ _ _ _ _ _ _
.
for $ _ _ _ _ _ _ _ is just and correct ::md #tt: .:ur,,tt: e·5 dut: a~eJ a,9~aa·ti-, to
- ~ -- - - - -, 191::!L
- - - ~_._..'-------=--=-~ ~~~~~ - - - -N. P.
"M: C
P""
b"t,
..;V,
1920
-- .
......
�'·
�_ .. . . .... ~
-
r ·'l': .. ....
•
FLETCHER' S PHARMACY
HARRISONBURG , VA.
Report o f Flet c he r Bros . of Ha. rrisonb i re; , Va . in 1<.ccord€'.r1cf' v1ith the Provis i o n of Chapter 146
of The Acts of The fa s sembly of Viggini& 1916 .
Amount Gra. i. n Plco hol on hand Feby . 1 , 1920 , 2 Galls . 1 pint • .
State of Virginia, Rockingham County, to-wit:
I, .
~AV
'f Notar)I_ Public in
I
bt.J!::.,
do 1;.ertify t h a t ~ ~
personally a/J1eared
and far said County,
~
~
and made oatk tkat tke above ~
,
-
for $ _ _ _ _ ___is just and correc_t tmd l,h,e same is d.1u1 a,ed empai-d,
the best of his knowledge and belief.
to
ofd
~
~ '---"----'- --
vs _ _
LJ
Given under my hand this
"
:r
C nmmuu'llr,n e:ir~ r
~
t
?O 1920
�f ed i
th, :\erk'~
. oc \n~harn
f;~ f ,
l
0
;~e
111\''r-., ,
!'.L r'~'Q.. &)
· 1,
1
�-·- -
. FLETCHER'S PHARMACY
HARRISONBURG, VA.
Re port of Fletcher Bros . of Fa rrisomburg , va . 1.n accordance with the Provision of Chapter
146 od The Acts of The Assembly of Virginia 1916 0
.Amount Ga rin Al cohol on hand April 1 , 1920 none .
.Amount
.Amount
,,
fl
" r e ceived during April , 1920, 4 7/8 Ga llons .
II
on hand May, l , . 1980 , 2 Gal . ~
~~
C. H. MAUZY
Notary Public
My Commis~ion Expires September 29th, 1922t
�l
�FLE TCH ER'S PHA RMA CY
HARR ISONB URG, VA.
Repo r t of Fletc her Bros. of Harri sonbu rg, H. in accor dance
with the Prov ision of
Seol4 Chap ter 146 of The Acts of The As sembl y of Virgi
nia 1916 0
AmoEn t Gr ain Alcoh ol on hand Ma y 1 , 1920, 2 gal . 3 pints
.
Amount
"
Amount
II
II
re ce ive d durin g May, 1920, 4 7/8 Galls .
II
on hand June 1, 1920, 4 7/8 Ga ll~
~r~
~
---1· ~
~~ J4 7 7J ;
\Y GDM~ISS1Uk tX lficS Alfi L J, 191
~
/f'~
~
~~ .
1
�. ....~a;::::=:. . \ , - ~
•
-- -
.
,
filed In ttie Cl~rk's Office
Rockingham Cou, ,ty,
JUN : J·t02 0
.., .
�FL ET CH ER 'S PH AR MA
CY
HA RR ISO NB UR G, VA
.
Re
ri,
f ?h t~ he r Bro s . of Ha
rri son trg ,
Js. . in ecc ord a.n ce w "t.li
of Chfl. t er 146 o.f The Ac
ta of The
sa m l y f Vi rgi · a 191
6.
_mo un t Gra in ~ .. oh ol on
ha.nd Jun e l , 192 0, 47 / 8
ga llo ns
II
"
II
11
'
iY
co JM)
rec eived d r i rng Jun e l
20 , non e
on han tl J
SIOt' EXP/HLS APRIL 1, 192;
st . 192 0, 1 ga ll Q 7 p·
t
t:
e Pr ov isi n of
ec 14
�r •
.
Filed \n the
R'oc'Kin~am eoun
l\.l l S - 192
- --------~fer·
�FL ET CH ER 'S PH AR MA CY
-'1~--~
__ -':. . · \
HA RR ISO NB UR G, VA .
Re per t ef Fle tch t1
of
c_ apt er
Bro s., of Har ri son bur g , Va
I -' 6 of the Ac t s of The
Amount Gra.:.n Alc oho l on han
d
II
II
!I
Rec eived
"
on han d
Ass em ble o f
Aug - I - 192 0 .
d rin g
Se t-
acc ord anc e
Vi rgin ia.. 191 6 0
Non e ,.
Ag - 192 0,
I~~
wit h the Pro vis ion of Sec
I4
4 7/8 gal lon s
192 0, 2 gal lon s - 3p int
1o
o
�Filed in th e .C~r 's O.ttke
~oc in ham Co11n+.•, ' · -·,
• l
?
~ r1~1- ~
.-
_ _ _ __ _ Clerk
�FLETCHER' S PHARMACY
HARRISONBURG , VA.
of Chl:l t"'r 1 46 of th~ Acts of T'r.·~ A seir:. _e, o: V
.oun t -rr. i n ,' icoh · l on hand Sept .
I!
Ii
2 G0. l or:
ept .
Eeceiv<'!d dnrning
II
gi ni ~, 191 ' •
- 3 Pints.
1920., .:one ,.
State of Virginia, City of Harrisonb,,lfl:
/
a Notary Public in and.for said city , do
L. T. FLIC ~
(/J_ ~~
certif; that / ~ -~
personally appeared before me and made oath that the above
of _ _ __ _ __ _ __ _ __ _ _
vs _ _ _ _ _ _ _ __ _ _ _ _ __
for $________is jm; t tt,rd correct
best of !tis k now ledg e and belief.
drt~I«' .,. ~ ~ -
rAHfi
U c sai'l'ie
@·,;
Jue eenzl unpaid, to the
~
_ -__ day o./.
Given under my hand tltis_ -'-¥
~
-
, 19~
~7, 7-Luu
. _ _ __ _
-=-- - - - - - - - --"-~
!,/;1f l-'• J.Ht . l ll S] OTI expires J LIJ J Z llQ, l~lJ.
.
N . P.
Set-
- IP2 .
��FL ET CH ER 'S PH AR MA CY
HAR RIS ONB URG , VA .
P.•r ort of Flet cbeo r ?- ,-s . of i i·r
ison )U"E , V · • ir,
11, !)te- r 146 o
Thr)
i'ct s of 'f..'1~ AEs,.rr,"1 ., ot Virg ini
.L.!.,0 1JPt
Gr•. ir ii.lc oho l on Y£>.nd Oct .
'
/"I ...' .
.!'J_
lli"1t
i!
.
J
c cocr .."r.c ~ v i th UL Fro~ dsio n o:'
Sec . 14 of
st
'£1? 0, pone.:
coh ol rec, .i ved J.uri ne; Oct . H'?O ,
A!llo11r. . _ ~rai n ; ' co'· o
on 1-.r 1
. . . . O""I 111
1 16 .
'r
7 /8
~
lorn , .
st • 1!)20 ,
Stat e of Virginia , City o f..ffmorisonb dfg:
f,
L. T. FLIC~ ~ J ?N otary Publ
ic in and. for said city, do
certi fy that - ~=:.. ....... L-~..:-~
'.. T,----=
~=-= :....: :~~~ ~'.... ___- --- - - - - -~-perso nally appe ared be.fore ·m e and made
oath that the above
ef.__ __ __ __ __ __ __ _
~/L A.. f
vs _ __ _ __ __ __ _ _ _ __
.for $ __ __ __ __is :i~~ci emri corre
ct and tl1e rawe i. d.Ju1 tutti nnpa i,c; to
the
best o.f !tis lmow ledg-e and belief.
Give n 11JU_der my hand this
\ ?~
- day o.f_
f, '. ' ~~. '. :
_.
�·--
�FL ET CH ER 'S PH AR MA CY
HA RR ISO NB UR G, VA .
ur g , Va . in a c oo rda n co , "t h
onb
l•
rr
Ba
of
.
s
Bro
er
tch
Re po rt of Fle
embly
14 6 of The ~ cts of !he as s
ter
~p
~
of
14
.
ec
a
of
t he Pro vi s ion
of Vir gi n ia 19 16 .
s.
Nov . 1s t . 19 20 , 3 ~/ 8 ga ll
d
han
on
l
ho
lco
~
n
i
Gra
t
un
mo
d du ring Nov . 19 20 no ne .
Amou nt Gr a in ~ luo ho l r e ce ive
.;i__-=---- - - -Amount Gr e.1n . l co ho J on }, o....,,,._
3/4 ga ll s .
-
....
~ ff l/ ) .
do
Notar1, Pub lic in and for sazd
~
~
T. F L. I C ~/ t -·~ · _,.
~
:J. < J .' J -~
.
. g; 1,8 Cit y of Har riso nbu rg:
Sta te o f V tr tn •
.
C1ly,
L.
I,
e tzrt;( )#J
me and mad e oath that the abov
a-M-.eare before~
tlhlzat
cert ify
rf'
J'
pers ona
vs - - - - - - - - - - - - :z....u-.-t,..
,-
r,-
== == --
-It,~ :,,_......
is i:tJ, zf ' ,i corr ect
best of his kno wled ge and beli ef.
d th zs·
Giv en und er my han
""
r1/J
A
,-...
IM@SI:
to the
tltc JttJne ts. az, 1e tmtl ., ,r,c,tj
,. ,rnd,
' 19~.
~
,,
=----,- =-==;.-/)
u~~
day of.:____
~
_,I)
~ . 7 . ;f ~ ~
N. P.
�f\\~, . n
"
1ei'I!
j\\:e
~oc\c.\l\g\\8.f<' CoUl\ j I
Dt.C 'i.; \9?.0
•.
------('}.e
�FLETCHER' S PHARMACY
HARRISONBURG , VA .
E.e port of Fletcher Bros . of E!lr r ison·:) u:c g , Va . i n ilccordanc,;;J 'l,i t h the Provis i o n of Se c . 1'1
of C'1apt- r J.46 cf 'i'he Acts of '!he As .,el"'lbl y of Yirf;i ni a. 1916 .
J.· ·o,..nt Gr ai n , bc hoJ. r Ct i vcc~ ·lv ri n 6 Dec . 1920 . . 4 7/8 gal.
,r;iou nt Gr ain ;\lu.,ho l o. hand J ny. 1, . 221 , 8 ?/ 8 g<.~
State of Vi rginia, Ci ty of H arrisonburg:
f,
L.T: ''::..-2..i:::LN ,tary Public ;,, andf,r ,-;d dly, M
J.o
~
certify tlzat
f
personally appeared be/ore m e and made oath that the above
ef ( / " ~
RCt:
st
AJ-t
~
~ - - - - - --
-;_f~(,l~r...;$~~- - == ==-is ~ d correct anti tae u1cwe ,·c iUi e
best of his knowledge and belief.
J
Given under my hand thzs__:;--day of
6!stti
-
1tnPttid, to the
/
'I
��FL ET CH ER 'S PH AR MA
CY
HA RR ISO NB UR G, VA .
Re por t of Fle tch er Bro s. of
Ha rris onb urg , Va. in ac cor
dan ce wit h t he Pro vis ion of
Se c. 14
of Cha pte r 146 of The Act s
of The Ass em bly of Vi rgi nia
191 6.
Amount Gr ain Alc oh ol on han
d Jany . 1, 192 1, 3 7/8 Ga
l.
II
II
11
rec eiv ed du rin g Jan y, 1!121,
non e.
fl
II
" on hand Feb y. 1, 192 1,
l 3/8
.
,---
_,.
Sta te of Vir gin ia, Cit y of Ha
rris onb urg :
I,
L. T.
FLI CK
, a Not
-- ~ ~ ~ , .. ~ ary Pub lic in a11d f or said city , do
cert ify tha t -"""'-"''-'--V=-·-- ~- -- =' -- -'- -= --- -- -- -- -- ~~
- _..,, ._-_ ___,
(lf__ _l,L_:~ ~::: ::c:: ::::. ,,~~'.._____'~
~ ~~ ~lt i" - - -
--------
fi71r,",-$.;11:=""""-~===:=:!!...~ is ji,* i iimi
correct 6U@fi Nte scu,re is
best ef
!tis kno wledg e aud beli ef.
Giv en u nde r my han d tl1is
~
/ -
fHtC
----
g~ui em/Jttid , to the
day of.
1'.
CC,J1J•ll..JC:c,l lJ.0 07.J. 1·~
, l
'1,
~d'
�---~
Filrrt in the Clark's Offlc,
R ckin a County, a. .
E8 1- 1 21.
_ _ _ _ _;..._Clerk "
i
�FLETC HER'S PHAR MACY
HARRIS ONBURG , VA .
Report of Fletche r Bros . of Harrison burg, Va . in accordan ce with the Provisio n of
Sec. 14
of Chapter 146 of The Acts o~ The Assemb l y o:f Virginia 1916 .
Amount Grai n Alcohol on hand Feby 1, 1921, l 3/8 Ge. l.
"
II
"
11
II
11
received during Feby . 1921, 4 7/8 Gal .
on hand March 1, 1921, 4¼ Gal.
T r.iE OP VI <:C L:IA
)
}
CITY OF HARll' lIBlIBG , )
I , L. T. Flick ,
notar-<J Public in --i n d or s~id City J o ce tify th.3.. t
S . P • .!Pletcher . JJe·,..sonn lly app ea r ed before me and made oo.th t h2.t t he above stnteme
nt
o... •let c_ er Bros ., is correc t t o the be st of his lGlO\·,le dce and belief .
Given unde my h""nd thi 2 d D~y o· .fc.r ch. , 1921.
rry Co wmission exp :i:res J uly 2nd , 1 921.
• P.
�filed in the 'Cl rk's OtHt 11
Rockin a C unty, V ,
M o
n o. 192
•
1,
~
�FLETCHER'S PHARMACY
HARRISONBURG , VA .
Report of Fletcher Bros . of Harris onburg, Va . in accordance with the Provisi on of Sec.
14 of Chapter 146 of The Acts of The Assemb ly of Virgi nia 1916.
Amount Grain Alcohol on hand March 1, 1921 , 44 Gal .
II
II
II
received during fa.rch 1921 none
: l__,¼"--G_a_l_.__~-~~ ~ -.:p~r_ i _l_ l..,:. _ 1_9_2_1..,_
•• ___ _"___ "__~o_n_ h_a_n_d_ A
- -~ - - - State of Virginia, City of Harrisonburg:
I,
. a Notary Public in and.for said city, do
L. T. FLIC~
-
: ~7
-=
certify that _~~!:':....:.---=- ~:...:::::-===-===-=--- - - - - - - - - 4===;;--~ personally appeared before me and made oath that the above a•cn .,,
fe, $
- - - - -- -
~
9~
ef
-
is }~<&i totd correct ~Nd flu .,ia:ue ie ,i,,n a mt nnj>ailt , to the
;£:
best of his knowledge and belief.
Given under my hand this
~
-
day of.
~ r oom rrJN,icn c-, ,·c J u,'J
Ilil •
,..l
~~
�Filed in the Clerk's Office
Rockingham County,
l.PR -419~,
____ ___c
::·,
'.
'
'
j
l.
- .. J;
I
�- - - -- - - -- - - - - - - -- - ~ -- -- ....... ,r,
,
...
St at e o ~ n ia , Ci
ty of Ha rr iso nb ur g:
wi t h the Pr ovi s i on
of Se c . 14
-:1tcmo,~$f:::=======::
::=--is j ~,.,;I am i cor rec
t a~ui Mte fitfrJtc i<Y
bes t o.f his kn ow ledg e
an d bel ief.
Given un der my ha nd
this
day
£..
¥-
,f
@fW tm ti rm pa iri
,
1 1 t ~ ,19Jt._!_ .
Lf°:7'. '
:V.r- oom mi f-iC I) <:'X ~- ~
-- - .,, ,
~
to the
c/ N .
.; ll1J ;mj_, l;j~
P.
��FLETCHER'S PHARMACY
HARRISONBURG, VA.
Filed in the Cterk's
Rocki ngham County, Va.
.·lf N :,_ 1921
_ _ __ _ __ Clerk
Report of Fletcher Bros. of Harris onburg , Va . i n ac co~dance with the Provisi on of Sec ·
14 of Chapter 146 of The Acts of The .Ass embly of Virginia 1916 .
Amou nt Grain Amcohol on hand May 1,1921 , 2 7/8 Gal.
.Amount
II
.Amou nt
11
II
received dur i ng May, 1921 none •
11
on hand Ju ne 1, 1921 , none •
S'.l'.A ' O.!! VI GH I A
CI TY OF HARHISOWBURG:
I, L. T• .!! lic k , A Notary Public in and f or said c ity, do ce r ti f y that
P • .E'letche r per s onally appeara.d bet·ore me and ma de oa t h that t he above s t ntement
of Fletcher Brothers i s co rrec t o the bes t of hi s lmowl edgll. and belief.
Given under my hand this 2rd ®Y of June,
~~~
My Commis s ion expires July 2nd, 1921.
/ ~
.::i .
l921L.
...
.
I
N. P •
�•·
�FLETCHER'S PHARMACY
HARRISONBURG, VA.
Report of Fletcher Bros. of Harrisonburg, Va. in accordance with the Provision of
sec . 14 of Chapter 146 of The Acts of The Assemb ly of Jir-.ginia. 1916.
Am u nt Grain Alcohol on hand June 1, 1921, none .
~ount
"
"
Amount
"
"
State of ~irg inia,
r ece ived during June, 1921, 4 7/8 Ga l
on hand Ju ly 1,1921,
2 3/8 Gal.
J
)To-Wi t:
City of Ha r r is nburg ,)
J='J_
I, L. T. Flick , N t a r y P ub lic in and for ..._ City
, do hereby ~ t hat • p . Fletch er p ers onal ly appeared be fo re me and ma.de
oath that the above - - • or· .l!'letoher Bros., is c orre ct to the best of h is knowledge and belie f .
Given under my hand t h i s 2nd day of July , 1921 .
Icy- Commiss i on expires on J une 10th, 1925.
L. iJ":~C/N• l'e
��FLETCHER'S PHARMACY
HARRISONBURG , VA .
Report of Fletcher Bros.of
Harr isonburg , Va . ~n accordance with t~e pr ovision of
seo . I4 of chapter 146 oft e Act s of The Assembly of Vi rgi nia l9I6 .
Amount Grain Aii,,ohol on hand July I I 92! ., 2: 3/8 Gal.
Amount
II
II
Amount
It
II
received during July 4 7/8 Ge.l.
Amount on hand August I 192 !
4 3/ 8 Gal .
~
State ot Virginia, City of Harriaonburg
~ / )_J__
~~
I, L. T. l'l.ick 1 IDtary Publ'ic i, c:-in am fer aaid city. dt certify that
P. netcher personally appeared before me an:1 made oath that the abeTe
•tatement ef Fletcher Broa. b cerrect te the be•t et hi• knowledge alld belief•
s.
Given um.er nT/ hand thi• 3rd day et Aug., 1921.
My cemnissien expire• June 10, 1925.
�~-
,.,
t~
. I'
~
\'
Flied In the Clerk' s
"
r\"'if' !}
Rockingham County, \J a,
~HG 3-·1921
.,
- - - - - - ----:Clea
I I
.1 •
- I
:')
r
h i
••
},
..
�FLETCHER'S PHARMACY
HARRISONBURG, VA .
Rep ort .of Fletcher Bros. of Harrisonb 1rg , Va . i!l accordance with the provi ion of Sec +ti14 of Chapter 146 of The Acts of The Assembly of Virginia 1916.
IL"nount Grain Alcohol on hand Aug . 1, 1921 , 4 3/8 Ga l.
Amount
II
II
Amount
"
II
re ceived during .Aug . 1921 none .
on hand Sept . 1,
921, 1 7/8 Ga. l.
C. H.MAUZY
Notary Public
\.
�y
A
�FLETCHER'S PHARMACY
HARRISONBURG, VA.
Rep or t of Fletcher Bros. of Harrisonburg , Va . i n acc ordance with the provision of Sec.14 of
Cha pter 146 of r!l'he Acys of The As s e mbly of Vir ginia 1916 •
.Amount Gra i n .Alcohol on hand Se pt. 1, 192 1, 1 7/ 8 Gal .
mount
Amount
n
"
II
II
received duri ng Sept. 1921 , 4 7/8 Gal .
o n hand Oct . l, 1 92 1 , 4 Gal .½ pt .
State of Virginia,
City of Harrisonburg
I, L. T. Flick, Nofa:try Public, in a:rrl for sa,id c Hy, do certify that s. P. Fletcher
personally appeured before me and made oat h that the above stat ement oi Fletcher Bros. is
correct to t he best of his knowledge and belief.
Given under rrry hand this the 3rd day of October.
My connnission expires June 10, 1925.
Notary
�lo t!.o.a lo nolaho-iq wlJ' d.t.hr 9CXI•b-Jooo• n.t .av ,J'IDdaoal'l'I.SH lo .ao-xa 'ledo.ta!,: "lo .t'JO(ld
.alel alct.g'llV "lo
.iao a\,
I
"(IdmNaA edT "lo -to.A erllh ".to
,IseI
,I • .tq.a
.rao a\, ,. ,rser •.tq.a
Fi\ed-,n the C\erk's Offlc@
Rockingham County, Va,
mad
30.h.ub bw.teon
• .tq j • .C.eO ,- ,ISQI ,I • .toO .:fxr.erl ao
r
l
"I-.tq&dO
a:o IorloolA a.ta-d> .t.ru,omA
OCT 3- 1921
~---- -C
a•I
•
•
"
•·
"
.tm.1omA
�FLETCHER'S PHARMACY
HARRISONBURG, VA .
Report of Fle tcher Bro s . of Harris onburg , Va . i n accordance with t 1 e
provi sion of
#1/:B
~Efc . 14 of Chapter 146 of The Acts of The As sembly of Virginia 1916 .
mount Grain Alcohol on hand Oct. 1 , 192 1 4 gal.
Amount
II
II
Amount
ti
fl
1 p i nt .
r e ceived dur i ng Sept . 1921 , none .
on hand
Nov: . 1 , 1921 2 gal. •½pints . ~
~
~~
State of Virginia,
City o! Harrisonburg,
I, L. T. Flick, Notary Publi c in the said City alil State, do certify thats. P. Fletcr.e
personally appeared be f ore me and made oath that the above statement of Fletcher Bros. is
correct to the best of his knowledge and belief.
Given under rcy hand this second day of November, 1921.
Notary Public.
My commission expires June 10, 1925.
�..._,,_, _ .
- .... )
ti
-
.led in the Clerk'~
-t .~
nocklngham Count,,
NOV - ~ 1921
_____c,
)
�FLE TCH ER 'S PH AR MA CY
HAR RISO NBU RG , VA.
Fepo r t of Flet cher Bros . of Ha. ~risombu r g
, Va . i n acco rdan ce wi th the pr ovis ion of
Sec . 14 of Cha ter 1 6 of The Acts of The
Asse mbly of Vir gi ni a. 1916 .
Amou nt Ga.r in Alco hol on hand Nov . l > 1921
, 2 ga l. 4~ pt .
Amounk. Grai n Alco hol rece i ved duri ng Nov
. 1921 , 5 Ga l.
Amoti nt Gari n Alco hol on h nd Dec . 1, 192
1, 5 Gal.
Stat e of Virg inia ,
City of Ha rri s onbu rg .
I , o. L. Dund ore , N0 t · ry Publ ic in and for
ui d City , do c erti fy that S. P . Flet c her
pers ona l ly a ppea red b ef ore r e and ·d e oat
p tl t t he above is c orr ct to the be st
of his
kno wl edge and beli ef .
Give n unde r my hand this 3rd day of Dece m
ber , 1921 .
Nly comm issi on expi r es Nov . 1 , 1924 .
_ /4_~
Notc.ry Publ ic .
�filed \n tne Clerk's Cet,,~e
Rockingnam County, \/a,
OEC 3- \92-'
---
_Clerk
'
�FLE TCH ER' S PHA RM ACY
HAR RISO NBU RG, VA.
. of Fletc her Bros . of Harr i sol":!:mrg , va .
in a ccord ance ,,Ji t~'l the provi sion of Se c •
Rc por~
· im.e
· · 191G
mh
ssem b ly of Virg
4 of C:hap i.er 14 o f .1. e p· tc:~ 0 --r 'T'hc
Am ,1-nt r.rRi n A .coho l on h and De , J. ,
92 1 , 5 rra l.
L
Arr\ount
Amou nt
II
II
II
II
·
•
r eceiv ed du r · Pe; De c . 192 1 , none .
on ha.n
Ja.ny . 1 , 192 2 , l ·J- G 1.
Stat e of Virg inia,
City of Harr isonb urg,
I, C. L. Dund ore, Nota ry Publ ic in am for
said City , do cert ify that s. p . Fletc her,
g-f the ·· fi;irm •of.- Fl~tc her Brot hers , per s onal ly
appeared befo re me and made oath that the abov
e
state ment is corr ect to the best of his know
ledge and beli ef.
Give n unde r my hand this 3rd day of Janu an,
1922 .
My commission expi res Nov. 1, 1924 .
/{~~
�lled In the· Clerk'. 0 ,
klngham o mty, ' ,
Ji·
~
1CJ?'.t
(
.
�FLETCH ER'S PHARM ACY
HARRISON BURG, VA.
Report of Fletche r Pros , of .a rr i sonbure; , Va . i n
i:
cco· dan
Sec , 14 of Chapter 146 of The A ts of ThP- Asso nb l y of
Arr.cunt rrain Alcohol on hand Jany . l ,
II
It
II
II
922 , 1~ ,a l.
II
received during Jany , 1922 , 5 Ga l.
II
on hand Feby , 1. 19 , 2 ,
~
~a l.
-
State of Virginia ,
Cit y of Ha rri sonbur g ,
I , C, L. Dundore, Nota ry Public in and for sa id City, do c er t ify that
P . Fl et c her , of the firm of Fletcher Bros ., per sonally ap peared before me an.d
made oath that the ab ove statement i s corr ect to the b e st of his knowledge and
b elie f.
Gi v en under ID'f ham this 6th day of Feb.
s.
li:z:~
My
cormnissio n ex pires Nov . 1 , 1924 .
Not ary Public .
�''
�FLE TCH ER'S PHA RMA CY
HARR ISONB URG. VA.
' h er O)r os . o"
~c?or t o f ....,
; c~c
1
=--~ rr-.._".,,oriburr,-b ,
0
w
_ of :~haptc r H 6 of ,..,he · Ac ts of Th
P·,oun t Grain A. coho l on h0.nd "'."'c
Amou nt
II
!I
II
11
,.
VG , i n nccor dance v·i th t11'-, nrovi
s i on of Sec .
_
Ass011
yo
• 1 , 19 2 , '1
r"cr, i vcd du ri ng :-"ebr •
, 19 2 2 ,
'Tir g i n i a 19 1 •
'!f-1
.9 2 , none .
oz
.ra 1 .
St &t e of Virgi nia ,
City of Harri sonbu rg ,
I , C . L , Dundo re , Not a ry Public in and for said City
, do certi fy that S. P .
FletE her, of the firm of Flstc her Bros. , perso nally
appea red befor e me and made oath that
the a b ove stc.te ment is corre ct to the best of his knowl
edge and belie f .
Given \. . nder my harrl this 2nd dJly of March 1922 •
,
/A
My commis sion expir es Nov . 1 , 1924 .
~.Notar
~
~
y Publi c .
�(.
Flied i the Clerk's
Rockin0 h Cuu y, a
MAR 2~ 192?
-------------...Cler
�FLET CHE R'S PHA RMA CY
HARRI SONBU RG, VA.
Repor t
f Fl etcher nros . o_ Har r ison 1.'r~ ,
Chapte r L6 of Th<> .Act!'l of
w..
in a .cor ancc wi t
on }-,and l.iarch , J. , J. 922 , 3 Gal
II
II
re ceived du ring i..:arch , 1922 , none
II
on hand Apri 1 , 1 , 19 .2 , none . -
Amoun t
II
State of Virgin ia,
City of Harris onbur g,
tho provis i on of Sec . 1
h0 Assem'b l~r of Virgin ia 191 •
Amoun t Grain Alc oho
Acr:o\.1nt
1
To-V/i t:
I, c. L. Dundo re, N. otary Public in and for siad Ci y, clo
certif y thats . p.
Fletch er, cf the firm or F.Letcher Bros., person ally appear ed
before me and ma.de ca.th that
the above statem ent ~ correc t to the best of his knowle dge
and belie f.
Given under "'I hand this 3rd day of Ap.-il, 1922•
~~
My commi ssion expire s Nov. 1, 1924.
/4\~
-~
Noatra y Pbblic .
of
�i in th. Cler~ . Office
.Jc.kingham C unty, \Ja,
,MR ,. 19? 11
- - --·-··-·- -Clerk
(
.
�FLETCH ER'S PHARM ACY
HARRISON BURG, VA.
R~port of Fletcher Bros . of Ha rri sonburg , Va . in a.ccorclA.ncc wi th the
_ of
ha
er 146 of The Acts of The Assembl· o
n~ nt Garin
or hand April 1 , 1922 ,
echo
" ''
II
II
II
rccei ved durine; Jrpri
State of Virginia
City of Harr is onburg
J
.
roviraion of Sec .
Tirginia .9 6.
~~n~ .
922 , 5
r:.e_ l.
?2 , 3 ,a l.
To-Wit :
1 1 C . L . Dundore, Notary Public in and ·f or said City , do certify thats. P.
Fletcher, cf Fletcher Br os ., personall y appeared before me and made oat h that t he -abov
statement is correct to the best of his knowledge and belief .
Giv en under 'ill'/ hand this 4th day of Ma y , 1922 •
L>,~.~
My commiss i on expir es Nov . l, 1 924 .
Not a ry Pub;.i c .
�fW~d in he C\er~ s Offl
~
i
c.uoty,
)
~a.'
. ~ 4,- \9??
'.
�FLE TCH ER'S PHA RMA CY
HARR ISONB URG, VA.
k /
Rep•r t ot Fletc her Bros. et Harri sonbu rg, va. in accor dance
with the provi aien o f ~ 14
et Chapt er 146 of The Acta of The Assembly of Virgi nia, 1916
•
.Ameunt Orlin Alc.it el en hand May, l, 1922, 3 Gal.
•
"
"
" •n
receiv ed durin g May, 1922, none.
STATE OF VIlGINU
CITY OF HARRI SONBURG
hand June 1,192 2,
l
Gal.
)
) TO-WIT:
)
I, C. L. Dundo re, A Notar y Publi c in and for said.
Oity att~ State .~ d.ct certi fy
that S. P • .Fletc her of Flete her Bros. perso nally appea red
befor e me and mde oath that the
a bove s t ateme nt is corre ct ,tot the best of his knowledge
and belie f.
~iven un~er ~ hand this 2nd daT ot June, l~~G•
My comm ission expir es Nov. 1st, 1924.
Notar y Publi c.
�I
~;~urrty, Va ,
IUN 2- 16~~1
--- _
O~rk
�FLE TCH ER' S PHA RM ACY
HARR ISON BURG , VA.
Repo rt ot Fletc her Bros . of Harr isonb urg,
va.
in acco rdan ce with the prov ision ot Sec. 14
ot Chap ter 1'6 ot The Acta of The Assembly of Virg
inia, 1916.
Amount Grai n Alco hol on "'nd June l, 1922, ½ Gal.
Amount
"
"
Amou nt
"
n
reoe i-.ed durin g June , 1922, 5 Gal.
on hand July 1,19 22,
S! Gal.
STATE OF VIRG m IA
CITY OF HAllli ISONBURG.
TO-WIT:
I, L. T. Flic k, A Nota ry Publ ic in and for sa
id city , do cert ify that
P. Pletc her perso na llv appe a red befo re me and
mde oath that the a bove . t a t en•n t
is corr ect to t ne b~&t of his lO'lowie~e beli ef.
Ky commis s ion expi res June 10th , 1925 .
Given unde r JDT.r hand this the 8th day of July
, 19 22.
s.
L~
Bo ta.ry Publ ic.
�Fi1P.d in the c1 ~r~'s () fiir:e
Rockir ,gham ( · .,, ''f , Va.
0
JUL 8- 19?
_ ._ _ _ _ __ Clerk
�FLE TCH ER' S PHA RM ACY
HARR ISON BURG , VA.
of Sec • .
arris onbu rg, va. in acco rdan ce with the prov ision
H
Of
Repo rt of Fletc her Bros .
of Virg inia, 1916 .
1 of Chap ter 146 of The Acts of The Asse mbly
4
Amount Grai n Alco hol on hand July , 1,19 22, 3½ Gal.
AJD.ount
"
11
rece ived durin g July , 1922 , none .
It
It
on hand Aug. 1,19 22,
ST~TE OP VIBGINIA.
½Gal.
)
CITY OF H.ARRISOUBUBG • ) TO-WIT:
city de ce rtify that
I, L. T. rlick , a Beta ry Pabl io in and fer said
ef
befe re me and .rm.de •ath that the abev e state ment
s. P. Jletc her pers enal ly a ppea red
af his knew ledi• and beli ef.
lletc her Brea ., is in:i: Xat cerr eot t• the beat
1922 .
Give n ande r my hand this the 3rd day ef A11gast,
Ky oemm issie n expi res Jane 10th , 1925 .
�l
•
. ·- 'L- . 's5J IH'
"' .
.•,
_J wn4 Uf)f9 ll
�FLETCHER' S PHARMACY
HARRISONBURG ,
VA.
Report ot Fleteher Bros. ot Harrisonburg, va. in aooordanoe with the provision of
Seo. 14 of Chapter 146 ot The Acts of The Assembly ot Virginia, 1916
Amount Grain Alcohol on harid Aug. 1,1922,
Amount
Amount
"
,,
received during Aug. 1$22 5 Gal.
"
"
on hand Sept. l, 1922, 3½ Gal.
State of Virgini•,
City of Har r i sonburg, Va .
n th
k111 : ,In.If/
,r
. _
To-ilit:
~ ~r-if-t
(!y!,{P ~
Dundore , l!otury Public in and for s a id City, do c ertify that
I , c . L•
S. P. Fletc her, of Flet ch er Bros., personally appea r(J d before me and made oath
that the above sta ter.ient is · correct to the beet of his knowledge and beli e f.
Given under my hand this 14th day of 6ept., 1922.
C:, ,.,
•
½Gal.
:
•
\i
My commission expires Nov. 1, 1924•
Ji:.P flirPJi91fl'1the 'I ,rk's ()rflce
~re1M
U11ty, Va.
Rockin
,., PI~ 19?~
k.~
Noatray Public.
��FLETC HER'S PHAR MACY
HARRISO NBURG, VA.
Report of Fletche r Bros. of Harrison burg, Va. in accordan ce with the provisio n of
Seo. 14 of Chapter 146 of The Acts of The Assembly of Virginia , 1916.
Amount Garin Alcohol on hand Sept. 1,1922, 321 Gal.
Amount
"
"
II
11
received during Sept. 1922, none.
on hand Oct. 1, 1922, 2½ Gal.
STATE OF VIRG I}!I A,
TO- WlT :
CITY OF' HARRISO! !B URG .
I , L• T. Flick ,
Nota ry Pu l i e · n e.nd f or sai d c ity L.d o c erti fy
that -S . P . F etch er pcrs ono. lly a ppear ed b f or e me and t'lu.d. e othat t hat t he ab ove
statemt nf t Df Flet cher Bros i s cor r ect to t he best of hi s knowl edge and belief.
Given under my h~nd t his ~rd day of Oct . 1922 •
fy Co mmiss i on expires June l ot h , 1925•
~ r .~ c / N , P.
��FLETCHE R'S PHARMA CY
HARRISONBU RG. VA.
Report of Fletcher Bros. of Harriso nburg, Va. in accordance with the provision of Sec.
14 of Chapter 146 of The Acts of The Assew.hly of Virginia, 1916.
l.lllount Grain Alcohol on hand Oct.l, 1922, 2½ gal.
Amount
.Amount
II
II
"
II
received during Oct. 1922, none
on hand Nov. 1, 1922, 1 gal •
St ate of Virginia ,
Ci ty of Harri sonburg ,
To-r!it :
I , L, T . Flick , Hot a r y ublic in and for s a i d City , do cert ify t hat S .
Flet che r personally appeared befo r e me an made 0&. th that the above st at ement of
Fletc h er Br os ,, ia, c or r e ct to the best of h is knowled g e and belief.
Giv en under my hand this 2nd day of ll ov., 1 922 •
lay c ommission expi res June 10 , 1955.
l: otar y Pub lic .
�l
• l
• l
flied In the Clerk's Ottlc
ockingham C&unty, Va.
\JOV ..4 1922
_ _Cle
�0
FLET CHE R'S PHA RMA CY
HARRI SONBU RG, VA.
Report of Fletche r Brothers, of Harrisonburg, Va., in accorda nce with a provisio
n of
of Chapter 146 of the Acts of the Assembly of Virginia, 1916.
Amount Grain Alcohol on hand . . . ... ...... . .~... /. . ....... ........ ..........19...2 ...:L
Amount Grain Alcohol Received during ...............~............................... 19.... ...~
Amount Grain Alcohol on hand . . . . ... .. .
State of Virginia,
City of Harrisonburg,
-wit:
t...,.., ~ . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .
I, .....
Nt>tary Public in and for said city, do certify that Mr.
S. P. Fletche r personally appeared before me and made oath that the above stateme
nt of Fletche r Bros. is
¢t~.~~:. .
correc ~:::eu !::: o;;i:a: :o;~:d_~.~ ..
1.:?~. ~. . /... . . . . . .
My Commission expirts..........
day of
-~
~ A . . . . . . .. .. . .
192 ..
~
.& . ~ .....C-C --~.....~....N. P.
19.¥
�_ _ _ __ _ Clerk
�Rod<ifi .
FLE TCH ER' S PHA RM ACY
HARR ISON BURG . VA.
.
epo"ft of Fletc her Broth ers, of Harri sonbu rg, Va.,
in accordance with a provision of Section 14
- - - or-C hapte r 146 of the Acts of the Assembly of
Virginia, 1916.
Amount Grain Alcohol on hand . . . .. . ....... ~........ L
........ .............. 19,:J...~
Amount Grain Alcohol Received durin g ............. ~...............
..............19 ..~...~
Amou nt Grain Alcohol on hand . . .. . ..
.....~..... .
-h ~ :z~~ .........., r : ~. . .
.~ £ /l -
State of Virginia,
0
City :,:z:oz,21wi'.:.. . . . .. . . ....................:Notary Public in and for said city, do certify that Mr.
correc~~:::eu:::::;i:a::o:~:d~~~li~'.: _day of~~~ N. P.
S. P. Fletc her personally appea red before me and made
oath that the above statem ent of Fletch er Bros. is
J.:f ~ . . . . . . . L. . . . . . . . . 19. .2.f
My Commission expir ts. . . . . . . . . . . .
��FL ET CH ER 'S PH AR MA CY
HAR RIS ONB URG , VA .
Rep ort of Flet che r Bro ther s, of Har riso
nbu rg, Va., in accordance with a prov
of Cha pter 146 of the Acts of the Ass
ision of Section 14
embly of Virginia, 1916.
Amount Grain Alcohol on han d . . . .
.. ..... ...................... .. .....;............ ......... .. 19o'2 ...3..
.. . c2.. .~~
Amount Grain Alcohol on hand . . . . . .
. .. .. ..
~....
...
��FLE TCH ER ·s PH AR MA CY
HAR RISO NBU RG, VA.
Repo rt of Fletc her Brothers, of Harri sonbu rg, Va.,
in accordance with a provision of Section 14
of Chap ter 146 of the Acts of the Assembly of Virgi
nia, 1916.
Amount Grain Alcohol on hand . . .... ..~ .......
/ .................................. 19.. :b..... '3.....
Amount Grain Alcohol Received d u r i n g Q
··················m 2$.
Amount Grain Alcohol
State of Virginia,
City of Harri sonbu rg, to-wit:
on hand . .. .. .. . .. .. ... ·······~~
~
. .........../....~ ....
.r !' ~
_.....
.~
·
i..1.. 7......L.:... . . :... . . . . . . . . .
correc~i:::•u:::~~;i:a::o~::d~=:~~~:- day of _'!f14,__ 192f r,~ . P.
My Commission expires. ~. . ..!..tZ...=·········19,Z.6':--
I, ... ,....,..........................
Notary Public in and for said city, do certify that Mr.
S. P. Fletc her personally appe ared before me and made
oath that the above state ment of Fletc her Bros. is
. -1
��FLE TCH ER'S p ·HAR MAC Y
HARR ISONB URG, VA.
Report of Fletch er Brothe rs, of Harris onburg , Va., in accord ance
with a provision of Section 14
of Chapte r 146 of the Acts of the Assembly of Virginia, 1916.
Amoun t Grain Alcohol on hand . . . . . . . ...~
/ . ......... 19 .... . ....
Amoun t Grain Alcohol Received during ......... ...... ..c.(......................................19
A.3......
AmountGrainAlcoholonhand ........~
~. .
..........S. .
~. ....
/. ........19. · _: ::. ~~
~
..! .............
State of Virginia,
:icorrec::;~:~:~:~1:i:;:~;;~db;f
~::t~h~n:b:~! :1::1!~~t~°F;:,~::r1~:!,M~;
~~::~·u::::o~:i:.::o::d.::~ :f: day.of
lz-192-2 - .
~;. ;;;; ~~d ;;;.~.0 ~.i';;
~tf
My Commission expirt:s............................................................ 19.............
iTeBlfO'f",
,
92 a.
0
P.
�I ilrd in the C16rk's O"ftlce
Rockii..
3 '192
--
t
�FLE TC HE R'S PH AR MA CY
HAR RISO NBU RG, VA.
Repo rt of Fletc her Brot hers, of Harr
urg, Va., in accordanc e with a provision of Secti
of Chap ter 1:46 of the Acts of the Asse mbly isonb
on 14
of Virginia 1916,
Amojt Grain~ Alcohol on hand . . . . .. . ................... ... .... ......... / ........
19. .b.. ..
Amo !nt Grain Alcohol Rece ived durin g...
.. .!>..
Amount Grain Alcohol on hand . . ... . . ....
State of Virginia,
:,A:z:....
0
City
:i:=.................. ............................. Notary Public in
and for said city, do certify that Mr.
S. P. Fletc her personally appe ared before me and
made
oath
that
th
e
abov
e state ment of Fletch er Bros . is
corre ct to the best of his knowledge an ~f .
Given under my hand this ····-~
.
'"
m.y Oom foslo
·······- day of · · · · ~ · · ·192_...2.
... . . ...4 ~ . . ... . . . . . . . . . . .... ... . . . . . . . . . .. . . .
irec ~ , 1, 19~4,
My Commission expi rts......................................................
...... 19.............
·
N. P.
�' \Ja,
�FL ET CH ER 'S PH AR MA CY
HAR RIS ONB URG , VA .
Rep ort of Flet cher Bro ther s, of Har riso
nbu rg, Va., in acco rdan ce with a prov
of Cha pter 146 of the Acts of the Ass
ision of Section 14
embly of Virginia, 1916.
Am oun t Grain Alcohol on han d . .......
...........~........
19...2.... . .
. ...........q-__.
~
Am oun t Gra~n Alcohol Rec eived duri
ng . .......................~...... ...... 19 ..2:...3..
. . ..~
Am oun t Gram Alcohol on hand . . . . .
. . . ...... ............~
:·./... 19 ...2:. J .
..... . .
¥ /. . .. . . .
.
·1· ··•2·•··~
Stat e of Virginia,
City of Har riso nbu rg, to-,t t:
~ g . .. . . . . . . . . . ................................... . ..
-f2-..
::t.:.r..l..
l, .......
Not ary Public in and for said city, do
S. P. Flet cher personally app eare d befo
certify that Mr.
re
me
and
mad
e oath that the above stat eme nt of Flet
corr ect to the best of his kno wled ge
cher Bros. is
an~ lief .
Given und er my hand this ........
day of
.. 192 ..~~ . A ...
....
/ .::cc.............
~
· ··· ··/4~~ .......... .... .... . . . . .. . . . . . . . . . .-... . . .N. P.
My Commission expirE::s.._...................................
...................... 19......... ....
Oamm!Mon txpl"NII! Jew, 1, l 92~
��FLETCHE R·s PHARMA CY
HARRISONBU RG, VA.
Report of Fletcher Brothers, of Harrisonburg, Va., in accordance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virginia, 1916.
Amount Grain Alcohol on hand . . . . . .~.. /.. ......................... ........ 19..,2... ..1..
Amount Grain Alcohol Received during . .. :....~...................................19..~....5i....
Amount Grain Alcohol on hand .... ... . ~ . / - ~
State of Virginia,
City of Harrisonburg, to-wit~
.. ....:.Z.~. .
. ..~ .
..~
- k0 =~z~ ~&U_,
.
.
·
-£),;--~
.
I, ..........................iJ..!.....
~
Notary Public in and for said city, do certify that Mr.
S. P. Fletcher personally appeared before me and made oath that the above statement of Fletcher Bros. is
!...:.. . . .. . ..... .. ..... .
.... . . . .
correc~~::•u ::::o:;i:a~:o:::d.~ea~!~f:
1,
day of
~
_ _ _
My Commisiion expires_ ~···-~·°-·~ -···········19_'/c.,L'.
- __ t g 2 } ~
_
I: l. T-............................... ..N. P.
�...i
�FLETCHE R'S PHARMA CY
HARRISONBU RG, VA.
Report of Fletcher Brothers, of Harrisonburg, Va., in accordance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virginia, 1916.
Amount Grain Alcohol on hand . . . . . . .. ....... ........... .. / ............................19c,'.2.... .':3. .
Amount Grain Alcohol Received during...................... .................. .......................19 .~ ...1 . .
Amount Grain Alcohol on hand ... . .. . ........
.. t ...>
State of Virginia,
City of Harrisonburg to-w~
•
ZL.1-:. . . . .. . .. . . ~. . ... . . . . . .
l, ......................
Notary Public in and for said city, do certify that Mr.
S. P. Fletcher personally appeared before me and made oath that the above statement of Fletcher Bros. is
correct to the best of his knowledge and w,ef.
~
Given under my hand this ............
My Commission expires..
~...
/.-=:. . . . . . .day of ..........a.«7.1.. . . .. ... . J92J.......
J.~.:. . . . .
. ... .. . .. ... . . .. . ... . . . . . .L r ~. . . . .N.P.
191::C
�f,r'"1 in the Clllf k's Oll!c•
l ock;,,,,.- ,,, iJeull(y, Va,
4U ll- ~ ,
-·
(
.
,C ..
�FL ET CH ER 'S PH AR MA CY
'~lU
·
HAR RIS ONB URG , VA.
S 1~.i 0( ~ ,·-1~1 U(
Pflltf
Rep ort of Flet cher Brot hers , of Harr ison
burg , Va., in accordance with a provision
of Cha pter 146 of the Acts of the Assembly
of Section 14
of Virginia, 1916.
Amount Grain Alcohol on hand . . . . . .
. ..........
Amount Grain Alcohol Received duri ng
.... .... .. ....... .. ..........................................19 ...2.. .6....
Amount Grain Alcohol on hand .. .. ... ............
....... . ....... / .............. ..19 ... ~..$
Stat e of Virginia,
City of Har ri,n bur~ , tot7 it:
~c. ,. .L _ _ L } ~
I, .......
Nota ry Public in and for said city, do certi
S. P. Flet cher personally appe ared before
fy that Mr.
me and made oath that the above state men
t of Flet cher Bros . is
correc~:::::::::o:;i:a~~o:li:d.g~~e'.: da~ ~I,&_N, ~Commission expires_ _~_ _ / _ _ _ _ __ _192-"-;7"
My
y O mmlPelf'11
'r
ij
No . 1, . Z
�t •
'
r
'
�fl
In e Clerk's
Rockln am Coun t
oc
f 1•
"' 19'2-11
_vi~
FLE TC HE R'S PH AR MA CY
HAR RISO NBU RG, VA.
·I,(
Repo rt of Fletc her Brot hers, of Harr isonb urg,
Va., in acco rdan ce with a provision of Secti
on 14
of
Ch•::o::: :,::: ;J::h:: :hne ~:tly of ~ [
Jgd J_ .·.·.·. . ....d.~
. ·.·. .·. ·.··..··~
. .·.·.. ..·.·.··. ·. .·. ..·.·.
Amo unt Grain Alcohol Received durin g ............;4
. . . . . :.:."i·................... . -.. . . .19.a?...;;$....
Amo unt Grain Alcohol on hand . . . . . . . ... .. ~
/......... - ............ .19....:.bts.
~
State of Virginia,
City of Harr isonb ur , to-wit:
,-;--
~
I
I,·-----·---·--·--.. --.--------'. .__:/_!_. _
_ .. --.--.---..-·--------~ -... ---.. --..-.. _Nota ry Public in and for said city, do certi
fy that Mr.
S. P. Fletc her perso nally appe ared befo re me
and made oath that the abov e state ment of Fletc
corre ct to the best of his know ledge and ~ief
her Bros. is
.
~
Given unde r my hand this ---·--------/_·-=---·---· -·-· day
of ------.. -...--....._.. __:__ .___ .. ___.____192_J .__
L,
My
··-·-. ·-··-.· -·-·-.-·-. . . . . . . . . £J ~ . . . . . . •
Commission expires~------.L.!'.."'::. .___192')__
c..,,. __ ........ N. P.
�d
I
C
f
;,
I
.N
..' .
I
(r
.t/i
C,LJ
.<I
.I
I
.
�·1. t,
I
Cvu
1t :, • •·
FL ET CH ER 'S PH AR MA CY
HA RR ISO NB UR G, VA .
Report of Fletche r Brother s, of Har
riso nburg, Va., in accordance with
of Cha pter 146 of the Acts of the Ass
a provision of Section 14
embly of Virginia , 1916.
Amount Grain Alcohol on hand . .
. . . . ........... ~ . / ............................ 19..:t.. . '3.
..
Amount Grain Alcohol Received dur
ing ...............~......................... 19 ..c:2. 3.
Amount Grain Alcohol on hand ... ...
. ..........
.19.. ~.. ...
~
1.... . .... . . . . .
Stat e of Virginia,
City of Har riso nbu rg, to-wit:
1,................................................................ ...........
........ ................... Notary Public in and
for said city, do certify that Mr.
S. P. Flet che r personally app eare d befo
re
me and made oath that the above stat
corr ect to the bes t of his knowledge
eme nt of Flet che r Bros. is
and bel i;.
Given und er my han d this ...............
day of ..........H..~ ...............192 1..... -J
,
_
'k.'!!.. .. . ...
................ ................ ..........
My Commission expirts.~
r.-.J...
.......l.~.1......... ........... 19..
LJ ,:- ---~
~..!.. "./' ... J ................................. ........N. P.
�A
J
r. -
,
(
�FLET CHER 'S PHAR MACY
HARRIS ONBUR G, VA.
Report of Fletcher Brothers, of Harrison burg, Va., in accordance with a provision of
Section 14
of Chapter 146 of the Acts of the Assembl y of Virginia, 1916.
~
Amount Grain Alcohol on hand . . .. .. ..
../......................................... 19..:z_..3.
Amount Grain Alcohol Received during.........../,l:Z:tt:LL. . .. . . . . . . .. . . . . 19 ..2.. ...;)
Amount Grain Alcohol on hand . . . . . . . ..... .....~ /..... ...............19 ....~.3
State of Virginia,
City of Harrison burg, to-w· .
·
~
I,........ ..,.....~ . ................... ......................................... otary Public in and for said city, do certify
that Mr.
S. P. Fletcher personally appeared before me and made oath that the above statemen t
of
Fletcher
Bros. is
correct to the best of his knowledge and belie~
.
.J!:.:;f'....... day of
Given under my hand this ..........
lly Oonunil!ldon nptree Jr.,-. f, 19H
~·'······12.
&.?.. . L✓.... .
...............
My Commission expir<::s............................................................ 19 ............
1. ...
.$.,.
•
•···· ··•·· ·· ... .
��Flied In the Clerk ft-' r~
R ckin ham Cou• ty, Va,
R
1
~4
FLETCHER'S PHARMACY
HARRISONBURG, VA.
State of Virginia,
City of Harrisonburg, to-wit:
t.. ~¥ ... . ..... . . . . . . . . . . . . . . . . . . . . . .. ....
l, .......
Notary Public in and for said city, do certify that Mr.
S. P. Fletcher personally appeared before me and made oath that the above statement of Fletcher Bros. is
b
correc~::::•u!:::o:;i:.::o:::d_~::1;;;t _day of
.My Oommiaeion explm lfff, f , l9H
_192'7
·····················"··(-.A . ................................. .. .. ............ ......N. P.
My Commission expirE:S............................................................ 19.............
��FLETCH ER'S PHARM ACY
HARRISON BURG, VA .
•
Report of Fletcher Brothers, of Harrisonburg, Va., in accordance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virginia, 1916.
2..f-(
Amount Grain Alcohol on hand . . . .. ........................../ ..................... .... ....19..
Amount Grain Alcohol Received durin ...... ...........................................1 9 ...
2.::¥,
Amount Grain Alcohol on hand. . . . . . . .. . ................ ··-· . ......./........ ..........J ....
State of Virginia,
City of Harrison ~ t~
it:
4 ..-{. "-~ ··· · · · ·· ·· ··· · · · · · · · · · · · · · · · ··
l, ......
Notary Public in and for said city, do certify that Mr.
S. P. Fletcher personally appeared before me and made oath that th e above statement of Fletcher Bros. is
correct to the best of his knowledge and belief.
~
Given under my hand this -·········/ ·~·········· day of ···········~ · ·"···•······ 192j-{
· · ··· · · ··· ···b~.~A ... .... . . .. . . .. .... .. . ... . .... ..
My Commission expin:s............................................................ 19.............
My Oommi1eion api?M J°ff, t , 19H
.. d
I t' I
1ei •·'s Officr
a County, ·
1:ff3 '"1 1.
1
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�FLE TCH ER' S PHA RM ACY
HARR ISON BURG , VA.
Report of Fletc her Brothers, of Harrisonburg, Va., in accor
dance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virgin
ia, 1916.
d(,~./. . . . ... ... ... . . . . .19....:bY,
Amount Grain Alcohol on hand . . . .......
Amount Grain Alcohol Received during........... ~
2.:¥.
~ ···· ·······················.19 ...
Amount Grain Alcohol on hand . . . . ... ...........'.f.2 (.~f
. .. . . . . . ..J 9....2.....77;
State of Virginia,
City of Harrisonburg, to~
~
&. ./ . . . . .!... . .. .. . . . . . . . . . . . . . . ..
I, ...........................
Notary Public in and for said city, do certify that Mr.
S. P. Fletch er personally appeared before me and made
oath that the above statem ent of Fletch er Bros. is
corre c~~:~ :eu::: : o;;i: a:o: ::d.~·~ ··:j. ~:.... day of
...
. .... . . . 92.i ...
Jk.~
.
My Commission expiresc~ · ···•L ..
··········································••······' ··T·~·················· v
!2.,........._..19_'}_...-::
\
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P.
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FLE TCH ER 'S PH AR MA CY
HAR RISO NBU RG, VA.
Repo rt of Fletc her Broth ers, of Harri sonbu rg, Va.,
in accordance with a provision of Section 14
of Chap ter 146 of the Acts of the Assembly of Virgi
nia, 1916.
~
~
Amount Grain Alcohol on hand . . . . . .......
.../. ........................19.d2....
Amount Grain Alcohol Received durin g ............~
.........................19 ..4 . .:;{
Amount Grain Alcohol on hand .. ..... .... ~
.....................! ....2.,,.. . .
State of Virginia,
0
City :,~z.:zzi:=.. . . . . .. . . .. . . . . . . . . ... .. .Notary Public in and said city, do certify that
correc~~:::•u~~::~;i:a~:o:i:d_~:a~~ day./41!;1ix 192y..
for
Mr.
S. P. Fletc her personally appe ared befor e me and
made oath that the above state ment of Fletc her Bros.
is
'y Ommcle on exphee N , t, 19H
My Commission expin~s ............ ..................... ........... ...............
19.............
�...
�FLETC HEJ~" S PHAR'MAC Y
HARRIS ONBUR G,
VA.
Report of Fletcher Brothers , of Harris0nburg, Va., in accordance with a provision -df
Section 14
of Chapter 146 of the Acts of the Assembly -of Virgin· , ;}916.
....
.Amount Grain Alcohol on hand . . . .. .. .. . . ....... .... .~-·-~.-~.-.
Amount ,Grain Alcohol Received during.......... ........... ..
Amount Grain Alcohol on hand ... . . . . .. ......... .... ....... . . .... ....;-,,._/~-
State of Virginia,
City of Harriso &'g~o-w it:
/4.~~
jJ _ _
. . . ... . . . . . .. .. .
I, .....Cb..,..
Notary Pu'blic m·and for said -city, do certify that Mr.
S. P. Fletcher personally !!ippeatted before me and made ,oath that the ·above statemen t
of Fletcher Bros. is
correc~~:: •u~;:::~:o: ~=::is Ua~~~ ·:9=
-~
on npm• .11e,-, t, 1924
,
My Commission expirts ............................................................ 19 ............
Y\'
· ···············- .. . .
P.
��FLE TCH ER' S PHA RMA CY
HARR ISON BURG , VA.
of Section 14
State of Virginia,
City of Harrisonburg, to-wit:
IICIIIGHAM COUNTY, VA,
0
S. P. F~~ t~h ~~~ ~~~ :f~· ~<- ;~·a ~ec::r :~:t~h
~n a~no~! :t=~~ ~:r~°F ~::ct~ f:r
correc t to the best of his knowledge and belief.
t~~~s~r~
Given under my hand this ............. ....2=:-:...... day of ...........~
..192..<:/!.
···= Pe,).l~.6... ... . . . ...=. .. .~...~~-
My Commission expirt s ............................................................19.............
•
I
��FL ET CH ER 'S PH AR MA CY
HAR RIS ONB URG , VA.
Rep ort of Flet cher Bro ther s,
of Cha pter 146 of the Acts of the Assof Har riso nbu rg, Va., in acco rdan ce with a provision of Section 14
embly of Virginia, 1916.
Amount Grain Alcohol on hand . . .
...
1R2 ..y{
Am oun t Grain Alcohol Received duri
ng ............~
······················:19......~ .: :(.
Am oun t Grain Alcohol on hand .. ....
,·
. ............... ..... ............ .... ... .......... 19.. .......
· k-/_ .... .
Stat e of Virginia,
City of Har riso nbu rg, to-wit:
~ 4, . .... . ... . .. . .~.... . . . . . ... .. ... .... .... .
I, ...
..
Not ary Public in and for said city, do
S. P. Flet cher pers onal ly app eare d befo
certify that Mr.
re
me
and
mad
e oath that the abo ve stat eme nt of Flet
corr ect to the best of his kno wled ge
cher Bros. is
and belief.
Given und er my han d this ......
day of
.....
192.f .
£.-!!:. . . . . .
~
· · · ········t_. L
]( On aal •• upirel Iw, t, 1911&
My Commission expirt:~
.................................................... ....... 19.............
A
~ ~ N.P .
�_ _ ___ _ Cl rte
�.,..
FLETCHE R'S PHARMA CY
r
HARRISONBU RG, VA.
Report of Fletcher Brothers, of Harrisonburg, Va., in accordance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virginia, 1916.
::::: ~::: ::::::: ;:c::::. d~;;~ ·. . . . . ......... _ _ _ .
Amount Grain Alcohol on hand .. ..... .
State of Virginia,
City of Harrisonburg, t -wit:
-g
~
_ 19 2- 1/ ..........
~ :~~: ~~~
.,
t,
,-~
1,--------------------------- ____
!..._] ___ .!._ _±______________________~
Notary Public in and for said city, do certify that Mr.
S. P. Fletcher personally appeared before me and made oath that the above statement of Fletcher Bros. is
correct to the best of his knowledge and b ~
Given under my hand this
My Commission expirt~
1
··· · ·-/f..c:c..... day .oL.·········~
•..JJJ,-............. 19.2-_.J "-
1/. ·········1;/:r ~ ~ P.
��FLE TCH ER' S PHA RM ACY
HARR ISON BURG , VA.
Repo rt of Fletc her Brothers, of Harrisonburg, Va., in
accordance with a provision of Section 14
of Chap ter 146 of the Acts of the Assembly of Virgin
ia, 1916.
Amount Grain Alcohol on hand . . . . . . . . ........ .
Amount Grain Alcoh ol Received durin g.......
-rr,
A. .- -.."". ..,....
Amount Grain Alcohol on hand . . . . . .. . ... ..
State of Virginia,
City of Harrisonburg, to-wit:
·
~~
I, ....
....
......fk-:-. ........ ~ l i c~
rsa i~e rtif y that Mr.
S. P. Fletc her personally appea red before me and made
oath that the above statem ent of Fletch er Bros. is
corre ct to the best of his knowledge and~
Given under my hand this .......~..................... day of .......S"'_
_.~
............192..frf...
c;;,,:,.,-,;---z_-d, . . . / ¥ ~ ...... . ~
My Commission expir ts ................................................. ........... 19............
.
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..
�FLET CHE R'S PHA RMA CY
HARRI SONBU RG, VA.
State of Virginia,
0
City :,~i :~ •wit:····· . .................. ..... . . Notary Public in aod for said city, do certify that Mr.
correc~::::•u::::o::i:.~:o::d.~~l~~f~ da~~
S. P. Fletche r t ;;t~ally appeared before me and made oath that the above stateme
nt of Fletche r Bros. is
~i:-
My Commission expirts .........~
:......../ .........19.k.-- j/'
192(
�----·
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�FL ET CH ER 'S PH AR MA
CY
HA RR ISO NB UR G, VA
.
Rep ort of Fle tch er Bro the rs, of
Har riso nbu rg, Va., in accord anc
of Cha pte r 146 of the Acts of the
e with a provision of Section
Assembly of Virginia, 1916.
14
Amount Grain Alcohol on hand
. . . . . . ... .. ~
./ ..............................19....
...............~ ........ .............
Amount Grain Alcohol Received
dur ing... ......
19. 2.,. ~ .......... . .. ................
Amount Grain Alcohol on hand ...
. . . . ... .. ~
.. ....... ...19. ....2.. ~
l?c.:t:=. . . . . . . . . . . . . . . . .
Sta te of Virginia,
City of Har riso nbu rg, to-wit:
~ 9 - V '~..
•
a...,.
2.j,<
~
. . ..~.4 . _. . .
~
I, .......
.......
Notacy~
S. P. Fletch er personally app ear ed
or said city, do certify tha t Mr.
bef
ore
me
and
mad
e oath tha t the above stat em ent
cor rec t to the bes t of his knowle
of Fletch er Bros. is
dge and b~
Given und er my hand this ..........:.(..'
?... ......T ....... day of .....
192 ..
o/-.d........ . f- '
....
~ .~
My Commission exp irts ......................
...................................... 19.............
········ ~
�"t
I
�FL ET CH ER 'S PH AR MA CY
HA RR ISO NB UR G, VA .
State of Virginia,
0
City :,~
x
- . Lit, ····· ·· ············· ·· ····· · ····
o ary Public in and for said city, do
S. P. Fle tche r personally appeared
certify tha t Mr.
before me and made oath tha t the
cor rect to the best of his knowledge
abo
ve
stat
eme
nt
of
Fle
tche r Bros. is
and b~ f.
Given under my hand this ···-· ··£'-···
········· day_oL~
My Commission exp irts.....~ ,........
l..~. ...... . .19..Jcff.
? ~ - P.
�FHed 1n the Clerk's Offir.~
Rocking ham County, Va1 ·
.DEG 4 _;
- - - - - - - - - - 01
�FLET CHE R'S PHA RMA CY
HARRI SONBU RG, VA.
State of Virginia,
City of Harrisonburg, to-wit:
I, ............................·..................................................-···············•····- Notary-Pubtic in and for said
city, do certify that Mr.
S. P. Fletche r personally appeared before me and made oath that the above stateme
nt of Fletcher Bros. is
correct to the best of his knowledge and belief.
Given under my hand this
······-···_;2_ ··-····-····-
day o~ ·····- ~..,,. .,.._, ,..,.., /....N:1':-
My Commission expirt:s ............................................................19.............
~-
��FLETCHER' S PHARMACY
HARRISONBURG . VA.
Report of Fletcher Brothers, of Harrisonburg, Va., in accordance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virginia, 1916.
Amount Grain Alcohol on hand . . .. . . ...~
Amount Grain Alcohol Received durin/!.....
~~
.-/. ..... .............19.2.. ..
tJ!.;~. . ;.. . . . . . . . .. . . .......19 a.,,.~
Amount Grain Alcohol on hand . ... ... .... ....£7..La::]. . .1:,.....
State of Virginia,
City of Harrisonburg, to-wit:
·
q_,
......
&.:~. ..
......
. . . .. . . . .
.... .
9~r.-;, ...... /...--!-
~ ~
..
~
....................... Notary Pttblic in and for said city, do certify that Mr.
I,...~ ..1(..~
and made oath that the above statement of Fletcher Bros. is
me
before
appeared
S. P. Fletcher personally
correct to the best of his knowledge and belief.
day of ...... ~..~..::............192...~ .
Given under my hand this ............
3/.. . . .........
··················1'-t."P:"
········ ~·······~
My Commission expires ............................................................19.............
~
. e.
•.
�Flied in th e Clerk's Offi ce!
Ro\, '. \;,,J ,J.111 Cou nty, Va. :
f k.li 4 J 1925
. · O\erk
�FL ET CH ER 'S PH AR MA CY
HAR RIS ONB URG , VA.
of Section 14
Stat e of Virginia,
City of Harr ison burg , to-wit:
I,.......~...... ~.........
....... Notary Pttblre in and for said city, do
S. P. Fletcher personally appe ared before
certify that Mr.
me
and
made oath that the above state men t of Flet
corr ect to the best of his knowledge and
cher Bros. is
belief.
Given und er my hand this -········~
·········· day of ...~
~ · · · · ·192 ...
~-:= .
·············~
My Commission expir(:;S..............................................
.............. 19.............
········~
.
··········~
~ - ~.
��FLETCHER' S
PHARMACY
--v
.
.
HARRISONBURG
t VA.
,. · :
•;: -
~~--
Report of Fletcher Brothers, of Harrisonburg, Va., iir accordance with a provision of Section 14
of Chapter 146 of the Acts of the Assembly of Virginia, l916.
.
d
/1)1,1 .:.- .
Amount Gram Alcohol on han . . . . . X/ /.ta.,/JL.. ............ . . ......................19.~...s>.......
;1!/
., , ,__
Amount Grain Alcohol Received during ................ ..
.._..............................t9 o2. £
Amount Grain Alcohol on hand . . . . . . . . ....... ........ ... .: · . .: ..... / ... ······.,..
1 ____
,1£._
State of Virginia,
0
8
:.::r:i..:~LZ:~<:: : : : : : . . . ..
Mr.
City
Notary Public in and for said city, do certify that
S. P. Fletcher personally appeared before me and made oath that the above statement of Fletcher Bros. is
correct to the best of his knowledge and b~f.
Given under my hand this ..........
My Commission expirts.... ..~ .../
C,
J/. .=······-· day of .....&.0.d.. . . . .. . 192.f.:=~
.t ..."::.............19..1:J..-
1
d: ...........-
·············································· ( t ' . T
.. ...
~ N. P.
.. .
��FLET CHE R'S PHA RMA CY
HARRI SONBU RG, VA.
�.....
Fi'"d :in tL.A
GJerk's " :fir,e
H. '. ,,~i.am Coufl' ,-· ('-,
• AY =••1925
-----······
C1erk
�FLE TC HE R'S PH AR MA CY
HAR RISO NBU RG. VA.
Repo rt of Fletc her Brot hers, of Harr
urg, Va., in accordance with a provision of Secti
of Chap ter 146 of the Acts of the Assembly isonb
on 14
of Virginia, 1916.
Amount G~in Alcohol on hand . . .. .. .~
/........................ ....19...c:2..J=Amount Grain Alcohol Received durin J.;'.~
......................................19.~ .. .....
Amount Grain Alcohol on hand . . . . . . . ....... ...............
..... . · · • ···-/2 .......... .19
--rr -¥
_.,
State of Virginia,
: : . .2 ~
0
City :,::rri~:2r2t~g, :'=::?" _ _Notary Public in and for said city, do certify that Mr
S. P. Fletc her personally appe ared before me
and made oath that the above statement of Fletc
her Bros. is
correc~~::e o:;i:a::o;::d•::d~ : -day of _ µ ___ ,C
,
· · ·· ··· · ·••·•· ·· ·· ·· ··· · · ··i, T ~ c : - - -N. P.
My Commission expir
_ _ ./.ef:...___________ 194
0
::::
192
�I
::....:....
::x: -.:'.?
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�FLE TCH ER'S PHA RMA CY
HARR ISONB URG, VA.
14
Amount Grain Alcohol on hand . . . . . . . . ..
Amoun t Grain Alcohol Received during..................... ...
Amount Grain Alcohol on hand . . . ... . ......... .
State of Virginia,
City of Harriso nburg, to-wit:
r-;- - -
...
,.,,.
!, ......................._. ..,:.,J..,. ~
···· · ··· •·· ········ ·· · ····· •· · ····· ·· ········ ··· Notary Public
in and for said city, do certify that Mr.
S. P. Fletch er personally appear ed before me and made oath that the
above statem ent of Fletch er Bros. is
correc t to the best of his knowledge and b~
c2.... .=-:::.... day of ········· · · ~············192. t...-:-
Given under my hand this ...........
y/
My Commission expirts ..........................
--- ·
..1...:.::.. . . ..... ........ 19..."J::.f...
___
,
.,f,.,J, £ ...... . .. ..~ P.
��FLE TCH ER' S PHA RM ACY
H ARRI SONB URG, VA.
Repo rt of Fletch er Broth ers, of Harri sonbu rg, Va., in
accordance with a provision of Sectio n 14
of Chap ter 146 of the Acts of the Assembly of Virgin ia,
1916.
Amou nt Grain Alcohol on hand . . .. . ........
Amou nt Grain Alcohol Received durin g ......
Amou nt Grain Alcohol on hand . .. .. . . ....
My Commission expir ts ............................................... ............19. ..........
.
97.~'ll~ ,pc
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�FL ET CH ER 'S PH AR M
AC Y
HA RR ISO NB UR G, VA
.
Rep ort of Fle tch er Bro the rs, of
Ha rris onb urg , Va., in
of Ch apt er 146 of the Acts of the
Assembly of Vir ·nia, 1916. accordanc e with a provision of Sec tion 14
Amount Grain Alcohol on han
d . . ... . .
Sta te of Virginia,
City of Ha rris onb urg , to-wit:
N~r~P~ict✓an~ J;:
' I,~ · · · · · · · · ~ · ·
··········
S. P. Fle tch er personally app ear
d·o certify tha t Mr.
cor rec t to the bes t of his knowleed before me and made oat h tha t th e above sta tem ent
of Fle tch er Bros. is
dge and belief.
Given und er my han d this ........L
......................... day of ..........~
.............. .192 .C
....~ .... ~
........ N-..P . .J0. '2My Commission expires .....................
....... ................................ 19.............
��FLE TCH ER 'S PH AR MA CY
HAR RISO NBU RG, V A.
Repo rt of Fletc her Broth ers, of Harri sonbu rg, Va.,
in accor dance with a provision of Section 14
of Chap ter 146 of the Acts of the Assembly of Virgi
nia, 1916.
Amo unt Grain Alcohol on hand . . .... .......... ~
Amo unt Grain Alcohol Received durin g .........~
Amo unt Grain Alcohol on hand .. ... . . . . ....
/ ...............19..o?..
.4. -:--....//.z_......... ... . . . ..
··············-····· ·.19 . ~ ~ ............................ . ...........
J9 ;2.. ....
......... -;/.. . ····- .........
°"lJ:u.Y."). •-· •· ·· .
State of Virginia,
City of Harr iso~ rg, to-wit:
/i.!..~
~
········· ··
1, ...............
Nota ry Public in and for said city, do certif y that
Mr.
S. P. Fletc her perso nally appe ared befor e ~filf d
made
oath that th e abov e state ment of Fletc her Bros.
corre ct to the best of his know ledge and b~ .
is
J.t.~ .... . .~2 ......... ·
Given unde r my hand this ..........."J...?!............. day of
...........
Q,.
/
A,
i
t
//_,-~✓
•···············•····•··••················· '1\··,L~
My Commission expir ts..·-· - r ~·····l.·········:········-19
_'k!j-...
.. ! . . .... . ....... . ..... . . . ........... ......... ...N.
P.
��•
FLETC HER'S PHAR MACY
HARRISO NBURG, VA.
State of Virginia, .
City of Harrisonburg, to-wit:
1, ................................................................. ...................... ............. Notary Public in and for said city, do certify that Mr.
S. P. Fletcher personally appeared before me and made oath that th e above statement of Fletcher Bros.
is
correct to the best of his knowledg e and belief.
Given under my hand this .................................... day of .......................................... 192 .........
.............................................................................................................N. P.
My Commission expirts............................................................ 19.............
��A . P . A. 644. H>-I9-I6·JM
IND IVID UAL
BOND for ALICENSE to MANUFACTURER of FLAVORING EXTRACTS, Etc.
itirThe Penalty of this Bond is to be fixed by Court (not to exceed Sxo,ooo)
J, ~
tn hp tbtSt ll}rtStntS, That we, ...
all
?.1!1~_ ~· . ~
-· · · ··· · ··· ·· ······· ··· ··· •··· •·········• ••· · · ·· ·· · · · · ··· · · · ·· · ·· · · ···· · ·· ·· · · · · · · · · ···· · ···· ····• ·· · · ··
·· · ·- ~
are held and firmly bound unto the Commonw ealth of Virginia in the sum of.. .. ~...'?. ................. .
Thousand Dollars to the payment whereof well and truly to be made to the said Commonw ealth
of Virginia, we bind ourselves, our heirs, executors, and administra tors, jointly and severally,
·
firmly by these presents.
And, as to this bond, we hereby severally waive our homestead exemption , and any claim,
right, or privilege to discharge any liability arising thereunde r to the Commonw ealth of Virginia
with coupons detached from bonds of the Commonwealth of Virginia.
Sealed with our seals, and dated this ... 2<l ......day of.. .... ~.. ~ .......... , one thousand nine hundred and .. ~ ···~·······
THE CONDITION OF THE ABOVE OBLIGATION 1s SucH, That~,
(3 .--. ,
=:~.~~·-
~:t...~~-lh ~.h, -'::4.~~.~.~.~t.:.: ....~ 1
WHEREAS, The above-bou nd . .
··· · ·· ··~ ·
19.1.t ... , by the ...~..~..........Court of the County (or-eity) of
,
.........
.
.....
7
day of ..:·· ~ ·
0>.u ~ ..~.~·~ ···· ...... , granted
a LICENSE as a manufactu rer of flavoring extracts for
the term ending April 30, 19.J.1 .. , at .... ~ ....................., in the County (or 6-rty) of
fl..o.cl.~ J-1..~
Manufacturer
of Flavoring
Extracts,
Etc.
of
Purchase and store ardent spirits or alcohol necessary for the manufactu re of
· ef}-t,~i: a,tmns e~olut:i:ons,
·tet , mea icia ,
flavoring extracts, G;
]:\a~,{j~ 811 prnptie'-fiY }io}Oiliew:es ot:.:JlE€:p:ua ti.o;ae permitted to be manufactu red by
Chapter 146 of the Acts of Assembly of 1916, but not to be sold or given away, but
purchased , stored and used in accordance with the provisions of Chapter 146 of
the Acts of Assembly of 1916.
tl:, ~!!~::i:,:~·
0
.......,to-
~fc-£!~1~··~
A~t~· ~f·A~~;:;;;iiY. ~£
~~. 1:~tgi~t1 P:~ ':d:;'.
0
receive, store, dispense or sell any at~~iri ts, wines or alcohol except under and in accordance with the previsions of ..said Cllapter 146 of - the- Acts of Assemb4r_oL 1916,....then...thi
OBLIGAT ION is to be void; otherwise to remain in full force and effect.
. ..... ✓,?dz...... . .............. ....
& . .~ ..
. . . .r .
[SEAL]
[SEAL]
.... ....... ............. ... ........ .. ... .................. ............ ............ [SEAL]
�f
�INDIVIDUAL
BOND for ALICENSE to MANUFACTURER of FLAVORING EXTRACTS, Etc.
.ltir'fhe Penalty of this Bond is to be fixed by Court (not to exceed
ltnob.1 all .ffltn bp tbt5t f)rtstnt5, That we__✓ __ ,__
--- ~
- --~
$10,000)
G_! ------ ~ ~-- --·-·-· ----·-·
-- ~---- --- -- -------- -- -- -- -··- ------- --·- · -··---- --- ---- ·- -- --- ------- ----- -·-----·-- ---· · · · -· ···- --· -- ·- · ----- -- --·
are held and firmly bound unto the Commonwealth of Virginia in the sum oL __~:-:-n...b __ ______________
Thousand Dollars to the payment whereof well and truly to be made to the said Commonwealth
of Virginia, we bind ourselves, our heirs, executors, and administrators, jointly and severally,
firmly by these presents.
And, as to this bond, we hereby severally waive our homestead exemption, and any claim,
right, or privilege to discharge any liability arising thereunder to the Commonwealth of Virginia
with coupons detached from bonds of the Commonwealth of Virginia.
~
Sealed with our seals, and dated this ___ ~ -~-------day of__ _______~ - ~ ------~---------, one thousand nine hundred and __~
THE CONDITION
OF
THE ABOVE OBLIGATION
WHEREAS , The above-bound~=~-i.~
day of__ ________ ~
----·
.~
1s
SucH, That-
C\~
,
~
.
--~ ~ s~ o~
-~-k~
-------------, 19_\.~ -- , by the ____Q _ ~-:-:. ____
_Court of the County (oi:-City) of
~ - ~ - --- ---, granted a LICENSE as a manufacturer of flavoring extracts for
the term ending April 30, 19l_r , at ____ __~ - - - - - - - - --------, in the County (of City) of
: ~_____ ___,toManufacturer
of Flavoring
Extracts,
Etc.
Purchase and store ardent spirits or alcohol necessary for the manufacture of
flavoring extracts, 01 of tGilet, m 8dicinal, .mtis.!ilptie pt1epEtFati:on5 01 solutions,
,pa:titmt Qr p;i::gprietary i.i.ediein0s or pr0pa.;i::atiGns permitted to be manufactured by
Chapter 146 of the Acts of Assembly of 1916, but not to be sold or given away, but
purchased, stored and used in accordance W1th the provisions of Chapter 146 of
the Acts of Assembly of 1916.
0
P:~{
0
of t~ ~~i;~~!!~~--~i1 -h~; ;t ~~
~t~--~i"-A~~~~biy--~£--~~~~. f:~}f~~l
r:d:~~
receive, store, dispense or sell any ardent spirits, wines or~alcohol except under mid in accordance with the provisions of said Chapter 146 of the A_c;:ts of Assembly of 1916, then this
OBLIGATION is to be void; othe,wjge to remain in full !"!"°"
r'/°=1:
_.
-. Ir/::.;:_~ -.. ... . ... ...
. . ~. rk . . '&.
[SEAL] .
~(SEAL]
----------------------------------------------------------------------------------[SEAL]
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e
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~~
��mu1~~~s lhug Sto~~
lhi6geuude.-, llli.-ginia
Invento~y o ~ Ar ~ 1t S~irJts .
To The Clerl· cf' r1,:1e Cir·c t'i.it Co-1r'.:.,
State of Vir : inia.
The f oll ow in...; i G an i 1voi cc o:'.' ;,rdon~, ;~·) i r i ,.:.G used for
1
o t.h .r- thn.::1 '..Jevorar·c purp oo o :1 of tl:.c ::L!. ler ' c-; Dr-:::; ;'t or c , l3 ri d.:; water,
\'o. . fo r tho c ont'' o~ --- --~ - - -- - - --------- .
.n oun t on
hand--~--- ,✓-"~---- ~~--~-~ --.
Amount ' out:;11.t d1~r in '" no .-------------~-- - ---- ---.
e :.:o::~ J"' :..,o~"T,
t ,i-'"1.~n:::; i
1
t ----- - - _,_ ________ ___ ____ - __ .
Inount used cl ::.:>ini;· r.o .---- - -·~-' : ~- ---.
.'.nount o,i hand---------- ~
" i ne
0
-- ~
¼-~
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�Inventory of Ardent Spiritc
To the Clerk of Rockingham County,
St ate of Virgi ni a .
The f ol lowi ni is an invoic e of Ar de nt Spirits for other
than b vera e purp ses of the lli l ler 1 • Dru g Store , Brid Gewater,Va . , for
t he month of March 1 919 ;
Amount on hand the precedi ne month~
Amount bou ght duri ng mo . of Uarch _j ( ..~~
Amount now i n
.Amount u sed duri ncr n o . of •.~a.each.I.: --
·- ./L r.-
A o-i.;.nt on ho.1 d Fi rst o·f April-; ) ~ 6 ~
,I
Signed :--#
d ~ 1-
A'~
,t,,,<-<--
; 1, r
r~ ~
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y ' ~~d. '
1.11111 1~,1~.,
,5~
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L.1 ,. • ""• •, ISth I 21
'
J
�---- -----:
�I nventory of Arden t Sp irits
To theClerk of the Circuit Court of Rockingh am Com1ty,
State of Virginia .
Tho following is an invoice of Ardent Spirit
for other than
beverage purposes of the Miller's Drug Store,Bridaewater,Virgi nia . ,
for the month of April 1919 .
Amount on hand April lst . ~
- flf!!.::
Amount bought during April - ~
Amount now in transit- --~
---
Amount used during mo . of April-~
Amount on hand May
lst .-:2:--~J..d;;-
ridg water, Virgirnia .
l'Y1r--
,(,Y .,A-- ~
rl
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.
~
3/- ),Kl
Iffy .
es:{# 7/r: ~A_d . vP~~ c?~
My Comrr.· ..,1on Expire Septe her 18th, 1921
,.
�..
r
'!
�3. D. •ill~ t+, J11l. D.,
In ent ory of Ar den t Spi rit .
To th
Cle rk of the Cir cui t Cou rt of Roo king
hara Cou nty ,
Sta te of Vir t ini a.
..
Th
fol lowin
is an inv oic
of Ard ~nt Spi its for oth r
th n bev 1"0.g o pur pos es of the iU
ll r '
Dr uf: Sto re,B rid e; wa ter ,
for tho mon th of ~ay 191 9 .
Amount on han d May lst . ) ~
._J.. £ 'h,_;_
.Amount bou ght dur ing Ho . of
!,!ay - n '.:IC:~~ ...!...
Amount nov in tra ns1 t- - -
/)_
A,'1lotmt use d du rin g Ho . of :..fay ./
~
AJnount
01
.'
_?::_ _
lst . .L~
:-Y-4...•
,.
s1~ net l~~~
- ~-~ ~~ ~ ~~~
hand Jun
~
~--~-~
Per -
-
-~- -
~~
,
--- ~~~
~
~~~ ~~ ~~ ~ ~~- ~
Bri d ewa t r,V iru i n ia .
-'G ~
~
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7-
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t1
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-:z;,/ _~
-:-71 ·
~
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.d_ ?f
H ft- .<f:J/
m issi n E
:
~ J r, j- -t> <3 J«~/
t!/- t:7'J~
d__ /
ir
k -:~
Vf-.1r?~
Septe mber 18th, 921
/91 7,
0-~
,c .
�_
..)
_______ __
�Inv ntory of Ardent Spirits.
Clerk of tho Circuit Court of Rockingham County,
To t h
State of Virginia .
The f ollowinf~ i
a n invoice of Ardent Spirits for other
Drue Storo , Br i d~ewa t or , v--
t han b vera 're purposes of the Miller '
.
for the month of June l91.9 .
Amount on hand- J~..:M•- *s~ .~ _ t ~
Aruou.nt bought durins month of June - ~
-
Amount now in tran it~
s d durine; month of June
J...mount
Amo
t on hand July
lst. L2d.~!!?:.Y~ '
Si ned:mMiller '
4
~
7- ;-,Vt_-, ~
J
~~
-...
-...
--
)' /~ ½
/
Dru
Store,
7-~ 0~~/ ~ ~- -
~,.u4 ~ ~~ ~
-fu_ ~
-l&✓--!: :
z/
1
,0-r,~-
J:.;
<M-C_ G
*~,~
M y Commisai m l<~xr i.es
i::. rcqu 1r,.d upon t1,i_
,0;c.,
o-y
~
j xo
/ tft9.
tc/./(7'--
By 1he Lawe; of Virpin ia, no tax
~
pt • 1be1 '
h, 9?1
c?~
.
��.:t. D. Jlllille.., •• D.,
Bri6g~mate.-, 'Ut.-gtnta
Inventory of Ardent Spirits.
u Coun tv
T0 Th "" c1 .... ,,. of the Circuit CouY't. of Rocl-::ii"li~lt~.
=
., ,•
V
State
.._ ~.._ a
oz
Th
bev
1'
•
-
-
Virc ini a .
foll ·::inc is an invoic
c; e purpo s
of th
of
rdent Spiri ts for oth r than
Miller ' s Drug Stor , Bri d ewat r,Va . for the
month of July .
I , , /. I /?--1-_ y .
Amount on land July lst . ~
~ - ----
1/ ~ ~ 0,
July-- -- - -~
·
Arlount bou ht dur in5 no . o
Amount now i n t rans i t - - ~
unount used dur i n
Amou.'l'l t on h and A
-
mo . of J uly! ~- '1..~
~ • 1st . ~
~
:..
~ y~/ ~
xi~ ~
/
,6~
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J_,;z;: 1/-c)'
Si ~ned :~
,;rj,;f ,;z,e_
\
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~ e (c ' c - 1 ' ~ ~ --;I;
-~ ~ 1
ry
,y--,,-,~
d
4~
,) ·4 ~
..
l
lrgln ta , no fllX:
required upon th·
J
1s sea,
/
-
~
~ 1 ,;( d-.; 7 ~
<Iv: Ylr~ ~;,,{. ~
My Commission Expires Sept 18th, 1921
By the Laws of V
~
<?~
�.....
---- ------ .
�'llh!i6g1'mAt1'1', 'llil'ginia
Inv ntory of Ar dent Sp iri ts
Tc T~e Cle r k of the Ci rcui t
curt,
nocki n , aJ:J. , Count - ,
Sta
~
of
V
r r nia .
Tle f ollowi ng is an i nvo i c
of , rd ent S. i r it s us~d
for oth r than bove r ase pur osJ ~ oft e Uill r ' a Drue Sto e,
Br i d~ owat r,Va . for the month of
.Anount on
~
ormt
_ mot
a.
ucus t 1
and 'ug . 1st . !l.~Je! J. (Jl·.
ouv~t durin
·
~
mo. ~uc . ------- -.
---.
t now i n transit ---~
Amo·· nt us ed d 1r i n .e· mo . of
.:.!~- .
cunt on, and Sept . l~t .~.:!.. ~~~ .
~;ltvC-
1-
~
-1
~to r ,
ed : Jiller ' s Dru
Si
~ --t- ~ .• •
~~ ~~ 7y ? Cf~
Jry ~ -c-J -J .7Jt~ , ~ ~ /
<!1/f~
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1
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7
~
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.
Q-:,(Y,)1-. ~al/
vh-7:;,
~
iMy Commissioz, Expi E'II StptcB1 .r 18th, 1921
i
��3. J!I • ._ille-r, Jll. J!I.,
l 'ht6gewate.-, ,in.-ghda
I nvent orJ of
rdent Sp iri ts .
To The Cl er : of The Ci rc i t Cou rt,
_,ockin ham County,
State of Vi r ini a .
I
rrhe f ollowi n, ic< an inv oi ce of
-r dent Sp irits of the
1i ller ' s Dru· St ore, ridGe ater, Va .used f or ot h er t han bevera ·e
pur o ses f or the month of Septemb er 1 19 .
-- -·- ~
-..,:/,#:
mo . Sept .-~
-- - T
_mount on hand Sept . 1 - mount bou ·ht dur in
mount now i n tran sit - - -- - - ---Amount used durin& mo. of Se pt ~ ~
Anount on h and Se:plb'ber
.L~Y •
l st.~
~ ~ 4/irc_
-~~--77'-------,
Si ned : - - - - -- - --- Dr i d r: eyat.e ~
r~
--- - - -- - - ------ -- - --.
Pe r --
°:I- ;cc~~ ~ ~ ;f;;- ~
~f ~ ¼, hr ~J_/f51-.?11_~,
/ ,p':.;z
~
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11ltsic,n
Ex~ ires Sepl. 1 th, 19 1,
�r-- - - ~-- ---
.-
.....
__
..,
____ _
.--- - ------- ---- -----
•.r •:'
,.
�3 • .II . ._ill~l!, Jn • .II.,
'.111!i6gemnte1', 'llhghda
Invento y of Ard ent Sp iri ts .
To The C er
~ oc in~ham
of T 10 Ci c· · t Court,
ount y,
State of Vir ~in i a .
T e fo l o·ni
other tha
rr
is an invoice of Ar dent Sp irits used for
evera ~e purposes o f t h e Ili ller ' s Dru~ Store,
Drid~ewa t e r, Vir~inia, f or t he month
of--( e ~-~..2LZ _·__ .
Amount
mount
.,_; r 1 , ewa
O L cri
r .--·i nia. .
Par-;/-•--~-•-~
.J ~ '7-·. Ir~
~~
~
0. •
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�.:f. Jll. Jtlillel!, Jtl. Jll.,
'llrt6gemahr, 'llirgfnfa
I nventory of Ardent cp irits .
To Tl e Cler k of T e Circuit Court ,
State of Virc inia .
The f oll oVi i nc is an invoice of . rdan t S , iri t n us ed f or ot h er
I
t han ~evera e purposes of t h e Millers Dru" Store, Drid r ewate , Va .
½
f or t h e mont
dlr~
1- r_,_;_ l
I
~~
I
'l-
,t;.~
C1/!'d-e_
~
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o--J-j ~
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~~
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th,, ('J, '•r,, ~ - - - - -
Rock1r 'ha,r,
)
1,
,(1 I
"
''e
, o11 . I~ I
Va ,
J
Clerk
4--<~
1
~~ -
�-- .
�3. D. !ttillct', • • D.,
'lht6g,.mnt,.r, 'Utrgtnfa
Inventor y of
rd ent Sp irits .
To The Clerk of The Circu i t Court,
.1.oclcin' ham County ,
State of Vir ·ini a .
The f ollowinr is a n invoi ce of Ardent S i rits used f or othe r
of t h e .iller' a Drur Store, Drid Gewater,Va .
t ha n beverage
f or t he month
,;... / . F . ; L ~- - - --- .
.nount on hand-- ~
------.
..mount bou h t dur ing mo .-- - - =-=~
~
mount now in trans i t - - ----- ---- - ---------------- .
A
~ - --- - ---- .
o. ---- ~
ount u:oed durin
n ount on hand- - - - - ~ ~ ! ! ' ~ ~.
~~~
Si ned : - --- - --- ---- -- - ---- ---.
Drid Gewate8 ~i r c ini~ .
· Per/ •
d,~
crf- ! / ' ~ ' ! ~ / ~
o::f~
~
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1
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7
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m. JJ.,
Brt6gema1'"r, 'Utrginia
...
Inventory of .rd ent Spi ri t s .
To The Cl e r k of~ e Circuit Court ,
oc~in :ham County ,
State of Vir " inia .
The f ollo winc i s an i nv oi~e of Ar d ent Sp iri ts used f or
othe r than bevera e pur poses of the Llillar ' s Dru · St ore , Dri dc ewater,Va .
f or t e mont
o~
-l 2.2::!?.
1mount on hand- ~
..:_( ~- ~
,.mount bour ht during
mo.--2 : : : . ~-.
Amount now in transit---- - -- - -- - -- - - -- - - ---~ - -.
mount used d1rin~ mo .---- - ~ -~
J, cunt on
_-:and--)?.;"~-4
--- --- .
-~~-~ . . L ~ ~ ~ ~
~
~
"' i cned :- - - -·- - - --- - - -- --- - - - ~
,,Q/~ ~ Ir~, ~...,,
4~
~I ~
/ 'J ,.2 0
7
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~
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---,
-.
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~ / I(,rV ~,,.__,L ' ~ ,,.:r.,,, 0 ~
J Co.nun
,ion 1:. p·r
i
S
e.;i epteruher 18th, 1921
�.,
---- ---- ---- ---- --- ---- ---- ----
---------------- --------- --- ---.,
.
•
�BriflgemAhl', 'llil'gtnta
Inventory of i.rden t Spirits .
To Th e Cl e rk of The c•rc u it Court,
Roc kin~ham County,
Sta te of Vir i nia .
The f ollo win r i s an invo i ce of _rden t Sp irit s uded f or
othe r t han beverai e purposes of the Hiller ' s Drue Store, Drid ~ewater,
Va . f or t he month
of-~
Anount on
-~
-4 ~-.
hand----, Z ~-L~.w~/0,%;--
mount bou ·ht dur i n r mo .-;_ ~
V
Amount now i n trans i t --- . mount
- - --- - -.
- ----- - - - --- - -- - -.
used d ri~ ~- ~:::-..,.7¥---
mount on 1and---------------L ~ d : - ~ ~ , '
Si -ne d :-~ ~-
7
Fll d ii th Clerk's nfflr.e
.o · In h County, Va.
MAR 3~1920
_ _ _ _ _ _ _ Clerk
:My Commiss:on ExpITell September 18,h, 192
�--- -- .
y-- --------------------- --.
---- ------ -- --- --- --- --- --- -- --- --- !
�Blille~"s .l hug Sto~ e
:£hi6 gewah l'. lltil'g inia
Inve ntor y of 1\.rd ent 3p iri t:1.
To TlY' Cl erl::: of The Ci rc u it Cour t,
~oc kin~ ham Coun t~,
0tat c of Vir ~ini a .
n used for
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Liquor Inventory
Description
An account of the resource
Series III of the Prohibition Records collection consists of records documenting the inventory, sale, and transport of alcohol for medicinal purposes in Rockingham County. This series contains printed inventory records of the alcohol on hand of licensed commercial businesses during prohibition. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Identifier
An unambiguous reference to the resource within a given context
Pro003
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/6">Prohibition Records: Affidavits for Ardent Spirits</a><br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Liquor Inventory of Businesses: 3
Description
An account of the resource
(E-M) Printed and signed letters by a notary public reporting the on hand stock of alcohol of licensed commerical businesses.
Subject
The topic of the resource
liquor
inventory
commercial
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-016
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
-
https://omeka.lib.jmu.edu/erp/files/original/a7c890793a3084ad2a3901d8294403e4.pdf
64a4c5bb3491c437d577b34653c4ce27
PDF Text
Text
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ELKTON,
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To __ _ _,.;;/(_~
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Rockingham County, Va:
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ALCOHOL
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~,ng balanc
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Pul'chased durino· __ "h-'.Z-2'///
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I hereby certify th at the above inventory of ArdentSpi1 ·its is a
true and accurate sta tement of all receipts, disburse ments and quantity
of Ardent, Spil'its on hand at the abov ~ tes .
-
STATE OF VIRGINIA ,
-- -
✓
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CouN'l'Y OF RocKINGHA M--To-WrT :
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EL~ON, V A ~ ~ l g "
__ {/~ ~ Clerk of the Cfrcuit Court of
Rockingham County, Va:
T~
ALCOHOL
d ~ / ~On h a n
Be ing h:ilance from la st month.
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· Purchased during _~
- -~~---~ ~
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_
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Balance on
b,N{/~rn1 K
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I hereby certify tha~ the ab.ove inventory of Ardent Spirits is a
true and accurate statement of all receipts , disbursements and quantity
. atPs.
i
o
of A1·dent Spirits on hand at the
STATE OF VIRGINIA,
COUNTY OF RocKINGHAM- -To-Wrr :
Subscribed and sworn to before me, in the Co nty of Rockingham,
this
-J ___
day oL~
My Commission
--- -, 191 £'.,
~ 4'__:--_._________ _
expire(cfftvifi;J_:;~;-;::- - - . _ _ '}f;'f)
��ALCOHOL
lfg~
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On h a n ~ / ~ ____ 191</5-____
B ei ng balance from last mnn 1h.
Purchased d u r i n g ~-: __ ____ l9l _g :_ ~- ----~
~~ f l , _ !&¢,/_ ~Balance on ban . . . .
.. :
/~18':,
. ~ / ~ ..
Ardent Spirits is a
I hereby certify that the above inventory
true an d accurate statement of all r eceipts, disburse ments and quantity
of. Ardent Spi1·its on hand at th e hove enti nee dn.tes .
STA'l'E OF VIRGINIA,
COUNTY OF ROCKINGHAM - -To-WI'l.' :
Subscribed and sworn to before me, in tbe Co
this ____3-' ______ day oL~
---- , 1918:°,
..,, .,._,../T"-.,..,., . ,
My Commission ex'f)ires_~
_(e._ ______
19 _'7_
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KTON,
VA~ /----- --~-----19£
}ff_~ ./e_ L,______ 2&1L__ ,
Cler1tJ ' the Circuit Court of
Rocking ham County, Va:
ALCOHOL
TotaL ______ ________ ____ ____
- ~ --191J:_ __ __
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I hereby certify tfia~ the above inventor y of Ardent Spirits
STATE OF VIRGIN IA,
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COUNTY OF ROCKING HAM- 'I'O-WI'l' :
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�ALCOHOL
On hand
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Bei ng ha! · nee from last mo nt h.
.
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I hereby ~ tify tha~ the a bove inventory of Ardent Spirits is a
true and accurate statement of all receipts, disbursements and quantity
.
of Ardent Spirits on hftnd at the above entioned dates.
..Q ._ _:»~ - - --
STATE OF VIRGINIA,
z
COUNTY OF ROCKINGHAM --TO-WIT :
My Commission exfJires~ I ' : ¢ /
--1-~
��ALCOHOL
STA'I'E OF VIRGINIA,
COUNTY OF RoCKINGHAM - 'l'o-WI'l':
Subscribed and sw
J ......day
th;s . .
. .... .... . ..... . , lAl ~
My Commission e,p;,.,
·'·t ~
to before me, in th e Co nty of Rockingham,
b . • .
~ :;r:::;~;,_;·· ... .
._'?/,.9,
��ALCOHOL
Purch ased
I hereb y certif y t at the above inven tory of Arden
true and accur ate statem ent of all receip ts, disbu rseme t Spirit s is a
nts and quant ity
of Arden t Spi,·it s on hand at th
ve
ioned dates.
STAT E OF VIRG INIA,
OouN TY OF RocKINGHAM- -To-W rr :
��ELKTON,
~
VA.,¥
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. L.rn,3"'
Clerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
On hand _
Balance
d ent Spirits is c
I hereby ce rtify that the above inventory of
tru e and accurate state ment of all r eceipts , di s burse ments and qu antity
of Ardent Spi1·its on hand at th - ove me tion ed d, es .
STATE OF VIRGINIA ,
COUNTY OF ROCKINGHA M- -To -Wr.r :
��l!d/ :J/}
EL
~-✓-:- ~~-- -- Rockingh
the Circuit Court of
am County, Va :
ALCOHOL
B alance on
I hereby certify that the above inventory of Ardent Spirits is a
tru e and accurate statedi.en t of all receipts, disbursem ents and quantity
of Aruent Spirits on hand at the ove me tio d dates.
,
S'I'ATE OF V I RGINIA,
COUNTY OF ROCKINGH AM - 'I'O-WIT :
Subscribe d and si!!:)~ e me, in the Co nty of Rockingh am,
this __~ -~ --- -day of _________ ____ _____ ,
b __
rn1R'
- --My Cmnmissio o ex,ire~
,_c2__4d ______________ _
-~---7
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/ F_ ____19 _7 -
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--- ---- -- ----- ----- -, Clerk of th e Circuit Court of
kingham County, Va:
ALCOHOL
On hand ~ ~
Be ing ba lance from last mon1 h.
. . 191%
r£d-z0>
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-f'111•ehasef:l during ____ __ .. __ ____ .. __ ___ ___ 191_ ___ __ __ ___
.,,.,__ _:-::-:_~___ _:::-:_ __
~-~
Balance on
I hereby certify tha~ the above inventory
Ardent Spirits is a
tru e and accurate state ment of all r
ipts, disburse ments and qu antity
of A1·dent Spil'itR on hand at the . ov<> m
·
d eR.
��(_ U
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-~
_,,KTON, VA/ , _________ _________ ____ __ ____ __19i:'.)._ _
~
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Clerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
On hand
~
19L[{_ 8~/._2,_~ t 90q
/~
~-r.-:. -::.-_
Be in g ba la nce irom last month .
. .. . ...
Purchased during .~
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191K....~
~,1&:; j'f/C.
p(}.µ:;_~j
/ ~e:Ff i>j
~ .191!{_//;CdfcfJ;i--//1}
I hereby certify that the above inventory of Ardent Spirits is a
tru e and accurate statement of all receipts, disbursement s and quantity
· ed dates.
. of Ardent, Spi1·its on hand at th,,_..""'""cv
STATE OF VIRGINIA,
COUNTY OF ROCKINGHAM - ·TO-WIT :
t h i s S ~ b e d : ; n : , ' ; J = r : ~ ~ ~·Rock,n~h•m_.···
£ .......19 '2cc1
My Commission e<fires~ . f
��(U:£'
Tw
ELKTON,
Ckd '2 ~ 1'.Z
VA, __
= - , : : ~ - - ,~
-~; the Clrcuit Court of
Rockingham County, Va:
ALCOHOL
Bein g bala nc e from l:J.st month.
Purchased during _~ - : - ____
I hereby certify that the above inventory of Ardent Spirits is a
true and accurate :--tatement of all rece·pts, di burse ments and quantity
of Aruent Spit·its on hand at th , b
, · ned dat s .
��ELKTON, VA.p ~ ..
~
__ , CJerk of the Circuit Court of
Rockingham County, Va:
ALCOHOL
On handv Ck.-.
./~ 19.l/v}'_--- ~.#if!(~
";;ein g
Cl" ---o
balance from last mo nt h.
~
Purnbased duri~ c c c . . . . ... 19~ .. .
~
. Total~
Balanr.e on~
-
Z.~.. .
;;;;;?'-~&~ ~
.. 191'9' ,'l".L:,-;li}p_ .:fl5J
I hereby certify that the above inventory of Ardent Spirits is a
t1·ue and accurate statement of all recei ts, disburse ments and quantity
of Ardent Spii'its on hand at th
e
d dates.
STATE OF VIRGINIA,
COUNTY OF
RocKINGHAM--To-WIT :
thisSu?ibedda:n:f~for:~.~='.i•':~,C
] ~•,m~•• ~
My Commissi0n exph•e, ~
( f'........19 .fe /
�,.
�On l,ao d~/- d:_ __ l91rs f~~~~~
Being ba lance from last month.
~/7
(}
·Pu,·chased during ___ ____ _______ ____ _ ____ 191__ ___ _ -~ --
~~~f
Balance on hand~
/ ~
191'1--,
!!4~2~
:
~
tf!'-fJ-:'zj:-~
I hereby certify that the above inventory o ~ n t Spirits is a
tru e and accurate ~tatement of all rec~s{ ~:~ent s and qu antity
of Ardent Spirits on hand at t , e Y . 1 3 ~
/ ~
--- -t --- -- ------ -- ----- ----- ----- --·· ---- -- ·---- -----
�----==~-~~~- - -===- - - - -- - - -- - - - -- ==
�the Circuit Court of
ALCOHOL
�,,
�ALCOHOL
Balance on ha
S'rATE OF VIRGINIA,
COUNTY OF RocKINGHAM --To-Wrr:
Subscribed and sworn to before me, in th e County of Rockingham,
this
.0~.
day oL ~
-- • 1 9 1 J , ~ ~ ~
My Comm;ssion " • ' " ' - ~
_(__r_ ...... 7 /
19
��4
19¥----- ______
-- --~
the Circuit Court of
ALCOHOL
On hand
___ _ __
Ue in
_/if5
alance from last m o nth.
J;,
_19,f_')_~/~C
z;'
p-::-_ _./_,
Purchased during ~ - -- . ____
STATE OF VIRGINIA,
rn1f: __---~----------------C ___ _
7:~ ;_t::°Y.-:~
=--::~4~~:~
COUN TY OF ROCKIN G HAM - TO-WIT :
of Rockingham,
Subscribed and swo 1· to before
this __ _~
_day of
__
My Commission .,,ires __
~
_/_C__l9 ,?,-/
��... .;/i±_rn7
th
Circuit Court of
ALCOHO L
��ALCOHOL
I hereby certify : ha~ t
above invent ory of Arden t
true and accura te sta ement of all r eceipts , disbur semen ts Spirits is a
and quanti ty
of Arden t Spirits on hand at the
c?,\n tio
tes .
- - - ~ ~ -- -
--- - - ----- --- - -- ------
STAT E OF VIRG INIA,
COUNT Y OF ROCKI NGHAM - TO-WI T :
--
��DE T SPI I S .
INVE TORY O•
REPORT .
MONTIIL
J an .1,191 8.
To t he
,ock ngham .
County o
l erk of the Court of th
Spir ts of Wi ghtman
The · ollmv ing is an inven t ory of Arde
enume rat ed.
Drug Co . Bridge water ,Va . as of the dates h reina te
4
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t a.......1 } -· 1, 191'- L~_c::'_:· l __ : ____ l ___
------- ------ ---~---------- ----------------- ----------------ove inven tory of Arden t
1
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I hereby certif y that the ab
Spiri t s is a true and accura te statem ent of all recei pts,di sbursements and quant ity of Arden t Spiri ts on hand at the above
mentio ne r dates .
re£'' ;{)W
- ·--~#-:.:-~-~- ------~~
.
------------~--------------------~------------------------------------------------State
r
,
irgin ia,
County o uf.ouc..............1 ~
to-wi t :
Suscri bed and sworn to bef' ore me ,in the Count y
1 rtf~ ~
'
1918.
By /o,<J .X-1 ~,.__._._
.MyCommissio~ { v ; , ~ ~921
Notary Public
-------~-----------------~---~------------------------------------------------------------------- -----------------------~-~-
��INVE rTORY OF A DE T SPIRITS .
MO TILY R PORT .
To tle Cler
of t ie Circ uit Cou rt of Rockinham County.
The followin g is an inventor y of Ar dent Spir t
of Wightman Drug
Co . as of the dates hereina fter enumera ted .
--,-------------~----~-~~----------------~~-~~-------------~lr~-t~
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t, ____= 4~-i
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-------- -------certify the bove inv ntory of Ardent Spirits is a tru and
~
1 -----
- - -
i __
I he eby
reciepts ,disburs ernents and quantity of
accurate statemen of a
pir ts on hand at the above mentione d dat s . __-6,:. t),_, ( / j ~ ~~
rdent
--
--- --------- ------~~ ------~~
-------~
~------------- -- -------------------------~
----~------ ~-------~---------- --------
-~
State o v · rginia ,
County o Roc k inham t c -wit :
cuscribe d ancl · sworn o before m , in th
18 .
ay of F bruary
t h is
,r;
:My Commis~ion Expires September 18th, 1921
-BT
ockinham
county o:f
RJ/. t:7r;;,Lpy.<i? r.,
1
o tary
ubli c •
~-~----------~----------- ------~
--~---------------~-------------~----------·
------~
-----~~
-----------~------------
��WIGHTMAN DRUG COMPANY
ne~e,,e.a,Lts,-.
C. D. WIGHTMAN,
MANAGER
BRIDGRWATER, VIRGINIA
INVENTOIY OF~ DE 1T SP
ITS .
1\lONTULY RCPOllT .
State of Vi rginia ,
County of Roc;,:i ngham to-wit:
Subsribed anQ sworn to before me ,in the County of Rockingham ,this
day of April , H)l •
~
d.~~~rNotary P1tJ1ic.
Commission ~Xpites September 18tll, 1921
�•
�WIGHTMAN DRUG COMPANY
77'•~Stor,
C . D. ~IGHTMAN,
MANAGER
BRIDGEWATF,R, VIRGINIA
I NVE !TOi
or
A1
LJ:SJ.d
1
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•
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To the Clerk of the Court of the County of Rockingham.
The foll owing is an inven t ory of Ardent Spirits of Wightman Drug Co.
a s of the dates here inaf t e r enume r atecl.
: ~ - : :!I ::
a = :::=== ::= = =s 2 :a.::& :::s
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I he reby ce rtify that the ab ove invent ory of Ardent Spiri ts is a
~~-
true and accurate statement of all receipt s ,di sbu rsements a nd quantity
of Ar dent Spiri ts on hand at the above mentioned da ~s.
----- -=--
-------- ---- ---------------~- -~--=-~:1--~ ~ --------~--~-
STATE OF VIRGIN IA,
::(_
County of Rockingham -to-wit:
Subscribe d and sworn to before me ,in the County of Rockingham, t h i s g- day
o:f #(~
1918.
By
_-e
-£>.fr~~~
(l1_ .,/vf ~~1 NOt ary Bubl i
C•
y Comro.ission Expires September 18th, 1921
��Ha.r-ri s on bur r, . Va .
I'ebrua r y 1.1 918 .
Court of the City of I c,rrh,o nbure , Va .,
To the Clerk o f the Circ uit
The follow in g in an inve ntory of J'_ lcoh ol of
11,
illi r.rnson Iir-ue Co. , a s o f
the da t e s herein after enumer ated .
Pts . 0 Ozs.
On Hand January 1 . 1918 .
0 Ge.l . 6
Purcha s ed ,uring r1 onth of .fan . 191B .
9 Ge.l .f 8 ( n) Pts . 0 Oz s.
Total .
~
Us ed during tho nonth o f .T, nu,~:ry 1 918 •
2 Gal . g
I3a l ance
Orl Ha nc1
Gal . 12 r ts . 0 Oz s.
ts . 8 O· s.
7 G8l . 2 J' ts . 8 Oz s.
J•'e brua r y 1 1 ~lHJ .
..... . . . . . . . .. . .. .. .. . . .. . . . . . . . .. . . . .. . . .. . . . . . . . . . .. . . .. . .. .... .... . . ........
I hereby cer!dfy t hat tho ab ove invento ry of J. lc bh ol i s
true and
L
'
..... . ..
;
.
··,
on
a ccura te sta te men t of al l rece i p ts , ct i~,bun_;ements &.nd •:efue.~ ey · ttf •.A lcohol
hand at the ab ove mentio mi d da t 0 s .
• •••
.. ... . .. .. .. . . .. . . .. . . . . . . . . . . . . . . . .. . . . . . . .
•••
.
.
. . . . .. . . . ... . . .. . . .. .. .. . . .. .. .
.
3Ti\. T.;.:J OF VI HGI Tll iL .
Cit y o f I'ar:r i b onhur r, ,, ~•o-'f!i t .
Subs cribed and sv101·n to he fo r e me
F i r st Day o f Vebrua ry 1918 .
,~ft in t be c ity
0 1'
a rri s onburg t h i s
...................K. 1:.1.:4.Y.v.... .
0No t a ry Public )
W1 0t>~ ~ ~
J
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1'lll
•• ••• •• • • • •• • • • • •• • • • • • • ••• •• • •• • •• ••• •• •• •• • • • • • • • • • • • •• •• • • • • • • •• • • • • • • • • • • • •
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......
�Harrisonburg.Va.
Mar ch . 1.1918 .
To the Cl e rk of the Circuit Court of the City of Harr isonburg ,Va.
The Following i s an inventory of Alcohol of Williams on Drug Co .,as of the
dates hereinafter enumerated .
On Hand Ferbruary 1 1918.
7 Gal. 2 Pts . 8 Ozs.
Purchased During the Uonth o~ Feb . 191.S .
0 Gal. 0 Pts. 0 Ozs o
Total .
7 Gal. 2 Pts. 8 Ozs .
Used during the Month of February 1918. 5 Gal. 2 Pts. 140zs/
1 Gal. 7 Pts. lOOzs.
Balance on Hand March.1.1918.
•
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I hereby certify that the above inventory of Alcohol 1s a t rue and
accurate sta t e ment of all receipts , disbursements,and quantity of Al cos ol on
hand at the above aenti oned dates .
I
•
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BY ••••• •~ • •••••••••• • •••••••••••••• ( ••••••
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----=--=
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..... .
........................... .......... ......................................
STATE OF VIRGI NIA .
City of Harr i sonburg , To-wit.
Subsc ribed and sworn t o befor e me in the city of HarrisonbuPg , this
First Day of March 1918 .
••••.4. A::Q~.
.. 'o.,11a1•~-~
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�Earri::mnbur[; . ·a .
April .t. 1918 .
To t he Cl e rk ; of t ho Gircui t Court o:. tl c City of . ,a rri m nbure , Va .
Tho Foll,ovling i s an i n oon troy of ~-lcoh 1 of
.il l i t moo n Dr•u " Co . , ao of t h e
d n. t o s heroin '.ftor enume rat ed .
On r;and t·arch 1 . 1 918 .
l Go. l . 7 Pts . 1 0 Ozs .
I?urnhaoed dur i J.1r, tl1c r;1on t L.$
Ca r . 1 91 8 . 9C-a l . 6 f ts . 0 . Czs .
11 Gal . 5 -,s . 10 Ozs .
~Pota l .
Used :)ul''i n[; _ on tl
4
of I a rch . 1 910 .
7 Gal . 5 Bt s .
a l,ancc Cn flo.n d April 1 191 .
.
Ga l . O t ::: . 14 Ozc .
.
2 Oz s .
. ... . .. . . . . .. .. . . .. . .. .. . . . . .... . .. . ... . .. .. ... . . . . . . .. . . . ... . .. . . . . . .. . . . . .. . .
~
I hq·:e by cePtify tha t t ho "'bove invento.r y of ~ lcoh ol , is a true and a ccurate
'·I
state.tnen t of "'.11 __•ec o i p ts d:hs bur ccncntc , o.nd
above men tiorntd da te e .
qu:::.nt ity of' li.lcoh ol , on : and at t he
.~ : ~
--~ -.-?:.~.-.--• • • ••
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • •
H ~G I .', L\ .
Ci ty of ··arr j_G onburgv '110 - vri
t .,
3 ubs cribed and sv1orn to before no i n t h o Cit. of r a rri o onburg , t :l:is
Second Da y of .A.ril 1 91 8 .
cr;--/,-;J
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• • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • •
(Not::.i.r:y
' ublic).
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........ ......,,,.,,
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�Harriso nbur n; . -· •
t:!a y . 1 . 1 91 8 .
To tr:e Cl0 r ~ of
cr,c
C:.rc u i t Cottr- t of t he cit
'l 10 Foll or ng l e c.n i n veu·'.o y of i, lc oh ol
of · ,c.rri
.'
L: Oi1bur ~ .
of . i l_ i c.• Gon Dr ug Co . , a s 01 t. 1e
da t es hcre ino.f t e r l'.;nu·,1c r:-..cted .
On _rc..n
p nil l 191 G.
L
...~Ul" C ' i.r DC d.
C.ur.:.11....; Apr•i l
1 01 D•
ot al .
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.o.i lh April 1 91 8 .
... 11(1
. ~-1.y 1 . 1 91 8 .
t,s . .2
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7 Gc.l .
f)
0
Gal .
0
7
C-ul . 5 i., t s . 2 O,~s .
4
Go.l . 4 :et s .
3
Gal . 1 ~'t s • 2 Oz s .
(
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") t s . 0 Ozs .
0 C".,,..,
"
.
... ... . . . . .. . . . .. . . . . . . . . . . . . . .. .. . .. .. . . .. . .. . .. . . . . . . .. . .. . . . . . . . . . . . . . . . . ... ..
I
1c1."eby ce:c- t i f y t :m t tho (.bo vo inven t or y of · lc o:.10
ctn. temcnt o f , 1 1 r:o c o:;.p t s d i e ·
'
i G a t rue o.nd .,__ :.; cur· t e
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001.,cn tc , : .: . d Cflmn·tl ty o
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dr.. ·· of t.:c.y 1 91 8 •
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�Har•riso nb1.1.r r, . Va .
Juno . 1 . 1 91 8 .
To the Cl erk of t he Ci rcuit Court of t he City of ·brri conbv.n e . v • •
':\:_ e f ollo\'r in"' i s a n inve ntory of' Al c oh ol o~ '1i l liamso n Drus
0
o ., a s of t he
d· t e s hereinafte r enumer a t e •
On<i Hn n d
GUY 1 1 91 8 .
nurcho.secl Durin" 1:0.y 1 91 8 .
I
Tota l .
Uac d du.r:t n 0
rt .
3 Go.l . l
2 Ozs .
1 0 Gal . 0 Pts . O Oz s .
13 Gal . l.
; onth I~ y 1 91 8 .
5 Gal . 6
C')
t, . ...,
Ozs •
~t s . o Oz s .
....... .............. .. . .... ... . .... .. . . .... .. ... .... .. ................. ..... .....
B2. a.n e e on IIL.nd JULC 1 . 1 91 0 .
7 G'?.,l . 3
c.2
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I hereby cert i fy t ho.. t t . u - b o·.c inve ntory of Alcoh ol , is a t_--.u.e . . nd n.ccurcs te
s tatemen t of a ll roco i p t s d is bu.roc • cm ta <.nu q_
n t ity o:. :_].co'·w l , on ha.nd d...t t h o
above mentio ned da t es .
••••••••• ••••• ••• • • • • • • • •••• • •• • ••• ••• • • •• • •
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S':i:AT-_; OF VIRGL .L • •
City o f' Ho.r1"i "'o nbU1"g • Tp - n it . ,
Subs cribed o.na s r.'orn to bo :.. ore nc i n tho city o .? :·a.rri s onbw."g , t~1is
Firs t d a y of J u o 1 ::; 8 .
£~~ ✓
• •• • • • • • • • • • •• • • • • • • • • • • • • • • • •
( o t ., :i."y ?ublic)
......,
,,..
······· ······· ······· ······· ······· ······· ······· • ~;••·:·· ··· ~·······
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�Harri s onbUJ:\..,. Vir~ i n i a .
J uly . l P . 1 91 8 .
To t ;--~o ClcrJ: of' t ho Circu i t Court of the City of Ear : •if..; onburg ,
V-r.-. . .,
'_, he fo l _o ·Jine i u a._ i nvont or ty or l,lc o ·101
of · illi c.ns on Drug Co . , as of' t he
da t c c Jmre inufte r mrn.r:mr .tod .
On 11 n d Ju 1c l . 1 91 8 .
7 Gal . 3
Pi.ll' cho.r.;od Duri:!lg Juno 1 91 8 .
0 Gal . 0 Pt :::: . 0
'l ot .. 1 .
7 Gal . 3 Pts • 2 Ozs .
TJs0d dtu•inr; mo:n h J"une 1 91 8 .
6 Gal . 6 I-'ts • 2 Ozs .
;,o.l a nc e on 1ianu J ·u.ly . l 91 8 .
•
•
•
•
•
•
•
•
•
•
•
•
•
• · ••••••••••••••••
•
•••••••••••
•
ts .
0 Gal • 5
•••••••••••••••••
:Pts .
2 Ozs .
Ozs .
0 Ozs .
••••••••••
•
•••
•
••••••••
j
I he re by c e rtify that. tic tbovo invent ory of Alcoh ol , i s a true and
o. c cur 2-te :, '_c. ~.,J1.,cnt of
:..:.r.
l"J c oi ·) ..GD , d i sburso no n tn , c;nd (]_uo.n ttty of Llcoh ol , on hand
• e e • • • • • •• • • • • • • • • • • • • e • • • e . • • • • • • • • •
• e e • • • • • • •
• • • • • • • • • • • • • • e • e • • • • • •
Cll
e a e • a e • • • • • •
I
Ci t
;j :bsc:r'i br~d and. STIOr'n to before mo i
tho ci ty of ;:.a.rri s onbur , tl' is
Fi rst Day o~ July . 1 91 0 .
... ~ .....K..:f:.f.~~---·
. .... ... ... .. . ...... . .. . .. ..... ..... . .. .... . . . . .. . . .. . . . ... .. .. . . . . . ........... ....
.
(I .ot2ry :.:'uoli ~ .
l,i v "'·
n j '•-·:
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pa·t>tS u u..J , _
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r
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•
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�Earri::;on· 1.,1;;_., ,- . Vu,.
IIug . 2. . 1 Gl 8 .
o tho Clerk of t h o Ci rcuit Cou:i:~t of t
10
Cit y of Lo.1:•riLD nbuilg ,
'.:'ho fol l o ·d:ag i ~ 2 n inve:1.tory of :_J.cohol of
'-"- .
<)
i lli o.i:1c on ,J r~ ; Co ., nc of t.c
dutos hereinafter onu o~utcd .
On :uud July_ 1918 .
'.ro ta. l .
used d1rin
.
?tc .
9 Gal . G
t, 3 .
0 GL-: .
tho montL of J u ly 1 91 0 .
•)
:~::.~s •
12 Oz s .
9 Gal . 11 _ tn . 1 2
Ozri .
4 Gal . 8 -r;t : .1 . 6
::.s .
5
Ga l .
3 I'tr. . 6 O;:; s .
............................................................................. ......
•·
I her0by c ertlfy t h t the above i n vontor>y o f i lcohol is :: true a.nu ,.".. ccur t e
otaternent of a.11 rccoi , t,s dio bux's cmo n t s and qu· ntity o_ Je.l co ol , on
.und ci..t U1.c
o.bovo mentione:d dates .
.........................................................,,.~................ ...... .
- ~
~
I EGII: I f. ,.
c ...-:01.,.1~ to bo~.'orc r..10 i n t Lo City o
/n
·11n
1
- L~l"
t l 9J.. G·.
i c onbur.:; , L2. is . 'il's t du.y of
~ cf}/J3~~
••••••••••••••••••••••••••••••
,,
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, ,
•••• •••••••••••••••••
(Notnr y :::iublic)
d1A'~ I f ' ~
~~~~
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4
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�!10.rris onbur ,3 . ,; •
J eptonb cr 2L d . 191 r, .
-:1 0
t h e Cl e r
of t o Circu it Court of t1 o City of r ..... rri s onburc ; , vo. .
s of t h e
Tho :i?o110 :Jin 0 i ~ c._ n invent or~ of ~1co'1o l of ·. illi c.• c on 1,ru.e; Co .,
d~tos here inc.fto r cnumc r~t cd .
PUl"Cht.tGe d
~... u.1~:i.n g
c-.. 1 .
h
On no.nd Aug . 1 . 1018 .
V
r te . ~ Ozs .
3
.,_,..
1,..,
0 .,al . 0
l ,u.,c> 1 91 8 .
(; zs .
•
,.,
5 G'--1 • v ? t a . 6
r::ot u l .
Unc& durin 0 uontlt of
..ug . 191 8 .
.:
Do.l o.ne e oh J~r n d : :-· eptori1b n· l . 191 -> •
ozs .
Gal . 3 :2 t0 . 4 :>z.-• •
1 Ga.l . 0 I'ts . 2
c~.'-.' •
• • • • • • • • • • •• •
• • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
d o.ccur tc
I hereby ce1.. t i fy t ho..t t h o c1.bovc i n ven t ory of l,lco. 10 1 is c. true tm
••
hand o.t tho
sto.tem ont of 0.:... 1 rocoi p ts dm.sbu rsonon t c .:.nd qu...,nt i ty of Alcoh ul,on
....
.
4
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• • • • • • • • • • • • • • • • • • • • • • • • • • • • t{
Cit . or • U I'ri :1 on,Y
S ubscri bed and f.ltlor:n to bo:;.'oro
of - .3epto nbe r . 1 9J O.
~ ~.:t,
i n t o c · t J of • nr:.."'i::.c :1:-:ur , t h is cccond
1
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�:rar:;:' i...; 0:1.b-u.r·g . Vi:i."[:;i n ia .
0c t. . l . 1 Dl8 .
o t· e Blorh: of t :ic Cirac· :;_ t Court of tho City of "ir~:.e:r i. s onbiw c; ., 1 a .
u.a tee> h -:c u inc.f t e r enurneratocl .
.
On HD.nd. S ept, J . 191 8 .
nurehas ed Dur ing ~l ept . 1 9l e .
Total .
.L
Gal .
('
~
no.1 .
10
t;..;...L •
,
? t s . 2 Czs •
0 .: t, G • 0 Oz . s •
0 rts . 2 Oz s .
u GrJ.1 . 9 Pt s . 0 Oz.., •
Use u. dm" · ng T.-lontl :3e pt . :i. 91 8 •
r7.
Th le.ne e on ·r::.md Oc t . l . 1 018 .
,)
(}::i.1 •
7 I'ts .
~
Ozs .
•••••••• • •• • • •• ••••••••••••••••••• • • • • • •••••••••• • • • ••• • • • ••••• • ••• • ••••••••••••••••
~,rue c:.nd a c cur· te
I l1.or·e1J;;, c e rtify t .at the :\') ove inventor y of Llcoh ol i f,
sto.tenento of a l.:i.. re ce i pts d is b1u~r;e.::.ionts «md flllnn-~tt ~l of :-:.1.co· '.)]. ,n 10.na a t the
above mentioned datos .
-~ ~-~
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~
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B y ••• • ••••••
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Su bs cr i bGu.
D..j_1f
cworn t o b01'ore __o in tlw ci t~ Of '
r" . ~
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V J..1.i... l -
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if Oc tob e r 1 91 3 ••••
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�Har r i s onbur r~ . \'[~ .
Nov .1. 1 91 8 .
':1 0 t he Cl e rk of t h e Circ u i t C oui>t of
t l c Ci t i o f
r a r r i so n bu.1·\ 3
The ...?ollon in 0 iLJ an :i. n vo nt or y o d l, lcoh ol of ,, i __ it~r:..o on
Va .,
Dl'U~
Co ., ac of the
d a t e s he r e i n f t or onumo r a bdt1.
On Ha nd Ge t. . 1 . l 01B •
l'UY.'8 c haiodd
Ga l . 7 Pts . 2 Ozs .
3
Du.rin e Octl . 1 91 B.
1 0 G-al . 0 Pts . 0 Oz s .
Toto.J. •
13 Ga l . 7 Ptn • 2
Use (. durinl:, r:on t h Oct . 1 . 1 918 .
10 Ga l . 7 Pts • 2 Ozs .
~a l a nc o or. !~and f'. OV . 1 . 1 fJJ.8 •
3Gn.1 • 0
Pts • 0
O~s •
o~s .
•••••••••••••• •• ••~ ••••• o •••• • ••••••••• • ••••••••••••••••••• •••••••• ~ ••• o• • • •• ' ••••
I h orob:• CE' r· t:.:'-':/ t L ttho a.bovo i.nvcnt ol'y of
sta teme n t of' '.11
i 0 e c o i. p ts
J
lcollol WfJ a ·i,l'HC;J u.lH.1 r:•.ccul'::.~te
, O. is bur s o rx mts u:nd qua ntlflty of A:Choh ol on h2.1J.d • t tho
a b ove mer1 tio.a.eJ. de::'. t. e a .
' r"•
•....•...•...... ... ................... .......•.....•
-
8 u bn c ri b c d.
day of n ovembcr
C!.I
c mrn pn to 1.Joi'oi'O
i lO
I
i n t I .;.u cit y of
a r r i..:n HrG , t h is f i r c t
. i.
10:. e.
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�Ha r rison burg . Va .
De cembe r . 2nd . 1 9Ji
, va .,
To the Cler k of t he Circu it CouDt of t he City of tiarri sonbu rg
:arug Co . , a
The Fol owi ng i s an inventOl"Y of Alcoh ol of ,fillia mson
of the
dates here i naf t er enum erated .
,
Pursc ha.sed Durin g Nov.1 918 .
Gal . 0 Pts .. 0 Ozs .
1 0. Gal . 0 Pts . 0 Ozs .
Total .
13 Gals . O Pts • 0 Ozs .
3
On Hand Nov . 1# . 1 918 .
.
Used Duri ng t he Month of November 1918 . 4 Gal . l Pt . 6 o Ozs
8 Gals . 6 Pts . 10 Ozs •
On Hand Decem ber l 1918 .
•
•
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and
I hereb y certi f y that,# the above i nvent ory of Alcoh ol i s a true
of Alc ohol on hand
accur ate sta t ement of al l r e ce i pts , di sburs emen t s and quant ity
a t the above menti oned da t es .
(
•• ••••• ••••••• •••••• • •••• •• • •• •••••• ••••••••••
• • • • • • • • • • • • • • • • • • • • • • • • • • • •• •• •• •• ••
SUTE OF VI RGI ~IA.
City of Harri sonbu rg . To- wo t . ,
Subsc r ibed and sworn to befor e me i n the Ci ty of
secon d day of Necem ber 1 918 .
" r-"=1.· r ... ..,..,,., ,.. '!;,o
n
.
~
arri so nb'qrg , thi:!
......./4.rlLtJ.~
t!'>u,IM ..
a a•• a a•• a ea a e e ••a a a• I
• a a a a a • • e e • a a a a a ea• a a a•• a a a a a ea•
a a a a • a ·• a a• a • • •• a • • • e e • • a a • • • •• a •
�'
'
�g Vo. .
Ja.nua.ry l . 1919 .
0
t
10
ClO:i." • o f
110 Cj,riinr· -t COlll"t df t
10
Gi
_he Folloning io n.n invontory of i,lco 101 ,
On I o.ncl
y of
0,..,
C.
f:i. __ :.. 7 n. oon Drue Co .,c.o of the\
oc . l . 1910 .
Pu..rocho.aocl
DlU"ill[;
:~i a n · "8 , ~b. •
0
Doo . 1018.
Gal u Ptn . 1 0 Oz .
6 Go.l . Ol3to • OQ Oza .
~ Gn.1 G
Toto.I .
ts . 10 Ozo .
'
I
Uo od du.rinc nont'l oc . 1918 .
4: (!-o.1 5 Ptn .
On r:a.nd J o. • l . 1 919 .
4 Gc.1 . 1
e
l
l OzG.
Pto . 4 Ozo •
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •, • • • • • • • • • • • • • • • • • • • • • • •
I hero by certify t hut t
10
~
•••••••••• 1
~.bovo invo:cr~o "Y o·~ l,lcoh ol is '-• tr· c u. c.'. c.ccuro.to
o to. tor.1ont o·,., nll rocoipt.o , <liEJburoono 1to am _q uunt:t tJ
a bove montio·1od do.too .
....................... ...... .
..................-• ................................................................. .
~
.
!Jubsc r' ibod a.nd rmorn to before oo ·
do.y of January 1 919 .
t ho city of ha1" ~-· con
.......
urc ,
t h io second
:t. ~
/;-- /J J 'I
.........•.....•.
,¥
('l
~.
I
(IJoto.r>y
u b lic)
lb comm1ss1o ax:i,tres J u Jv 2nd, 1921
)
\,
.
,
••••••••••••••••••• ••••••••••••••••••• ••••••••••••••••••• •••••••••.•••• •·••.••••••\,,#•, ••
I
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�Harrisonb urg . Vo. .
February . l . 1919 .
To th0 Clorl~ of t c Circuit Court of tho Cit
Tho follo u in
of ·no.rrinonb urg , Va .,
i n a n inventory of ,.lcohol of vlilliamoon Drue Co ., o.s of t he
dates hereinaf t e r enumcr~te d .
4 Gal . 1
On Hand Janua.1--y l . 1 91 9 .
4
1 0 Gal . 0 Pts . 0
. uro ch.a.sed )uring J nuary 1919 .
za
Oza
14 Ga.ls . I Pts . 4 Oza
'1.' otal .
u... ed
to .
Dur ng t l o non't h of Jan . 1 91 9 .
On !!and
o bruury 1 . 1 91 9 .
5 G<;.1..1 . l
tp . 120 zs.
8 GLl . 7
ts .
8 Ozs .
........ ...•.....•.. •.•...... .•....... •......•. .......... .......... .......... ..•.
~
I horoby certi fy th.at tho
bovo i nventory of
lcoh ol is a true und
a ccura te stutcrnont of al l rocoipto , dioburoon ento and quantity of Alc ohol, on hand
at t ho o.bovc r.icntioncd dLtos .
e e •• e • • e e • • • • a e • e a e e e e • • • • e e • e • e • • e e e • • e e • e • • e e e • e
e
e e e • e • • • • • • • • • • • • • • • • ti • • • • e e e e
I
S.l!'.ATI: OF VI RGT'H A.
City of
rri s onburg . To- wit .
Subscribe d and o Jorn to before no in t he City ot ,. . rrii s onburg , thi s fi rs t
day of •cbruary 1 919 .
··t,,··
••••••••• ••••••••• ••••••••• •••••••• • ••••••••• ••••••••• ••••••••• ••••••••• ••••••••• •••
�1Pri~tPr i ~Tax
ci_•rk
1
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.
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=
$ -Tota/ $ _
1hiitted pr.,-,
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-
-- -
nam County, Va,
Clark
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Circa i t Court o_ t .c Ci ty o:'
cf th
The fol lo ,in--: i.• an i '"l.,T,m tor'y o::
cat s
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8 G.. 1 . 7 Pts . 8
0:1 Hn..::.1d
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its . 0 Ozs .
0 G::-.::'. •
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�Harrison burg . Virginia .
April . 1 . 1919 .
To the Clerk of the Circuit Court of t.J:1e Ctty of Harri sonburg , v a .
The followin g is an inventor y of .t1.lcohol of Willimas on Drug Co , as of the
date s hereina fter enume r ated .
0 Gal . 5vPts . 8 Ozs .
On Hand March 1 . 1919 .
Purschas ed during March 19 . 10 Gal . 0 Pts . 0 Ozs .
10 Galo 5 Pts . 8 Ozs .
Total .
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On Hand April 1 . 1919 .
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I hereby ce rti fy that the a bove inven t ory of Alcohol i s a true and
accurate s t ~t e ment of a ll receipts , di sburse ments and quantity of Alcohol , an
hand at the above menti oned dates .
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STATE OF VIRGI NI A.
City of Harr i sonburg , To - wit .
Subscri bed and sworn to before me in the city of Harriosn burg , this firs t
day of April 1919 .
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�Harr1sonbu1!g Va .
July . 1 .1919 .
To the Cl erk of the Circ ui t Court of t he City of Ha rri conburg, a .,
The follow int is an i nventory of Alcohol of Wi ltamson Drug Co ., as of t he
dates here i nafter enumerated .
Purschased during Mon th Jrme 1919 0
5 Gal . 2 Pts . 4 oz s .
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Total .
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On Hand Jrme 1 1919 .
5 Ga l , 2 Pts . 4 Ozs .
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10 Gal . 0 Pts . 0 Ozs .
Balance on hand July 1 1919 .
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I hereby certify that the above inventory of Alcohol is a true and accurate
statement of all rece ipts, disbursements and quantity of .:-_lcohol , on hand at the
above mentioned dates .
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STATE OF VIRGINIA.
City of Harrisonburg . Va. To-·w1 t . ,
Subscribed and sworn to before me in the _City of Harrisonburg , this first day of
July 1919 .
• mm·ssion e xp1r a S•i,t
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?O, 1920
( otary Publi c)
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�llar r i sonburg . va .
Aug.1.1 91 9 .
To the Clerk of t he Ci r cuit Court of the City of Harr i sonbur g . Va.
The fqllow i ng i s an inventor y of Alcohol of Williamso n Drug Co ,. as of the
dates here i nafte r enumera ted .
10 Gal . 0 Pts . 0 Oz .
On Hand July 1 . 1919 .
Purschas ed duri ng the month July 1919 .
O Gal . O Pts . O Ozs .
10 Gal . 0 Pts . 0 Oz .
Total .
Used during month July 1919 .
6 Ga l. 4 Pts . 0 Oz .
On Hand Aug . 1 . 1919 .
3 Gal . 4 Pts . 0 Oz .
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I hereby ce r t i fy that the above inventor y of Alcohol is a true and accurate
stateme nt of all receipts , di sbursem ents , and quantity of Alcohol on hand at tge
above mentione d dates.
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~TAT.m OF VIRGINIA .
City of Harrison burg cVa . To - wit .,
Subscrib ed and sworn to before me i n the city of Harris onburg , this first day of
August 1919 .
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Rbckin~ham Cou,ity, Va,
AUG l-1919
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�Harr i sonburg . Va .
October .l . 1919 .
To the clerk of the Circui t Court of tho city of Harri s onburg . Va .,
The following is a n inventory of \.lcohol of V/illiamson Drug Co ., os of the.
da tes here i nafter em.merate d .
On Hand Sept . 1 .
3 Gal . 1 Pt . 4 Ozs .
Purschased during September . 1919 lOGal. O Pt . 0 Ozs .
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used duri ng the month of Sept .
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I hereby certify that the above inventory of Alcohol is a true a nd accurate
sta tement of a ll receipts , disbursem ents , and quantity of Alcohol on hand a t t h e
above mentioned da t e s .
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o TATE OF VIRGINIA .
City of Harrisonbu rg . To-wit .
Subscrive d and sworn to before me in the city of Harrisonb urg , phis first da y of
I
October 1919 .
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(Notary Public)
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9 •1tt . 2 0, 92
�Filed in:the Clerk's Office
Rockingham Cou111ty, Va;
OtT 1- 1919
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harri sonburg . Virgini . •
Jovembe . 1. 919 .
clerk of the Ci rcuit 001.n.. t of the City of .tiarri sonbu g . V •
The fol
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inventory of Alcohol of !i lliamson Drug Co ., as of t2: e
dates hereina fter enumera ted .
On Han • October . 1 . 1919
8
Pu.rs cha sed During Oct . 1919.
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Tota l .
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On Hc.nd Jove b e r .
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Pts • Ozs .
6 Gal. 3 Pts • 0 Ozs .
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. 1919 •
2 Gal • 2 Pts • 0 Ozs .
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I he re y cer tify tha t the a ove i nvent or y of Alco 1ol i s a true and
st t ement of al l receipts , dis ur sements , and
above me n tioned
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Fe r u ry 2 .1 920 .
t10 c i t y of I rri8onbur 0
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Jl. :. cohol o f 1il illi ar.1son Dr11,3 Co , a s of
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me ntiohe d da t e s .
t 1e a b ove
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f ' lcoh ol on hand at
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S TJl. TE OF VIR I IT L '. •
City of Harr i s onbur i:; , To - Hi t .,
Sub s cr i be d a nd s vorn t o bef ore
day o f
e b r uary 1 920 .
r.:ic
i n the c it, o f Ear ri s onbur r, t h i s s econ d _
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"My Co
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fe n e lfpirea Sept; 20, 19
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Nii\R -1 \9'Z0
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�Ho.rr i on burg . Virg lnis.
May . 1 . 1920 .
To the clerk of the Circ uit Cour t of the City of Ha
rri sonb urg , Virg inia ,
The fo l lowin g i s an inven t9r y of I lcoh ol of Vl i ll i amso
n Drug Co _, as of
the da tes here ina ft e r en~m erate d.
On hand Apri l 1 1920 .
3 Ga l . 2 Pts • 0 Ozs .
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.Tota l .
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Us ed dur i n g the Mont h of
On Hand May 1
pril 1920 .
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. 1920 .
8 Gal. 5 Pts • 13 Dzs .
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• • • • • • • • • • • • • • • • • • • •• • • • • •• •
I h e reby cert ify that the abov e i nven tory of Alco
hol i s a true and accu rate
sta t emen t of al l r e ceip ts, disbu rs eme nts a nd quan ti
ty of Alco ol on h an d a t th
abov e ment i one d date s .
STATE OF VI RGI NIA.
City of Harr i sonb urg , To - wit .,
Subs cribe d and swor n to befo re me i n the city
of Harr i s o burg , t;[
·· s Z
fi r st da y
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, J . ;y ,1
o[! May 1920 .
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(Nota ry
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��Harr is nburg . Va .
Jun .. l . 19ijO .
To the Clerk s of the Circ uit Cou rt !bf the City
of
!~ rri s nbur g , Va .,
Tho fol owi :1g i s an i nvon tory of Alco hol of Vlil l
i ::tm"" on Drue Co ., e.s o
tho d a t es h ere i n a f t e r onum orato d .
On Ha d Ua • 1 . 1 9 2 0 .
Purs clr se d durin e t he r:1on th Ta
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0 Ga l. 0 Pts • 00 0zs .
8 Ga l . 5 Pts • 13 0zs .
6 Ga l . 5 Pts • 1 3 0 zs 0
t11.o mon t h h , - .1 92 0 .
On h and Juno . 1 . 1 920 1i
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Ci t y of Harr i s onbu ~fi , o - TT i t .
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t i ::- fi r st dD y
of Jun~ . 1920
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Augus t l .1 920 .
To the Cl erk of the Circu it Court of the City of Harr i s onbur
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dates here inaf t er enumer ated .
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y 1920 . None .
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• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
I h er- b y certif y that the a bove i nvento ry of A J cohol is a true
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TATE OF VI RGI I A .
City of Harri s nburg , To - n it
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Novemb er . 1 . 1920 .
To the Cl erk of the Circui t Court of the City of 11arr i s on burg , Va .,
The Follow ing is an invento ry of Alcoho l of \7illia ms on Drug Co,as
of the
dates herein after emunerate d .
On Ha nd Oct . 1 . 1920 .
l Gal • 1 Pt . 0 Ozs.
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10 Go.l . 0 Pts . 0 Ozs .
Total .
11 Gal. 1 Pt . 0 Ozs .
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I hereby certify that tho above invento ry o Alc ohol is a trute and a ccura te
statem ent of all receip ts , disburs ements , and quanti ty of Alcoho l on hand
at the a bove mention ed date s .
Dy •
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STATE OF VIRGIl!I •
City of ttar r"ls onburg , 'ro- wi t
Subscr ibed and sworn to before me in the city of Harriso nburg , this first
day of Nove mber 1920 .
Lr'7L ✓
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�Harr is onbu rg, Va .
March .1. 1921 .
To the Clerk of The .Circ u it Cour t of the City of
Harr isonb Ul"g, Va.
The follo wing is a n i n vento ry of J,lcoh ol of the
V!illi amson Drug Co .,
as of the dates here inaf t er enurJ erate d .
On Hand Febr uary 1 1 921 .
Pursc hased d uri n.g Fe b ru· ry 1921 .
Tota l .
8 Gal . 6 Pts • 0 Ozs .
None .
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us ed d uring Febru ary 1 9 21 ••
5 Gal . 6 Pts . 0 Ozs .
On hand March 1 1921 .
0 ••••••
3 Gal . 0 Pts . 0 Ozs .
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I h e reby certi fy tha t the above i n vent ory of 1~1co
hol is a tnue and accu rate
sta te me nt of all rece ipts d is burse ment s , a n d quan
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st the above me nti on e d date s .
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OG VI RG I NLi. .
City of Har r isonb urg , To - wit .,
Subs cribe d and swo rn t o befo re me i n t he City of
Harri n onbu rg , this
firs t day of March 1921 .
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Ci ty c f Harr i sonbur , 'l'o - v,i t •
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ffl#I/; Sec ond day of l\1a y 19 21 .
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�Harri sonbu rg , Va .
1
June , 1 . 1921 .
To the clerk of t he Circu i t Court of the Ci ty of Harris onbu
rg , Va ,
The follo winf is an i nvent ory of lcoho l of t he Vi illiam son
Drtil.g Co,
as of the da tes herei nafte r emun erated .
On Hand VJay 1 1 921 .
P Ul"S C a.hs e d
durin g May 1921 .
Total .
Used durin g May 1921 0
On Hand J une l 1921 .
1 Gal . 7 Pts . 8 Ozs .
5 Gal . 0 Pt s . 0 Ozs .
6 Gal . 7 Pts . 8 Oz s .
2 Gal . 7 Pts . 8 Ozs .
4 1J Gal . 0 Pts . 0 Ozs .
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I hereb y certi fy t hat t bh above inven tory of Alcoh ol i s a
t r ue# and acc ur a t e
statem ent of all r e ceipt s , di s burse raents , a nd quan tity of
Alcoh ol , on
h a nd a t the above menti oned dates .
S T..1:1.'1
OF VI RGI NI A.
City of Harri sonbu rg , 'i'o - wit .,
Subsc ribed a nd s worn to befor e me in the City of Harri sonbu
rg , thi s
fi r s t day of June 1921 .
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Nota ry Publ ic .
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�Harr•isonburg , Virginia .
July
T:> t he Clerl{ 'of the
1 . 1921.
incui t Court of tho Cit~r of Harrisonburg , Va . ,
e folJ:owinr; is an · i_nventory of Alcohol of the Filliamro n Drug Co ., as of
the dates here i nafter e murnerated
On Hand June 1 1921 .
1-'urschased durinr.; June 1921 .
4 Gale 0
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used duri ng June 1 921 .
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I hereby certify that the above inventor•y of Alcohol is a rue 8.nd ac
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statement of All receipts, disbursenents , and quan tiy of alcohol on hand at
the above mentioned date s .
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a..1'11.o. TE OF VIRGINL1 .
City of naririsonburg , 'ro-vrit .,
Subscribe d and sworn to before me in the City og Harri sonburg , this
first day of J
y 1921 ~
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�Har r i sonbur g; Va .
tsept . 1 . 1921 .
To the Clerk of The Ctircui t Court of the Ci ty Of Harriso nburg, Va .
The follow ing is an invento ry of Alcoho l , of the Williamson Drug Co,as
of the dates herein after enumer ated .
7 Gal . 5 Pts . 4 Ozs .
Ha nd Aug 1 1921 .
Pursch ased during Aug 192. •
Total .
Used duri ng the Month Aug . 1921 .
On Hand Septem ber 1 1 921 .
On
0
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7 Gal . 5 Pts . 4 Oza .
2 Gal . 5 Pt s . 4 Ozs .
5 Gal . 0 Pts • 0 Ozs .
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I hereby certify that the above invent ory of Alcoho l is a true and accUl'a te
state ment of all receip ts , disburs eme nts , and quantit y of Alcoho l on hand
at the aboye mention ed dates ,
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0 TATE OF
VIRGINIA .
City of Harri sonburg , To-wit .,
Subsc rived and sworn t o befor e me in the city of Harriso nburg , thi s f irst
day of September 1921 0
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the cit y of arr i son bur g, Va .,
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Bou ght in Marc h 1923 .
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�Harrisonburg , Va .
Nov. l . 1921 .
To the Cl erk of the Circuit Court of the City of Harrisonburgy Va .
The following i s an inventory of Alcohol , of the ~ i lliamson Drug Co .,
as of the da tes hereinafter enumerated .
2 Gal. 1 Pts . 8 Oza .
10 Gal . 0 Pts . 0 oz.s .
12 . Gal • 1 Pts. 8 Ozs .
2 . Gal. 0 Pts . 0 Oz s.
1 0 . Gal . l Pts . 0 Oz s •
hand Oct . 1 . 1921 .
Bought During Oct . 1921 .
On
Total .
used during Oct . 1 9?1 •
On hand Nov . 1 1 921 .
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I he r eby cert i f y t ha t the a bove i nventory is a true and ac curat e
s a t ement , of all r e ce ipts , di sburseme nts and quantity of Alcohol on hand
a t the a bove mentioned da t e s .
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STATE OF VIRGINI A.
City of Harris onburg , To- wit. ,
~ubsc ri bed and sworn to before me i n the city of Harrisonburg ,th1s fir s t
day
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Nove mbe r 1 921 .
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flied in th Clerk's Office
Rockingham County, Va.
NOV DJ 1 21
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�Harrisonburg, Va .
February 1.1922 .
To the Clerk of the Circuit Court cf the City of Harrioonburg,va .,
The following is an i ventory of All o ol of the vii lliamson Drug Co . , as
of the dates hereinafter emunerated .
On hand Janl 1 922 0
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On h and February 1 1922 .
0
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of a 1 rece ipt ,
isbur sements , and quantity of Alcohol on hand at the above
mentioned dates.
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�May 1.192 2 •
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,
To the clerk of the Circu it Court of t he City of Harri ro nburg
Drug
The follow i ng i s an inve ntory os Alcoh ol of the Willi a mson
o. ,
as of the dates herei nafte r enume r ate d
5 Ga l . 5 Pt s .
o Ozs .
Tota l .
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5 Gal . 5 r t s .
oz s .
u sed duri ng April 1922 .
2 Gal . 0
On Hand April 1 192
Bough t in pril 1922 .
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ay 1 1922 .
hand
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I here by cer tify t hat the above i nvent ory i s a true and acc
Alc ohol on
s t ateme nt of a l l r eceip ts , dis burse ments a nd quant ity of
hand a t the a b ove ment i oned dates .
.,.
• • • •••• •• •••• •••• • • • •• • ••• •• •• • •• •
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0T TE OF VIRG I NI A.
City of Harri s onbur g , To -wit .
0ubsc r iped a nd s worn to b efore me i n the city of
arris onbur g~ thi s
f i rst day of Ma y . 1922.
• • • • • • • • • • • • • •• • • • •• • • • • • • •
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�Harri sonbu rg , Va .
Septe mber . 1 . 1922 .
To the Clerk of the Circu ·t Court of the
ity of Harris onbu rg , Va .
The follow ing is a n inven tory of the Willi amso n Drug Co , as
of the
dates here i naf te r enum erated .
On hand Aug . 1.192 2 .
Boug ht in Augu st 1922 .
7 Ga. 1 Pt . 10 Ozs .
None ..
•rotal .
used durin g Augu st .1 9220
7 Gal 1
Pt . 10 Oz s .
2 Gal 5 Pt. 0 Ozs .
4 Gal 3 Pt . a Ozs.
On Hand Sept .l .1922 .
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I
I hereb y certi fy that the above inve ntory is a true and accur
ate stateme nt
of All recei pts , disbu rseme nts , and quan tity of Alcoh ol on hand
at thei
above emnti oned dates .
. . .. . . .
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• • • • • • • • • • e • a • ~ • • • • ~ •
STATE OF VIRG NIA .
City of Harr i sonbu rg , To-w it .
s bscri bed and sworn to before me in the city of Harri sonbu rg, t
is f rst
da o Septe mber 1922 .
.. /{.':!:~
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V
day of Octo er
Cit
of llal'ri so bill ;_; , tl1iu f i rs t
922 .
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�Novem ber 1 1922 .
To the cl erk of the Circu it Cour t of the City of
a r ri sonbur g , Va .,
'Ihe fo ll owing i s an i nve notry of t_e Willia ms on Drug Co ., as of t e
dates here i nafte r enume ra ted .
On Hand Oc tobe r 1 1922 .
Bpugh t in Octobe r . 1922 .
To t a l .
Used during Octobe r 1922 .
On rand Novembe r l 1922 .
Ga l . 7 Pts . 0 Ozs .
Ga l . 0 Pt s . 0 Ozs .
Gal . 7 Pts . 0 Oz s .
Gal • . Pt s . ll Ozs .
Ga l . 1 t s . 5 Oz s .
1
10
11
1
10
I hereby certi fy that t he above i nvento ry i s a true o and accura te
statem en t of a ll rece ipts , di sbursements , and qua nti t y of Alcoh ol
on
hand a t t he above men tioned da tes .
• • • • • • • • • • • • • • • • • • • a • • • • • • • • • • • • • • •
• • • • •
By • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
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STA'm OB' VIRGI NI1-1. .
Cit y of Har r i s onburg , To- 't it .
Subs c r ibed and sworn to be fo r e e me i n t he ci ty of Harri ro nburg , thi
s
fir s t day of Novemb e r 1922 .
•
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10,192
FHPd In th Cle ,
Rnr-~lnflham C unt
iQV .. J 19?,
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�D cembor 1 1922 .
o t _e c l er .. of the ci 'Cui t court of the ci ty f I- a rr i s on urc ; a . ,
follo •:ing · E an ir~vcmtor r o t .
,illiQ mson Drug Co . , as o t e
·na ter c umerated .
date s he
On hand ovember 1 1 922 .
Bought in lo rember 1922 .
Total .
used durin Nov mbe:c 1922 .
!Dn a nd Decem r 1 1922 .
10 Ga.1 . 1 Pts .
No •
0 a l -. 1 Pts .
2 Ga
2 Pts .
7 Gal . 6 Pts .
5 Ozs .
$ Ozs .
2 Ozs .
Al
I hereby certify t h~t t e a bove inventor
140zs .
i s a true and accurate
sta te ment of a ll r ceipts disburscme t s , ad qua tity of Alco ol
o
nd at the above mcnt oncd da tes .
,
9 • • • • • • • • • • • • • • • • • • • • • • • • • • •
y • •• • •• ., • • •••• • ••. •. • • ••• ,, . . • • • •
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IRGI NI ~.
Cit
O Harr i sonburg , T- it .
Subscri bed and svrn rn t o be ore me i n the Cit, of
fi r t daj</ of
11
arris onburg , t h i s
ecember 1922 .
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�Fe br uary. 1.1923.
To the Cl e rk of the Ci r cuit Co ur t of the City of Harrisonburg , Va .,
The follo wing i s a n invenoory of t he Willia ms on Drug Co., as of the
da t es here ina fte r enumer a t ed .
On Hand Jan 1 1923 .
Bought i n January 1923 •
Tota l.
use d dur i ng January 1923 .
On Hand ~ # February 1 1923 .
5 Gal. 4 Pts. 4 Ozs .
None.
5 Gal. 4 l' ts. 4 Oz . s
2 Ga l. 4 Pts . 2 Oz s .
3 Ga l. 0 Pts. 0 ozs.
•• • •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
I He reby certify tha t the a bove inven t ory i s a true and accurate
statement of all rec e ipts , di s burse ments, a nd quantity of Alcohol
on h and a t the a bove mentioned da t e s.
By• • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
•••••••••••• • •••••••••••••••••••••••••• • ••••• • •••••••••••••••••••••••••••••••
STATE
OF VIRGINIA .
City OfHarri ro nburg, To-wi t .
Subs c r ibed a nd sw orn to before me i n t he City of Ha r r iosnbur g, this
first da y of February 1923 .
••(?._ .';(.
4 ...................... .
•••••• Notary Publ ic •••••••
• • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • •
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�To the Cler
of the Circ uit Cour t of the city of
f he follo wing i o an i nven tory of the '.ill ia nson
here i naft er e num erate d .
,ar ch 1 1 923 .
arri~ onbu rg, Va .,
rug Co ., as of the date s
On and Fe br uv.r 1 1923 .
3 Gal . 0 Pts . 0 Ozs .
Boug ht i n Febr uar~ 1923 .
10 Gal .. 0 Pts . 0 ozs .
Tota l .i
1 3 Gal. 0 Pts . 0 Ozs .
u sed i n Febr uary .
2 Gal . 1 Pts . 14 Ozs .
On and Marc h 1 1 923 .
1 0 Gal . 6 Pts . 2 Ozs .
•• •• ••• • •• •• • • • • • • • • • •• • •• • • • • • • • • • • • •• • • • • • • • ••• • • • • • • • •
• •• • •• • • •• •• • •• • • • •• ••
....
I here y cert ify that the abov e i nven tory is a
true and. accu ra t e s tatem ent
of a ll rece ipts , dis u r s emen ts , and quan tity of
Alc ohpl on hand at the
abov e men tione d date s .
•••••• ••• • • • •• • • •• • • •• ••• •• • ••• ••
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I cG I'iIA .
Ci
of
riso burg , To - wi t .,
0ubs cri bed and STiorn to befo re me i n the City
of ·arr~ s onbu rg , this
f i rst day of March 1 923 .
••••••••••••••••• •• •••• ••• • ••••
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�May 1 1923 .
To the Cle r k of The Circu i t Court of t he Ci ty of Harr isonburg , Va . ,
The f ol l ov,ing i s an i nvent ory o f t he Wi ll i ams on Drug Co . , as of the
date s h ere ina fter enunera.ted.
On hand Apr i l 2: 1923 .
Bou ght i n April 1923 .
J.rota l .
us e d in April .1 9 23 .
On Hand May 1 l 923 .
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o~ all rec eipts , d is bursement and quantity of Algohol on hand a t t he above
me ntioned dates ,.
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By • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
...................................................................... ...............
0TATE OF VIRGINIA .
City of Harri sonburg , To - vri t .,
~ubscribed a nd sworn t o before me in tr& city of Harrisonbur g , this
f irst day of Ma y 1923 0
f!r,~
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My 0omm issfon expires Jun e 1\).- \"26
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To the
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of the Wi lli2.. rnson Drug Co , , c.s of the datJ s
here naft er enum erate d .
and Iviay 1 1923 .
ough t in May 1923
On
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2 Ga l
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3 Gal $ 7 rts ,, 0 Ozs .
To tal.
used i n ay 1 2
On H nd June
923 .
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state men t of all rece i pts , disb urse men ts and
anti ty of Al coho l on hand a t
the above ment i oned a a~e s .
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�Harrisonburg; Va.
JuAr.
1 1~3.
'l'o :the Clerk or the Circuit Court of the City of Harrisonburg, Va.,
the following is an inventory of the Williamson Drug Co.,as of the dates
hereinafter enumerated.
3 Gal. 7 Pts. 0 Ozs.
On Hand June 11923.
Bought in June 1923.
used in June 1923.
On Hand July 1 1923 •
None ••••••••••••••••
1 Gal. 5 Pts.12 Oza.
2 Gal. 1 Pte. 4 Oza •
•••••••••••••••••••••••••••••••••••• •••••••••••••••••••••••••••••••••••• ••••••
I hereby certif"y that the a bove l nlJentory 1s a true and accurate statement
of all receip t s , dusb'IU'sements and quan t i ty of Alcohol on gand at the
above men t ioned dates.
.... ............. .
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····································· ·········~··············~·········· ······
state ot Vir ginia .
City og Harrisonburg , To - wi t.,
Subecribed and sworn t.o before me in the City of Harri sonburg , this
second day ot Jul y l g23 .
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�Ha rri s onburg , Va .
Augus t l 1923 .
g, Va.,
To the Cl erk of the Circui t Court of the Ci ty of Ha rri sonbur dates
he
t
of
as
.,
Co
Drug
son
the follow ing i s an invento ry of the William
here i nafter enumer ated .
Hand July 1 1923 .
Bought in July 1923 .
Total .
used in July 1923 .
On Hand Augus t 1 1923 .
2
On
Gal . 1 Pts . 4 Oz s .
10 .
12 Dai . 1 Pts • 4 Ozs .
1 Gal . 5 Pts . 4 Ozs .
11 . Gal . 4 Pts . 0 Oz a •
....................,................................. ............ ........... .
I hereby certify that the above invent ory 1 s a true a nd accura te
statem ent or all rece ipts , disburs e ments a nd quanti ty of Alc ohol on
hand at the above mentio ned da tes .
,,
••••••• ••••
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STATE OF VIRGI NI A.
City of Harriso nburg, To-wit .,
Subscr ibed and sworn to be fore me in the city of Har r i s onburg , this
first day of Augus t 1923.
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flt.d kl ~ e Clerk's O
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�arr i s onbur g Va .
Sep t . 1 . 1 923 •
To the Cl erk of the Ci rcuit Court of t he city of Harr i s onburg , Va . ,
t he following i s a n i nventor y of the
ill i a.ms on Drug Co . , -a s of tpe
da t e s he reinafter enumerate d .
On and Au:,J 1 1 923 .
Boug t in Aug 1923 .
Tota l .
Us ed i n Augus t 1 923 .
On Hand September 1 1 923 .
•• ••• •• •
0 •••••• ••• •
•
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•
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1 0 Gal 4 Pts . 0 Ozs .
one .
10 Ga • 4 .P~s . 0 Ozs
2 Ga l . 5 .t'ts . 8 Oz s •
7 Ga l • 6 Pts . 8 Ozs .
••••••• • •• •• •• •
•
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•
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••• •
•
I here by certi f y that ~he above i nventory i s a tra e and a ccurate state me nt
of a ll rece i pts , d i s bursements a nd quantity of a lcohol on ha nd at the
above men ioned dates .
~
......../., ............ .......
.
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. ...... .......... ................. . . . . ... ...... .... . . ........... . ...... ...
~
Sta t e of ViEg · ni a .
Ci t y o~ Ha rri s onburg , To- vrit,
ubscribed and sw orn to before me in the c i ty of
firs t da y of Se t e mber 1923 .
a rri s nburg , th i s
/re; ~
• • ••• • • • •• • •• •• • • •• •• • •• • • • •
ota r y Publ i c .
f iieiJ lt: r· ·' '
Rucklugharn
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___ _ _ _ _Clerk
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· f4/#.ril/d} Oc to ,c r
t
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e k o f tLo C • re lit
e
t ho fo
rt of
o 11i ng i s an i n v -n tory o f t he
da t s
o Ci t :r
Drl r:, Co . , o..s
1 _ i&ms o·
v:r
c.rr i r3 on u rg , Va .,
f
ere i no.f er e umera ed .
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· · ••1' ••· ·· ····· ··· - · ·• •0••· "\' , ·1 the Clerk's OfflcP
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a.
Cl 1~1i'P
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Tovc mbe r 1 192 3 .
of t ho cit ,. of H2.r ri s onb ur , Va . ,
To t h e Cle r ~ of the Circ ui t Co ur t
as of t he
1
tl1.0 ·: i l li ans on Dru ~ Co .,
'.Ihe f oll ov1 i ng i s an i nv en tow r o f
d a t es h ere i n a ft e r e mum era t od .
5 Gal
Non e .
5 Ga l
1 Ga l
3 Ga l
On h and Oct 1 1 923 .
oug ht in Oct 192 3 .
Tota l .
u sed in Octo be r 1 9 23 .
On ~ a nd Nov e mbe r 1 1 9~~3 .
. 2 1: t s . 6 Oz s.
. 2 P t s . 6 Ozs .
. 5 .!:' t s . 1 2 Oz .
. 4 .!:' ts . 1 0 Oz .
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............. .. ........ ... ... .... .. .... ..... ... .... .. ... .... ...
ra t e
i n ven tor y i s a true and a ccu
I h e reb y ce r tif y tha t t he ab ove
ol on
i sbu rs eme nt a n d qu a nti ty of' Alc oh
s rt:'"l t e mon t of a ll r e cei p t s and d
and a t t h e a b ove men ti one d da t e s .
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::; T. , TE O , VI RGI NI .t-1. .
Cit r of La rri s onb urg , '.I'o- v1it .
in t h e city of rtar r i s on bur g , th i s
Subs cri bed a n d s1,1 orn to be for e me
f i rst da
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pf Novemb e r 1 9 23 .
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ft ed
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:.:,e ce !lbo r 1 19'::.3 .
To th e Cler_,;: of t10 Ci 1 cuit Court of the Cit~· of 1./:.rri son u r [:;, Va .
T:b.. 0
follouin;-; is ::m invon tory
o:
tho
illi ·:.ms on Dr,,.. Co . , as of tho
d-- toG hcrcin~1.ftor onumora tocl. ..
On I:::-.nd. !Tovenbor 1 19':3 .
:sou:::;h i n Foveq o r 1923 .
To t a l ,,
Used in L o v . 1 920 .
On Land Dec 1 1923 .
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sta te men t of a ll re ceipts , disburcoments and qu8.I1;tity of Llco
12.nd a t tho above mentioned dates .
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i::>Ubscri bed and sworn to be f ore mo i
third day of d ece • be r 1 923 .
the cit~7 of Farri sonburn- , this
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My Oommisslon expires :N'o-,. 1, 19.84
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he Clerk's f)fflce
ckl harn County: Va.
I\I o. fr
w~t.!t-~ ,e
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.
�Ha rrisonburg , Va .
F~bruary 1 1924 .
To the Clerk of llle Ci cui t Court of the Ci ty of Ha rr i sonburg, Va .
'Ihe Foll owi ng is a n inventory of the : illiamson Drug . , as of the da tes
here ina fte r e numera t e d .
None .
1 0 Gal . O
1 0 Gal . O
1 Gal . 6
8 Gal . l
On tt and Ja n . 1 . 1 924 .
Bought in January 1 924 .
Total .
used i n J an . 1924 .
On Hand February 1 192 4 .
Pts • 0 Ozs
Pt s . o ozs
Pt s .12 Ozs
Pt s . 4 Ozs
• • ••• • • •• •• • • •• ••• • • • •• •• • • •• • •• • •• •• •• • •• • • •• ••• • • • • • • • • • • • • • • • •• • •••
I hereby certi f y tha t the above i nventor y i s a t nue and a ccurate
state ment of all rece ipts , disburs ement and qua ntity of a l c oh ol on
hand at the above mentioned date s .
•••• ••••••• • • •••• ••• ••••••••
By • • • • •• • •• • •• • • • • • • • • • • • • • •
,,
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STATE
OF VIRGI NIA
Ci ty of n a rrisonburg , To- wi t
Subsc r ibed and sworn to before me i n the city of - arri s onburg, thi s
first day of February 1924 .
NOTARY
PUBLI C.
)(y Oommieelon expire11 1fo-,. 1, 192,
Filed In th
Rc
Ir
e Cle k's
f)ft
•• f'lam County,
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J,mrc 1 1 192 _ •
City of Farr ison urg , va .,
To the Cler k of the Ci :::,cu it Cou rt of thE.. illi.: .,ms on Drug Co . , as of
r.rhe Foll o·-,i ng i s an inve ntor y of the
u1 e sa tes here inaf ter enum erat ed
8 Gal . 1 Pt s . 4 Ozs .
On _ and 'eb . 1 1924 .,
1924 .
Bou r1 t i :'l Fe
sed n e • 1924 .
On Hond Iv arch 1 1924 .
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ea ove is a rue &~d accu r~te stat eme n t
ereb y cer tify that
y of 11.lc o ol on hand at
of all rece ipts , disb urse men ts and qua ntit
t e abov e men tion ed date s .
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ST1t TE OF VIRG I I
City of llarr ison b rg , To - wit
cit: ' of Har ris onb r , t i s
0ub scri bed and swo rn to be ore me in the
ay of Ma c_ 1924 .
fi l'S
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�Ha r r i s onburg , Va .
April 1 1924 ~
To the Clerlt of the Circui t Court of the Ci ty of Harris onburg , Va .
,
T.he f ol l owi ng i s an i nvento ry of the v.r illi a mson Drug Co ., as of the
dates hereinaf ter enume r ated .
~
Hand March 1 1924 .
Bou gh t in March 1 924 .
Tota l .
use d in March 1 924 .
On Hand April 1 1 924 .
On
5 Gal . 0 Pts . 8 Ozs .
None
5 Gal. 0 Pts • 8 ozs .
1 Gal• 5 Pts . 24 Oz •
3 Gal. 2 Pts . 0 ozs •
• • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
I hereby certi fy t hat the ab ove i s a true a nd accura t e sta t ement
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of all receip ts , disbur semen ts and quant ity of Alcoh ol on hand at
t he
ijbove mentio ned dates .
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By• • • • • • • • • • ••. • • • • • • • • • • • • • •
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SI.m.TE
OF
VIRGINIA
Ci ty of Ha r r i s:, nburg, To-wi t;
Subsc ribed and sworn to before ~e in the Ci t y of Harris onbur g , this
first day of April 1924 .
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our t of t . e Ci tv of
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Th e fol owi n 6 i s an i nventor
da t e s
I a r i s 01 bu g , •
eay 1 192 ·
a
· s n urg , a . ,
of t c i-- i lliamson D u 6 C . , s of t
3
ere i naf er en . e r a t od .
3 Ga • 2
t s .~ O
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None
G
pri l 1924 .,
~~ay 1 1 92 ,.
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ce t · y t ;,.. t t
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t c b.. cl ac:curate :::; tate · nt
ts ' dic b rnc r. ~ l s , ~ d quantit o Alc ohol on h and a t the
a ove me t i oned dates . -
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s firs
of
an
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to be f ore me
1924
•
tl e City 0
Tar · "onb
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�Harris onburg, Va.
June ls t. 1924 •
To the Clerk of the Circuti Court of the City of Harrisonbur g, Va.,
The following is an inventory of the Williamson Drug Co,as 6f the
dates hereinafter enumerated.
On Hand May 1 1924.
Bouglht in May 1924.
Total .
used in May 1924.
On Ha nd June l 1924.
1 Gal. 1 Pt. 4 Oza.
10 Gal. 0 Pt. 0 Ozs.
11 Gal. 1 l't. 4 Ozs.
2 Gal. 6 Pt. 9 ozs.
8 Gal. 2 :Pt.11 Ozs.
....................................................................
I hereby certify tha t the above i s a true and accurate stateme nt of
all receipts, disburs ements and quantity of Alcohol on hand a t the
above mentioned dates.
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, .
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... -...
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S TA T E
O F
j
V I R G I N I A.
City of Harris onburg, To-wit.,
.
Subscribed and sworn to before me i n the City of harrisonburg , Va.,
this second day of June 1924.
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�Harr ison burg , Va .
Aug ust 1 1 924 .
To the Cler k of the Ci rcui t Cou rt of t he lJity
The fol l ow ng i s 11 inve ntor , of the Wi l liam of Harr ison burg , a .,
son Drug Co , as of the
da s , here inaf ter enumerat ed .
0 hand July 1 1 924 .
Boug ht i n July 1924 .
6 lral .
None .
6 Gal .
2 Gal .
3 Gal .
Tota l ,.
used i n July 1924 .
On Han
Augu s t 1 1924 .
1 Pt . 2 ~ s.
1 Pt . 2 Ozs •
3 1't . 1 0 Oz.
5 Pt. 1 0 oz .
•••• •••• •• •• •••• •••• ••••
•••• •••• •••• •••• •••• •••• •••• •••• •••• •••• •
I here by cert i fy that the••••
abov i s a true and a ccur
ate state men t of
all rece ipts , disb m•se me
and quan tity of alco hol on h and at the
abov e ment i oned date s .
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City of Harr ison burg , To - wit .
:::>~~ ~'r i b e d and swor n to befo re me i n the City
of uarr i sonb urg , this
day pf Aug ust . 1 924.
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�Harrisonbur g, Va .
September l 1924.
To the Cle rk of the Circuit Com:'t of the ity of ...arrison b\jr I Va.,
'lhe following is an inventoi. .y of t he Williamson Drug o, as of the
dates he r e i nafter e nnmerated .
On Hand Aug . 1 1924 .
Bough t.
3 Gal . 5 .P ts. 10
oz s
None.
Total .
usect in Augu.st 1924 .
On Hand September 1 1926
3 Gal . 5 Pts. 10 Ozs
l a l . 5 l:'ts • 18 OZs
l Gal. • 7 Pts • 8 Ozs •
I hereby certify that th above is a true and ac curate statement of
al l re ceipt s , di bursements , an quantity of Alarohol on and at the
above mentioned dates .
····· ~··················· ··
...
By••••• ·• • • • • • • • • • • • • • • • • • • • • • •
S T.n TE OF VIRGI IA.
City of narris onburg , To - wit.
Subs cribed and sworn to bef ore me in the ci t y of Harrisonburg, t hio
second day of 0eptember 1924 .
Flied In the Clerk's ·,fl,:•
~ m Cgunty, V-,.
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�Harr i sonbu r g , Va .
Octob e r 1 1 924 .
-;: .
To the Cl e r k of the Circuit Cour t of the City of Har r i s onburg ,Va .,
The f ollovling i s an i n ve ntory of the Wil lia ms on Drug Co ., as of
th e d atss here ina ft r enu mera t edJ
On Ha nd S e p tembe r 1 1924 .
i;Bou gh t .
Total.
us ed in ;::;eptembe r 1 924 .
On Hand Oc tob er 1 1924.
.o
Ozs .
7 Pts . 8
ozs .
lGa l. 7 i:'ts
l OGal .
l l Gal .
lGal.
lOGal .
0 Pt s . O Oz s .
.a ozs
.!:'ts . o Ozs •
6 Pts
1
I hereb y c ertif y t hat the above i s a true and ac c ura te sta teme nt
of a l l receipts , disburs ement"' a n d quan ti ty of Al c ohol on h a nd
at t he a bove menti oned dates •
· ····· · ·•; ··•• y•• 1.; ·•..t. ···· · ··
By • • • • • • • . . . • • • • • • • • • • • • • • • •
iTATi OF VI RGIN I A
Ci ty of Harr i son bnr g , To - wit
Subscri bed a nd s worn t o before me i n the Ci ty of Ha r ri s on bu rg ,
th i s fi r st day of Octobe r 1 924 .
r
No:ber y Publ ic .
J1,ty ~ ,.Q.,,<L
Filed in th e Clerk's Offi
Ro k' ,,
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c ingu am CountyI Va,
OCT. l j i924
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Liquor Inventory
Description
An account of the resource
Series III of the Prohibition Records collection consists of records documenting the inventory, sale, and transport of alcohol for medicinal purposes in Rockingham County. This series contains printed inventory records of the alcohol on hand of licensed commercial businesses during prohibition. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Identifier
An unambiguous reference to the resource within a given context
Pro003
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/6">Prohibition Records: Affidavits for Ardent Spirits</a><br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Liquor Inventory of Businesses: 5
Description
An account of the resource
(P-Z) Printed and signed letters by a notary public reporting the on hand stock of alcohol of licensed commerical businesses.
Subject
The topic of the resource
liquor
inventory
commercial
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Date
A point or period of time associated with an event in the lifecycle of the resource
1918-1925
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (<a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a>)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-018
Format
The file format, physical medium, or dimensions of the resource
PDF
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
-
https://omeka.lib.jmu.edu/erp/files/original/c3bd5f1a5170a4edb5aa19a4b09f393f.pdf
5ff095a53fec0fc136a5963dfeb18a74
PDF Text
Text
DELIVE RY FORM 80
R&Vl91ED JUI.Y, 1917
ADAM S EXPR ESS COMP ANY
To-~. K.::l~ ~:::!.. --d::u .&:1~ L&~- !L
Shipper -1~.d:' .'-~Z:: .k.:.c~ ~~F:£: :.,_L.. 1:.,q.
P.O. Address
To Consignee
To Shippe r
(OVBB)
�·t/Z~
STATEOFV~
CO<JNTY O F ~
I,--....J~~:::'.L~-~~~::::::J6':::::~1...t.,::::::_~::::::::__, being duly sworn, depose and say that I am
the consignee of a certain shigment
ardent spirits, a~1ecified ~n other side of this form, this day
_,a, ~fh~ at
t=ts; i~
delivered to me by the Adams Express Company, frorrl/
~
I am not
a student or minor, and, if a female, I am the head of a family ; that
received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me
/-tt!.-,~
are to be used by me for
Sworn to Md ,ub~db
this
//J
/,,..
day
IB<omws,u...,~s-•••
0 ~11,A,ff?~
- .
•~•~
·
purposes.
~~,? 5
�DELIVERY FORM 60
REVISED JULY, 1917
ADAMS EXPRESS COMPANY
IAL LIQUOR RECORD
-\-,j~=~ ".!.-,,,b...J~ ~:JL~//_~t~.!::
a
191/- Affidavit
No._2__
P. 0. Address---,~- - - - - - - --
Consignee
To Consignee
I
To Shipper ______________ _
(OVER)
�I,--~~~-f/---t,,~~k: :'.'.:t__~Jl-~~~(.!d. ~1,44 _being
the consi
duly sworn, depose and say that I am
of a certain shigment of ardent spirits, as SP, ·fied on other side of this form, this day
delivered to me by the Adams Express Company, fro\9<~~=~::!..i~~ ~:.d::~~:_
a student or minor, and, if a female, I am the head of a family; that the ard
were brought into the State on my written order, and that I have not, wi in the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Vir.
ginia, approved March ~o. 1916, o r ~ ~ law~and:: the ardent spirits so received by me
are to be used by me for
g
, ~
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
Sworn to and subscribed before me,
this I / :?J day oJ/,p,u,
, 191
purposes.
�Delive ry Form BO
AdTaue ee to
Collecl
RECO RD OF NOTI CES
To Cons ignee _ _ _ _ _ _ _ __ _ _
_
To Shipp er
ittfAFFID AVIT FOR ARDIC NT 8P"IR ITS
FOR PICR8 ONAL ...U81 C,
(0'"8)
�--,..
.
STATE OF
COUNTY
.
,;
...
~.it
AFFIDAVIT FOR• fRDENT SPIRITS FOR PERSONAL USE.
Vrn~
->f-~
OF...._ruta:=-tr--"'::::--.___,,,,_....-"'_~_
I, ~
-·.
~
, being duly sworn, depose and say that I am
the ~
gne~,9f a certain shipment of ardent spiri1t; ;.;l.!~~c~fi:dA ~na:the:.t ~i~~m, this day
delivere,~in e by the Adams Express Company, f r ~ :.t/4.; ~ I am not a
student or minor, and, if a female, I am the head of a family; thatthearden tspiritssorec eivedbyme
were brought into the State on my written order, and that I have not, within t he thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 191(;, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said
·: ? : ~ o t b ~
n
Sworn to and subscribed before me,
thit2..lf--day of-+-""<lo'-C-...a:.-
~
·
'-Couigneo
�DEL I VERY FORM 60
ADAMS EXPRESS COMP ANY
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVEK}
�AFFIDA~IT FOR ARDENT SPIR ITS FOR PERSONAL USE
I,
the consignee of
...
, being duly sworn, depose and say'that I am
ertain shipment of ardent spirits, as ~ s i d e of this form, this day
deliver ed to me by the Adams Express Company, from _
~
~
at I am not a
student or minor, and, if a female, I am the head of a family; that the ard ~irits so received by me
wer e brought int~ the State on my wr'itten order, and that I have not, within the thirty days previous
hereto, received any ard~nt spirits of any kind whatsoever, f rom any person or from any place whatsoever, in excess of the quantity allowed by the provisions of t he Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirit will not be used in violation of law.
Consignee.
Sworn to and subscribed before me,
-f=?"'_J£_c:---=-=, 191~.
�Oelive ry Form 60
ADAl\'IS EXPRES S COMPA NY
RECORD OF" NOTICES
To Consignee _ _ __ __ _ _ _ _ __
To Shipper
AF"F"IDAVIT F"OR ARDENT SPIRITS F"OR PERSONAL USE ,
-
(OVIB)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
1,-----"-="----"'::C......:=--=-----+ '::....::::......_
the consignee of a certain shipment of ard t spirits
delivered to me by the Adams Express Company, (J:flf6:£~~:1.../4~~"4c~C..~ ~ltit I am not a
student or minor, and, if a female, I am the head of a family; that the a
tspiritssoreceivedbyme
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 191(;, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits will_;1~e used in violation of law.
·this..a;y of
~-
. ~cJ?o~-
Sworn to and subs~d before me,
r~.,/f._ , 191_,L-
.
~
~
�To Shipp er
AFFID AVIT FOR ARDIE NT SPIRIT S FOR
PERSO NAL USIE.
,
,;
\
(Offa)
.
........;~-_. .
..
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
.
,
·
.
STATEOF~V
CoUNTY OFt-t-......,-"-7..-=--L..=...;:;;....o.....,~-
~
•
being d~y iwom, depose
I,
the consignee of a certain shipment ·of ardent spirits,
delivered t.o me by the Adams Express Company,
student or minor, and, if a female, I am the head of a family; that the
were brought int.o the State on mywritten order, and that I have not, thin the thirty days previous
heret.o, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 191(;, or con_trary t.o law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
�Delive ry F orm 60
AD AM S EX PR ES S CO MP AN Y
Affid avit No,
RECO RD OF NOTI CES
To Cons ignee
•
To Ship per
AFFI DAVI T FOR ARDE NT SPIR
ITS FOR PERS ONAL USE,
-
'·
_.. ,.. _...~
(OYa l
-:ft(,,)
�AFFIDA VIT FOR ARl;>E NT SPIRIT S FOR PERSO
NAL USE.
COUNTY OF
1,
and say that I am
the consignee of a certain shipmen f ardent spirits,
this form, this day
delivered t.o me by the Adams Express Company, fp(j~l1:1_:..d,&J,,~c;).f.~
~~~~
~;
that I am not a
student or minor, and, if a female, I am the bead of a family; that the
entspir itssorec eivedby me
were brough t int.o the State on my written order, and that I have not,
within the thirty days previous
heret.o, received any ardent spirits of any kind whatsoever, from any
person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of
the General Assembly of Virginia,
approved March 10, 1911\, or contrar y t.o law, and that the ardent
spirits so received by me are for
my own use, at my own home, and that the said ard=t : : wiJlfot
be used in violation of law.
qi 4 , / / k ~
�AMS EXPR ESS COM PANY
.u ~
SPECIA L LIQUOR RECOR D
·dA~~~~~~~L__Date
\
191.,L Affidavit No.
.ORD OF NOTICE S
,'g'Consign ee
'
ToShlpp er
AFFIDAV IT FOR ARDENT SPIRlTS FOR PERSON AL USE,
~,e
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PEASO NAL USE.
C.0UNTY OF:-,: :f-:;,.:;:_L-!~~r~!::::-c.--- --
J, _ _ _~-,IJ'--= -_...c... __
__,;;;..__ _ _ __ _
being duly ·sworn, depose and say that I am
cified on othe side of ~ {orm, this_day
the consignee o a certain shipme nt of ardent spirits, as
delivered to me by the Adams Expres s Company, fro 1
~ t I am not a
studen t or minor, and, if a female, I am the head of a family;
thatthe arden
iritseo
receive dbyme
were brough t into the State on my written order, and that I
have not, within the thirty days previou s
hereto, received any ardent spirits of any kind whatsoever, from
any person or from any place whatso ever, in excess of the quantit y allowed by the provisions of the
Act of the General Assembly of Virginia,
approved March 10, 1916, or contrar y to law, and that the
ardent spirits eo received by me are for
my own use, at my .own home, and tbat tbe said ardent spirits
will not be used in violation of law.
·•
Sworn to and subscribed bt!forc,; me.
tbi~ da1 _0 , V - • 19
,
.•
. 4V
~~~~d<
,f
,
,
CouitrMe
�Deflvery Form 80
CIAL LIQUOR RECORD
1,tL~~~~~ ~2f...__oa te
U
-
,fl.;2.
19~ Affidavit . No.
Add
PUPilD
RECORD OF NOTICES
To Consignee
To Shipper
•
AFFIDAVIT FOR ARDENT 8191RITS F'OR 19ERSONAL USE.
(OffB)
Undercbarse
�AFFIDAVIT FOR AR l? ENT SPIRITS FOR PEPISONAL U S E .
"!!!hf:2
";,,';;.°'..
1.1~
, being ·duly sworn. depose and say that I am
the consignee of a certain shipment of ardent spirits,
delivered t.o me by the Adams Express Company, f~q,.L~:k::=~..aiu,..,.i:.::::::~~
student or minor, and, if a female, I am the bead ofa amily; thattheardent irit.ssoreceivedbyme
were brought into the State on mywritten order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 191£>, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ~en~irits will not be use!f in violation of law .
.rb ~ . .,
Sworn to and s u b s c ~ore me,
tbis.2.2da1 of
Jr,
. 191
�Dellvery Form 60
ADAMS EXPRESS COMPANY
Affidavit l'lo.
PRRPAID
To Shi pper _
AFFIDAVIT FOR ARDENT SPIRITS FO R ~,.ERSO t:IA_L
..
(Oil!lll.l
us;: .
�AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE.
STATE OF
CoUNTY
I
ot\...~!'. !::z~~~~ fP'.:.,Z." '7-,.,,.
I,--!u~....:,IIE::;.L......£:::::lii!....:~41:::::::!!!:::!:::::~:......... being duly sworn, depose and
say that I am
the consignee of a; rtain shipm
of a r d e n t ~ ~ side f • fo
delivered t.o me by the Adams Express Comp ,
_ _.,..,..._ _ ;
o
student or minor,-811d, if a female, I am the bead of a family; that the
tspiritsso receivedb yme
were brought int.o the State onmywri tten order, andthat I have not, within thethirtyd
aysprevio us
heret.o, received any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received
by me are for
my own use, at my own home, and that the said ardent sp" ·
•
used in violation of law•
0
........~.. ....-:;::tr,-:-·~,t .
tia r.& ..~
�AD AM S EX PR ES S CO M~ AM Y.
u ~-~,,._.
SPE CIAL LIQU OR REC ORD
Date
, _.. "
!.i_l
PRBP.&.lD
RECO RD OF" NOTI CES
To Cons ignee _ _ _ _ _ _ _ _ _ _
__
To Ship per
AFFI DAVI T FOR ARDE NT SPIR
ITS FOR PERS ONAL USE.
(O\'IB )
Add
Umlerc barse
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PEf lSO NAL
USE .
:~~
., .~--
and say that I am
this form, this day
.
delivered to me by the Ada ms Expr ess
Company, .a.ni ,-.a,. ~:u,.1 .a.,_. 1..u. i,q~..
..::~ ; that I am not a
stud ent or miner, and, if a female, I am
the head of.a family; that the
ntsp irits sore ceiv edby me
were brou ght into the Stat e on my writ
ten order, and that I have not, within
the thirt y days previous
here to, received any arde nt spiri ts of any
kind whatsoever, from any person or from
ever , in exce ss of the quan tity allowed
anyp lace wha tsoby the provisions of the Act of the Gene
ral Assembly of Virginia,
approved March 10, 191fi, or cont rary to
law, and that the arde nt spiri ts so recei
my own use, at my own home, and that
ved by me are for
the said arde nt ~ t s will not be used
in violation of law.
•.
I
rlL~ • t/unt
\.CuaalsDN
�--- ---------- ~---- ~~- ---- --- ---- --- --- --- -------,.
.
•.
ADAMS EX PRESS COMPANY
19~ Affidavi t No.
R ECORD. OF NO ~ . A
To Consign ee
~~
...)
• ~·.l,To Shipper
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON
AL USE .
(OVEII)
a:£
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATEOFV~
COUNTY OF-H------1---.-.=--+---'="
~
-
I,
, being duly sworn, depose and say that I a m
the consignee of a cer~ain shipment of ardent spirits, ~
citied on _o ther side of this form, this day
delivered t o me by the Adams Express Company, fro
~~
- ~/
hat I am not a
student or minor , and, if a female, I am t he head of a family; that the ardent spiri ts so received by me
w ere brought into t he Sta te on my written order, and tha t I have not, within the thirty days previous
hereto, received any arden t spirits of a ny k ind whatsoever, from any per son or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of t he General Assembly of Virg inia,
approved March 10, 1916, or con tr ary to la w, a nd tha t the ardent spirits so re ceived by me a re for
my own use, at my own home, and that the said ardent spirits will not be u sed in violation of law.
,M 7 / 2 ~ ~
"-
,
Consignee.
�Del lver i, For m 8 0
-
To -i,'t:: ::. .~~ ~~ :;=
..,
!:: ~~ ~.. .E ._~ ::: ::_-1
Sh ipp er ~ .J,.~::?:::!:::t:_
J~ ~ ~ ~=--~ ::,: :== r
Add
Underch arce
RE CO RD
OF NO TIC ES
To Co nsi gne
e _ _ __
_ _ _ _ _ _ _ __
_
To Sh ipp er
AF FID AV IT FO R AR
DE NT SP IRI T& FO
R PE RS ON AL US
E.
�AFFID AVIT FOR ARDE NT SPIR ITS FOR
PEfllS ONAL USE.
·: :. :: ,V •~
1. L _
·
, being. duly sworn, depose and say that I am
the consign4r3 of a certain shipm ent of ardent spirits
, as specified on other side of this form, this day
delivered to me by the Adam s Expre ss Company, from
C-- .--f~ ~
t I am not a
studen t or minor, and, if u female, I am the head ofafam
ily; thatth eaiden tspirit ssorec eivedb yme
were broug ht into the State on my writte n order, and
that I have not, within the thirty days previo us
hereto , received any ardent spirits of any kind whatsoever,
from any person or from any place whats oever, in excess of the quanti ty allowed by the provisions
of the Act of the General Assembly of Virginia,
approv ed March 10, 1911>, or contra ry to law, and that
the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent
spirits will not be ~d in violation of ~aw.
~
Sworn to and subscribed before me,
c, d evr.,L
fb;,/i~~or Adams ExPN nCom ~
41
a-is -
�~
Delivery Fe
~"' /
\
/
f
J{[?,g~
Received
Consign)
Kind of I
..,
w,,-~
To_
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;_.; y
~~
Shipp•
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- REC(
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,.,,.,I
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�&PU il.TS FOR P
AFF IDA (IIT FOR ARD ENT
STA TE OF
NAL USE .
V
-~~ in:'
CoQNTY o~~ dr:. ....J ~r/ G-H
.
r side of this form, this day
of arde nt sp iri ~f ted on othe
t
ship
ain
cert
a
of
e
igne
cons
t.be
""4 ~ t I am not a
Company,
delivered t.o me by the Adams Exp reu the head of a fami ly; tha tth~ irit sso rec eiv edb ym e
am
stud ent or minor, and, if a female, I
the thir ty days previous
ten order, and that I have not, within
writ
my
on
e
Stat
the
from any place whatsowere brou ght int.o
or
on
pers
any
any kind whatsoever, from
of
its
spir
nt
arde
any
ived
rece
to,
here
eral Assembly of Virginia,
by the provisions of the Act of the Gen received by me are for
ever, in exceBB of the quan tity allowed
so
spir"
nt
t.o law, and that the arde
approved' March 10, 1916, or cont rary
be 'Wl8d in violation of law.
~ts
the said ·
t.bat
and
'
ho"
own
my
my own use, at
~~~4a~
sL t.o ~ BUbscri.£i before me,
?~
Cj)
~ ; ~ ~•w9
• -~~
~
�Delivery F orm 80
ADAMS EXP..RESS COMPANY
Affidavit No.
RECORD Of' NOTICES
-To Consignee _ _ _ __
To Shipper
·,
.
Af'f'IDAVIT FOR ARDENT SPIRITS f'OR PERSONAL UBE.
(OffB)
60
~
�~-------
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
CoUNTY OF
1,--~~~~-'tfl::l!!:::::~4.r.:::za:::::..,
the consi~ee of a certain shipment of dent spiri
rm, th~"s
da
am n
• delivered t.o me by the Adams Express Company,
ttheardentspiritsso receivedb e
student or minor, and, if a female, I am the head of a family;
were brought int.o the State on mywritten order, and that I h e not., within the thirty days pr ious
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1911\, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said d t sp· · will not
in violati ·¢ law.
, s/:
J
,~_.,,p
to~•~-
Swom
. this-2::day of
m,,
, 191-7--
- - ~~
�ADAMS EXPRESS COMPANY
Affidavit No....;;CJ_CJ
_____
RECORD OF NOTICES
To Consignee
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE,
(0'\'IB)
�AFFI DAV IT FOR ARD ENT SPI RITS
FOR PEPI S ONA L USE.
I,
being duly ·swom , depose and say that 1 am
arden t spi~its, ~ i f i J I ~ other ~of this
form, this day
delivered to me by the Adam s Expre ss Company,
fro ~M ddd dJL ,/z, , that I am not
a
stude nt or minor, and, if a female, I am the head
ofafa mily; thatth earde ntspi ritsso recei vedb yme
were broug ht into the State on my writt en order
, and that I have not, within the thirty days previ
ous
hereto, received any arden t spirit s of any kind whats
oever, from any person or from any place whats
oever, in exces s of the quant ity allowed by the provi
sions of the Act of the General Assembly of Virgi
nia.
approved March 10, 1916, or contr ary to law, and
that the arden t spirit s so received by me are
for
my o\lVn use, at my own home , and that the said
arden t irits w· l not e
d · Yiolati n of law.
the consignee of a certai n shipme
�DeHver y Form 60
AD AM S EXP RES S ~CO MP AN Y
•~ ~=;! ~~~ ~19 1)_
-
Affida vit No, . % -
Way-
To----(,µ,:::.~~~ ~~~ 'S4-: .._.1::::;_~~-I
RECO RD OF NOTIC ES
To Consi gnee
•
A
To Shipp er
IDAVI T FOR ARDE NT SPIRI TS FOR
PERS ONAL USE.
(OVJB)
�AFFID AVIT FO R A RDEN T S P I RITS FO
R PERS ONAL US E.
I,
the consignee of a certain s pment
ardent spirits,
er side ,1 ~is form, this day
delivered t.o me by the Adam s Expre ss Company, fr·l:JIIJ~
::.£:L.:::U.C;,IIL..l:..L~~~U@!
a:::::a::.; that I am not a
studen t or minor, and, if a female, I am the head of a family
; thatth eard tspirit ssorec eivedb yme
were broug ht int.o the State on my writte n order, and that
I have not, within the thirty days previous
heret.o, received any ardent spirits of any kind whatsoever,
from any person or from any place whatsoever, in excess of the quanti ty allowed by the provisions of
the Act of the General Assembly of Virginia,
approved March 10, 191t;, or contra ry to law, and that
the ardent spir!ts o received by me are for
my own use, at my own home, and that the said arde
sp" • will not
sed ·n violation of law.
Sworn t.o and subscr ibed before me,
tlli~
da:, of
191L. _ '
~~,.,~Y, J.~
~
~
...
�Dellvery Form 60
Affidavit No.
RECORD OF NOTICES
To Consignee _ _ _ _ __ _ _ _ _ __
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE,
I
(OVIB)
7
"'j,,//
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
CoUNTY OF
l,---.!:t.~f:::'.;4._(t.J~~~&~~L--. being duly sworn, depose and say that I an1
the consigne
a r in shipme of ardent spirits, as
delivered to me by the Adams Express Company, fro,r¢U.~~SdlW~"C£~:Lt.f41that I am not a
student or minor, and, if a female, I am the head of a family; thatthearde spiritssorecelvedbyme
were brought into the State on my written order, and that I have not, withm the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the-provisions of the Act of the General Assembly of Virginia,
approved March 10, 191f\, or contrary to law, and that the ardent spirits so received by me are for
: ~: •m,•~-.ua~.,~-.-fii''~~
this/4-day
•
o~~~
·. t,v~
✓--.--
(,7
U>J,t,13.,..oa.•~
�Deliv ery Form 6 0
9"'-.,,_7__ __
Affid avit No ....
'1
COLL&CT
REC ORD OF NOT ICES
T•C onsi gne e _ __ _ _ _ _
__ _ __
To Ship per
AFF IDAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE ,
(<>Y a)
�ARDENT SPIRITS FOR P!ERSONA L USE.
STATE OF
COUNTY OF
I,--f,L U~~=.i ,._w.:i...:::: :!:::::::i~~- --
the consignee of a certain shipment of arde
delivered to me by the Adams Express Co
student or minor, and, if a female, I am the h d ofa
were brought int.o the State on mywritten order, an
at I have not, within the ir ty daysprevio us
heret.o, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
appl'Oved March 10, 191f\, or contrary to law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
.
·1 ~.
Swom t.o and su~~
this.%da y of
before me.
,f:.t-fc:::. , ~ ff
i
~
'
•
�Affidavit No.
!
RECORD OF NOTICE S
To Consignee _______________ _
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVER )
L/f
�--- - - ------ -·- ---AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, --+-.,_-="'---"<-~-=.:>..:a.:::,""'-44.. LL L - - --, being duly sworn, depose and say that I am
the consignee of a certain shipment f ardent spirits, as specified on oth si e of this form, this day
delivl;!red to me by the Adams Express Company, fr. ·
hat I am not a
!~ ~ &..~dent or minor, and, if a female, I am the head of a ii.mily; t'nat the ardent spirits so received by me
were brought into the State on my writt en order, a1)d that I have not, within the thirty days previous
h ereto, received any ardent spirits of any kind whatsoever, from an]' person or from any place whatsoever, in excess of the quantity aJJowed by the provisio'ns of the Act 6f ttie General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for
' my own use, atmy own home, and that the said
ent spirits will 110 be u
in violation of law.
Consignee.
Sworn to and subscribed before me,
thif'~day of
~ (k-:,191 _
�Delivery Form 80
ADAMS EXPRESS COMPAN Y
Affidavit No.
PREPAID
Shipper
RECORD OF NOTICES
To Shi ppe r _
To Consignee __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL U S E.
( OVER )
2._ l) I/
�AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE.
STATE OF
CoUNTY O....,:..,&.,< ;~-<,-:;Ji..,, c'-"!~s,rf,~
1,----,l,.J'= :!:::~:I..::~ :J...<:µ«£_ t_.¥,l.~~::! :::::=:::...L,
tbe consignee of a certain
ment of ardent epiri--..,,,._;-_delivered to me by the Adams Express Company, rnitn.ifL.J.LCIL,..~~llA!~l.4<:i:::a:~!ltll
¥t~ not a
student or minor, and, if a female, I am the head ofafamily ; thatthear dentspiri tssorecei
ved yme
were brought into the Stat.e on my writt.en order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind.whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act o'f the General Assembly
of Virginia,
approved March 10, 19lf>, or contrary to law, and that the ardent spirits ao received by
me are for
my own use, at my own home, and that the said
spirits will n t be used in violation of law.
�Receive
Advancea to
Collecs
RECORD OF NOTICES
To Consignee
To Shipper
.
AFFIDA'41Y. F.Oa ARDENT SfllRlTS FOR flERSONAL. USE.
(~
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PE A SON AL
US E.
CoUNTY OFr iJ~•
.
n~ ~,9 ---, ,-
l,....,.,LL4,)(.t'.~ ~2 '.!~ ~~;::5::::::::::_--.
that I am
ent of arde nt spirits,
delivered to nic by the Adams Exp
ress Company, fro~ :LJ ~.k:1.4-A~=::
::;J..::l..-"J!UlJa'I. I am not a
stud ent-or minor, and, if a female,
I am the head ofaf ami ly; that thea rde
_.pir itss o~e ived bym e
were brou ght into the Stat.e on myw
ritte n order, and that I have not, with
in the t hirty days prev ious
here to, rece ived ~~ arde nt spir its of
any kind whatsoever, from any pers
on or from any place wha tsoever , in exce ss of the quan tity allowed
by the prov isions of the Act of the Gen
eral
appr oved March 10, 1911>, or cont rary
to law, and that the ardent spiri ts so Assembly of Virg inia,
my own use, at my own home, and
received by me are for
that the said arde nt spir" will not
be
d in · ·
ion of law.
t.he consignee of a
Swo rn to and su~
thi. ax_ .day of~
·a
l>efore me,
191 2-
~
As,mtforAdam. :a:
/
~- Co m-
�Deli very For m 80
AD AM S EX PR ES S CO
M PA NY
REC OR D OF NO TIC ES
To Con sign ee
To Shi ppe r
AFF IDA VIT FOR AR
DE NT Sl"I RIT S FOR
l"ER SO NA L US E.
(O't 'a)
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PER SON AL
USE .
STAT E OF V~
CoU NTY OF
/)
,J :{, _~
~~ g
·
.
I,
duly swo rn, depose and say that I
am
the consignee of a cert ain ship men
t of arde nt spir " as specifie
ther sid f 's form, this day
delivered to me by the Ada ms Expr
eaei Company,
stud ent or minor, and, if a fema le,
,
not a
I am the head of a family; that
ents pirit sso rece ived bym e
were brou ght into the Stat e on my writ
ten orde r, and that I have not, within
the thirt y days prev ious '
here to, received any arde nt spir its of
any kind whatsoever, from any pers
on or from any place wha tsoever, in exce ss of the quan tity allowed
by the provisions of the Act of ibe Gen
eral Assembly of Virginia,
approved March 10, 1911\, or cont rary
to law, and that the arde nt spir its
my own use, at my own home, and
so received by me are for
that the said
ent spirits will not be used in viola
t ion of law.
�Delivery Form 60
ADAMS EXPRESS COMPANY
2::-/J
Affid~vit No.
v
RECORD OF NOTICES
To Consignee _ __ _ _ _ _ __
To Shipper __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
VlllR)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
CoUNTY OF
1,----,, ;J:.L!:~ ~~_J~ i!!::[Jt. :1::z./f !!;:.:J:: :!~
the consignee
a certain shipmen t of ardent spiri
delivered to me by the Adams ExpreBS Company, fro~~4'-:..L:.~'1.:U'4
~::::!:1.; that I am not a
student or minor, and, if a female, I am the-hea d
amily; that the
ntspirit ssorece ivedby me
were brough t into the State on my written order,
that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any
person or from any place whatsoever, in exceBS of the quantity allowed by the provisions of the Act of
the General ABBembly of Virginia,
approved March 10, 1914i, or contrar y to law, and that the ardent spirits
so received by me are for
my own use, at my own home, and that the said
nt spirits will
be used in violation of law.
�Delivery Form 60
ADAM S EXPRE SS COMP ANY
Affid~vit f'lo. /
RECORD OF NOTI CES
To Consignee _
To Sh ip per _
AFFIDAVIT FOR ARDENT SPIRITS FO R P E R S Of\lAL USE.
( O "J EJR)
•9'0
�AFFI DAV IT FOR ARD ENT SPIR
ITS FOR PERS ONA L USE.
(
CoUNTY OP'. U.,,~ Q;::L l!J~~ ~~•
I.--Jt:::ll-l:::J.~.!:=:l..~t:::!::i;::;;;:~~~ ·6eJne du.Jz
s""t_ ~ deP.()Se and say that I am
the consi
gnee of a certa in shipment.
ent a p i r i • ~ f J i ~ i ~
~~Y A
delivered to me by the Adams Expre ss C o
mpany,~
·
;</'
tha
~nr a
stude nt or minor, and, if a female, I am the head
ofafa nilly; thatth earde ntapi ritaao recei vedb yme
were broug ht int.d the State on my writt en order
, and that I have not, within the thirty days previ
ous
hereto, received any arden t spirit s of any kind whats
oever, from any person or from any place whatsoever, in excess of the quant ity allowed by the provi
sions of the Act of the General Assembly of Virgi
nia,
approved March 10, 1916, or contr ary to law, and
that the arden tlapirita BO received by me are for
my own use, at my own home, and that the
said
t ap~t8 will not be used in violation of law.
'/,
,
...........
~--
th~ day o
, 191- ,-
~
Oiit: r11,;f" Apnt tor Adam• Ezpre
u Compa ny
·a /4 f
'
�Dellve r, Form 80
AD AM S EXP RES S CO MP AN YAffida vit No,
WayTo-4: ~~~~ h.;;f-! L.C,,~ ~IQ,, ,-...JI IL~... .....,..
-I
RECO RD OF NOTIC ES
To Consi gnee
To Shipp er
AFFID AVIT FOR ARDIE NT SPIRI TS
FOR PERS ONAL USE.
COVE)
::;.o 'l
(
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PER SON AL
USE .
�,,
I'
DEL I VERY P'ORM 60
191-.f- Affidavit No.
/f tJ
PREPAID
01
RECORD OF NOTICES
F
O
To Consignee _ ____._0:.------'----- ----"'y
______
To Shipper _ _ _ __ _ _ _ _ _ _ _ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVE R )
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I
STATE OF VI
COUNTY OF-1J.~~.G e:;t;!,.~~';;J -'11~~~/
I, _ _j~ lL~-/:,~ ,L....L~d~~~ -:!:::_~:__ _ , being duly sworn, depose and say that I am
spiri;:;-:~ _sJ:cif~~.,o~ ~t(f1side o ~ o r ~is day
the con~~gnee of a ' rtain shipment of ard
,_qe,liver~d~~ m~!+•~he ,.Adams Express C o m p a n y , ~ ~ ezvu. /4 ; that I am not a
·, student or minor, ·arid, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my writ t en order, .and tn-at I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place what soever, in ex cess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to .Jaw, and that the ar dent spirits s received by me are for
used in vi ation of law.
my own use, at my own home, and that the said ardent spirits ·n not
Sworn to and sub~ed before me,
this_Ltf:..day of
'&L ,
1911--i
�Delivery F~rm 60
ADAMS EXPRESS COMPANY
Affidavit
Way•
To__.,_...,.~"'1[,,L<~f--c.~,,.,_.....,~HJ.W-._..'-71/
IIECORD OF NOTICES
1"o Consignee
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVIB)
NotP-//1'
�-
vAFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
STATE OF
CoUNTY O ~~~~¥~~~r;,c.
......'V'I-"""
and say that I am
the consignee of a certain shipm t of ardent spirits,
this foz,-, this day
delivered t.o me by the Adams Express Company, f
thMllnnota
student or minor, and, if a female, I am the head of a family; that theard
iritssoreceivedby me
were brought int.o the State on my written order, and that I have not, wi in the thirty days previous
heret.o, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisionso( the Act of the General Assembly ofYirginia,
approved March 10, 1916, or contrary t.o ·law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits will n
in violation of raw.
Conaignee
�ADAM S EXPR ESS COMP ANY
RECORD OF NOTICES
To Consigne e _ _ _ _ _ _ _ __ _ __
To Shipper
AFFIDAVI T FOR ARDENT SPIRITS FOR PERSONA L USE.
(OV-)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR PERS ONAL USE.
:: :: :; f ~
' I, ~ - being duly sworn, depose and say that I am
the consignee of a certai n shipm ent of arden t spirits
,
is fo~
is day
delivered to me by the Adams Expre ss Company,
fr·~ (l.,4~ t::IL.. l::~lli ~?::f: :ttlC{,-cthla\ I am not a
stude nt or minor, and, if a femal e, I am the head ofa
amily; thatth earde ntspir itssor eceiv edbym e
were broug ht into the State on my writte n order, and
that I have not, within the thirty days previous
hereto, received any arden t spirit s of any kind whats
oever, from any person or from any place whatsoever, in exces s of the quant ity allowed by the provisions
of the Act of the General Assembly of Virginia,
approved Maroh 10, 19W, or contra ry to law, and
that the arden t spirits po received by me are for
my own use, at my own home, and that the said arden
t spirits will not be used in violation of law.
1
•
Sworn to and subscribed before mti,
D
,
H J J/aM.«A /IV \
~~~-
•
<
0-eilP> Nt
"
�Deliv e ry Form 60
f
REC ORD
~~ ~~ ~II O.L 19~ 1- Affid
avit No.
7-/2--
Way To__ _JU, .£~:l :;'}lt: ::.".. /.4::Z ::::~~
a,.~J .L.... Ll!:
REC ORD OF NOT ICES
To Con sign ee _ __ _ __
__ __ ___
To Ship per _ _ _ __ _ _
_ _ _ __ _ _
AFF IDAV IT F'OR ARD ENT
l!lPI RITS FOR PER SON AL
USE .
'
(OVIB )
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO NAL
USE.
STATE OF
V ~
CoUNTY OF
/J
~~
.
'
I,
~ C / . A 4 heing duly sworn, depose and say that I an1
the consignee of a certain shipment of ardent spiri
delivered t.o me by the Adams Express Company,,rr,91&41-a.<1:,.a..~..L.J'--L~~~:4.l
; _that I am not a
student or minor, and, if a female, I am the bead . afamily; tbatthea rd
spiritsso received byme
were brought int.o the Stat.e on my written order, and that I have not. witbm
the thirty days previous
heret.o, received any ardent spirits of any kind whatsoever, from any person or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 10, 191fl, or contrary t.o law, and that the ardent spirits so
received by" me are for
my own use, at my own home, and that the
r ~ = t i o n of law.
saidzt
Swom to and
this./it- day o,t;r;.~ ~~~
Couisnee
�Delive r y Form ao
ADAMS EXPRE SS COMPA NY
Affidavit No.
COLLSCT
RECORD Of' NOTICES
To Consignee._ __ _ _ _ _ _ _ __ _ __
To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL. USE,
.; ".·...
( OVJa)
·....\ ;.
£1/
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
STATE OP
V
CoUNTY OP'-t/-~~a)~:::::::Z...q.F Jl:..,,,
l, _ _i.,::;.;:,::__...:_=---L-.e..::s.a, ii,..,::~::...,1;._._ __, being duly sworn, depose and say that I am
the consignee of a certain shipme
delivered t.o me by the Adams Express Company, f,«llti~f4~~~~M !!!!:~!:.tt&t I am not a
y; thattheardentspiri1's oreceivedbyme
student or minor, and, if a female, I am the head ofaf
were brought int.o the State on my written order, and that I have not, within the thirty days previous ;
heret.o, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 191f\, or contrary t.o law, and that the ardent spirits so received by me are for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
.
Sworn to and subsm before me,
t h i s ~ : , of-lfdi=......,....__, 191
. (w ().7/1ft?,
�-
Oellver y Form 60
ADA MS EXP RES S COM PAN Y
Affida vit No,
COLLBCT
RECO RD OF NOTIC ES
To Consig nee
ToShi pper
,
AFFID AVIT FOR ARDE NT SPIRJT S. FOR
PERSO NAL. USE,
&0
�AFF IDA VIT FOR ARD ENT
SPI RIT S FOR PEII ISON AL
USE .
STAT E 0 1'
~
Ii} i,
L
-.
"°""7, • y w ~ ,
-
bomg duly - ..-.. .... .. ..., my
that I am
the consignee of a certa in shipm ent of
arde nt spirits, as
clfied on othe r side of this form, this day
delivered t.o me by;c;he Ada ms Expr ess
Com ~y. ~Mll:lll::~ 11! !:~: :IG ~~E
stud ent or minor, and, if a female, I am
B"r d.it ~ am not a
the hea o a fa
; that the arde ntsp· · so rece ived by me
were brou ght into the Stat e on myw
ritte n orde r, and that I have not, with
in the t irtydays prev ious
here to, received any arde nt spiri ts of any
kind whatsoever, from any person or from
ever , in exce ss of the quan tity allowed
anyp lace what.soby the provisions of the Act of the Gene
ral Assembly of Virginia,
approved March 10, 191fi, or cont rary
to law, and that the arde nt spiri ts so
received hy me are for
my own use, at my ow.n home, and that
the said arde
w·
be used · viola tion of law.
.
�Delivery Form 80
ADA MS, EXP RES S COM PAN Y
Affidav it No-
Shippe r
RECOR D OF NOTIC ES
To Consig nee _ __
To Shippe r
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(OVIB)
:7 0 r/z
�AFFIDAVIT FOR ARDENT SPIR TS FOR , PERSONAL USE.
••o•~
~•
o
COUNTT
.
.
~ - ~ - - - - ~ being duly sworn, depose and say that I ani
ide of this
cified o oth
the consignee of a certain shipment of ardent spirits,
am ot a
delivered·to me by the Adams Express Company,
student or minor, and, if a female, I am the head ofafamily; thattheardentsp iritssoreceivedb yme
were brought into the State on mywritten order, and that I bave not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person i,r from anyplace whatsoever, in excess of the quantity alloweaby the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1911\, or contrary to .law, and that the ardent spirits so received by me are· for
my own use, at my own home, and that the said ardent spirits will not be used in violation of law.
I,
(/J//Y: ~fk'e~naignee
�FORM 370- VA .
-.
SOUTHERN EXPRESS COMPANY
(Incorporated )
EXPRESS CHARGES
PREPAID
I
COLLE CT
WarTax
Add
Coll ect
Und e rcharge
-I
RECORD O;J~T'r/f
To Consi~ nee/~
fl
~•/J
/
;iY.llJ.:fo Sh~pper·_ _
5
(OVER)
_ _ __ _ _
_ _ _ _ _ __
�.,. ., ~"it
~1
COUNTY O
~~
~
I,
the consignee of a certain shipment of ar
~
••y
bei•g duly mm, dep,., ~•
th,t I ,m
nt spirits, as specified on other side of this rm, this day
t..£~
;
delivered to m-e by the Southern Express Company, from
at I am not
a student or minor, and, if a female, I am the head of a fa~ily; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in -axcess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
. ~L
purposes at my own home, and in con-
"-;l~
~k
~
(State whether for Scientific , Sacramental, Medicinal or Mechanical)
~
formitywithlaw .
Consii»ee.
Sworn to ~d subsc~
ihi~
day of1
fore me,
, 191
�FORM 370- VA .
R evised June, 1918
SOUTHERN EXPRESS COMPANY
(Incorpora.ted )
LIQUOR
RECORD
Received at_-'-'--_ _ _ _ _ _ __ _____,___ _ilate _ _ _ _ ____ l 91 _ ) Affidavit No.
Consignee _ _ _ __ _ _ __ _ __ ~_ _ _ _ _ _ _ __ P. 0. Ad dress _ _f_
Quan tity_____~____ Weigh ~ _ _ _ lbs.
Kind of Arde nt Spi rits--~--------,---_,._/ _ _ _
Way-Bil l No. _ ____,___~_ _ __
_ _ _ ______ _
From _____ _________ _
Oate ~/_ __ _ _ ~ /_ _ 191_
)
To
I'
Shipper '
P. 0. Address
.-
I
t
I,. _,f
'"
-
-
I
'
-
'
"f-
.
I
Advan ces to
Collect
EXPRESS CHARG ES
PREPAID
COLLECT
I
I
WarTu
Collect
Add
Undercharge
I
'
I
-
I
RECORD OF NOTICES
To Consi gn ee _______ ___________
To Shipper_ __ _ __ __ _ _ __ _ _ _ __
( OVER)
�I, - -- - - - - - - - - - - -- - - - - -- - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form , this day
delivered to me by the-Souther.n-Express Company, from _ ___________ __ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatrnever, in excess of the quantity allowed by the provisions of the A:ct of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law , and that the ardent spirits so received by me are to be used
I
by me for ___________ ___________ ____ purposes at my own home, and in con(State whether for Scientific, Saersmental, Medicinal or Mechanical)
formity with law .
1
I
Sworn to and subscribed before me,
ihis..k____day of
J1 _r-'~ ~
I
V
;"';:)
Consht:Dee.
�L
\
ADAMS EXPRESS COMPANY
)::LIVERY FORM 60
REVISED JUNE, 1917
SPECIAl.. LIQUOR RECORD
Received at..__ _ _ _ _~ - --
~ -~Date __._l _ _ _ _ _ 191 _
Affidavit No , _____ _
P. 0. Address--,--- - -- -- - --
Consignee
•
1
Kind of Ardent Spirits_ _ _ _ _ _ _-=.::.....1:....:c:....,:..._:..::....:.__ __.A moun~- - -----Wei gh~.- - . , -lbs.
I
Way-Bill No• -,----- - - , -To
•
/
1
J
7..
_ _ 191_
'-------- +-/~...,
\...
Advances to
Collect
Shipper
I
P: O. Add r ess
RECORD OF NOTICES
To Consignee.___ _ _ _ _ _ _ _ __ _ __
From ______ ___ _
EXPRESS CHARGES
COLLECT
PREPAID
I
.r
Add
Undercharge
I
To Shipper _ _ _ _ _ _ _~ - - - - -- -
•
(OVER)
�STATE OF VIRG;INIA,
I
~()
COUNTY OF_·-.J.
\('
--.;..:.•:....::c:::....:...:......:.:-"'-'-::....;..___:'l_,,..,.-tt_, ({.. f.,,Vf
(•
.
1
I,
, being duly sworn, depose and say that I am
the consignee of a certain shigment of ardent spirits, as specified on other side of this form, this
day
delivered to me by the Adams Express CompJny, fro
/; that I am not
a student or minor, and, if a female, I am the head of a family ;that the ardent spirits so received
byme
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever , from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the 'Act of the General Assembly of
Vir_
ginia, approved Marcq 10, 1916, or contrary to law, and that the ardent spirits so received
by me
/'J.·lf (.-,:~,/ 9,,A'; ?(. &f
are to be used by me for
.
\"/ I
-
Witness:
purposes.
(State whether for Scientific, Sacramental, Medicinal or Mecha/ ic1
I) / ;
'•
j _,
,,
. I! (
;signature of Consignee)
I
•
•r
j
i
,;.,1/
f
•
:,.
I
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 14
Subject
The topic of the resource
affidavits
ardent spirits
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Penn Laird in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Rights
Information about rights held in and over the resource
<span>This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (</span><a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a><span>)</span>
Format
The file format, physical medium, or dimensions of the resource
PDF
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-009
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Penn Laird
Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/1b7daeeeb2352543a0584542b0aa71c7.pdf
e59f13da8de66e2fda80ef64c65d64f8
PDF Text
Text
SOUTHERN EXPRESS COMPANY
F"ORM 370•VA.
Cl ncorporat.ed )
LIQUOR
REC
'l __ , _
--===---===--=----.;..-~~'-'----'-----' ___.,...___ _ Date,_~_
_ _ 19
,
Affidavit No...,/'--/,__
_ _ __
I
Con sign ee - -- ' - -~-"'-~'-'--,---- - - - ~ ~~ ~- - - -- - - - - - - - - - - -+ - -- - -- ~ ~
~
..-Y__·__Weio~
Kind of Ardent Spirits--,..-'/_•~, ~ ~ ~ - - - - - -- -- - - Am oun ~ _,_/
_ _ _ __
., Way-Bill No.
I
-.,
A(
.1. 0
I
n,,i 1 _J
/ /
•
J '
-6 r I
J,(
A
Date~<~---"c.")'---'-------,/,
_ _"",7
_____ 19 :J.-
_,
7
lbs.
Fro m...,,U"--'-----'(---'1-"----'l_/2_ _
' ,...,_C-=---
' ~ -- - - - - _ . _ E_X_P_l!_E_S_S_ C_'B
_A
_ l!
_G
_ ES
_ _ _ _ _ _ __
Atlvnncee t o
ir . -
Collect
Add
1-'UEPAID ·
COLLECT
Un d er cha rge
ShiJ)!ler- - ~ - - -- -~~~--_,_--~-
RECORD Of' NOTICES
To Con signee _ __________ _______
To Shipper ___ __ _ __ _ _ _ __ _ _ _ _
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONAL USE.
(OV XR )
�AFFID AVIT FOP ARDE NT SPIR ITS
FOR
PERS ONAL USE
-(
, being duly sworn , depose and say that I am
a certai n shipm ent of ardent spirits , as specifi
ed on other side of this form, this day
' by the South ernEx press Comp
delive red tome
any, from ~---- -- - - -- - - i that
I am not a
studen t or minor , and, if a female , I am the head
of a family ; that the ardent spirits so receiv ed
by me
were broug ht into the Siate on my writte n order,
and that I have not, within the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind whatso
ever, from ·any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law, and that the
ardent spiri\s so receiv ed by me are for my own
use, at
my own home, and that the said arded spirits
will not be used in violati on of law.
~etrV
CoW1ie;nee.
J(
1t-- --.
�SOUTHER N EXPRESS COMPANY
fORM 3TO•VA.
(Incorporated)
/J
1
'
,r,.,
.
•I
Received at ~
(JL,,,(A,, V"l,
~
Consign~
•
I..)_
,
'
)
SPECIAL LIQUOR
b-
I
"'
RECORD
,,._ _- ...,_c__
,1 _
Date __,,,....
7
__ 191 _
AffidavitNo.
-fa{
<f I
A11vnn<" e & to
Collect
l 'REPAI D.
Add
Unde r cha rge
RECORD Of" NOTICES
To Consignee ____ _ _ _ _ __ _ _ _ _ _ __
To Shipper _ _ _ _ _ _ __ _ _ _ _ __ _ __
AFFIDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE.
( OVER )
�AFFIDAVIT FOP ARDENT SPIRITS FOR
~~GIN!A f .
STATE OF
COUNTY OP'
J_
-<
PERSONAL USE
/I
y
:,,-
,m1- r, ({
~
cJ'f"-,d-
1,
1.- ,>--~(.,, "?
, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as , pecified oil other side 'of this form, 1;his day
.
I
.
/ ) /.
delivered to me by the Son1;hern Eipress Company, from
{/ t
"·
; ha1; I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spi.rits so received by me
were brought into the State on my written order, and that I have not, within the thirtf days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary 1;o law, and that 1;he ardent spirits so received by me are for my own use, at
my own home, and that 1;he said ardent spirits w/ j / d in ~ :of~
CoDBienee.
I
Ai:ant for Southern Express Compan y.
�FORM 370•VA.
SOUT HERN EXPR ESS COMP ANY
(Incorpo
rated )
Affidavit No._ _ _ _ __
A d vnnree to
Collect
EXPRE SS CHARG.E S
Add
Und er charge
r
RECOR D OF NOTIC ES
To Consignee _ _ _ _ _ _ __ _ _ _ __ __
_
To Shipper _ _ __ _ _ __ _ _ _ __ __
_
AFFIDA VIT FOR ARDEN T SPIRIT S F OR
PERSO NAL USE.
(OVER)
�AFFID AVIT FOFI ARDE NT SPIRI TS FOR
PERSO NAL USE
- -- ---r-- -...---,~-+-- - ~ - - -= ------,r'--~, being duly
sworn, depose and say that I am
as §P cified Oll"' other s}de of this form, this day
deliver ed to me by the Soufae rn Expres s Compan y, from
.
{ t..I ; that I am not a
student or minor, and, if a female, I am the h ead of a family;
that the ardent spirit~ so receive d by m e
were brough t into the Siate on my written order, and that
I have not, within the thirty days previou s
h ereto, receive d any ardent spirits.o f any kind whatsoe ver
, from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisi ons of the Act
of the Genera l Assemb ly of Virgini a, approv ed
Mar ch 10, 1916, or contrar y to law, and that the ardent
spiri1.s so receive d by me are for my own use, at
my own home, and that the said ardent spirits will not be
u sed in violatio n of law.
/J /2:
Sworn to and subsc ibe before me,
this~
day of _ _ __ _ ,
(
1911.
,, ) l
Ai:ent for Southern Express Compan y,
r
/
/
~I, [
Consi2ne e.
�fORM 370•VA.
SOUTH ERN EXPRE SS COMPA NY
(Iuco rpo rnte d )
SPECIA L LIQUO R
Received a11=--- ~-=----........=-..:'----=-----=----;.:..._.- - - ~ -- - Date
1 ,..
RECOR D
191_
Affidavit r!o.
To - - - - ~ - - - - ' - ' - --""'--- -,,..--.. ..,.cc-c.__
Shipper _'~--=-- ---,'---==--=.L:::...-=-- -'-----=---
~
Add
Unde rcha rge
_,
-
RECORD Of" NOTICE S
To Consignee ____ ____ _____ _ _ _ __
To Shipper ____ ____ ____ _ __ __ _
Af"f"IDA VIT f"OR ARDENT SPIRITS f"OR PERSON
Ai USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
,
I, -''--"--'----,1---- ''------- - -_;_---=-----=--- - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as s,vi cified of other side 1>f this form, this day
.,./1.
_,_
~
delivered to me by the Southern Express Company, from
that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits sd received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in v iolation of law .
..,Q t.
Consh:nee.
�FORM 370-VA.
SOUTH ERN EXPRE SS COMP ANY
Clncorporn t ed)
Affidavit No._l_ '-·- - Kind of Ardent Spirits, ___ _~ ~ - - ~- - ----= --Amount- -'~--
--'--'~ -~..._ _Weigh .__--=_ _ Jbs.
J
J
Way-Bill
To ~ ~ -'-~~ ~=:::., _---"-.. ::::..-~ ~~-.... !..--
f'
A.1tvnn ces t o
Collect
l'HEPAID .
Add
lJndei-c harge
RECOR D OF NOTICE S
To Consign ee ___ ___ __ __ __ _ _ _ __
To Shipper ___ ___ ___ _ _ _ __ _ _ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE.
(OV J<R )
�AFFID AVIT FOP ARDE NT SPIR ITS
FOR
PERS ONAL USE
•
I, - ~- - ~ ~ ~ ~ -~ ~ -- - - ~ - - - - - , being duly sworn , depose and say that
I am
the consig nee of a ceriai n shipm ent of ardent
spirits , as specif ied on other side of this for,m,
this day
delive red to me by the South ern Eipre ss Comp
any, from ___ ___ _ ____ ____ ; that
I am not a
studen t or minor , and, if a female , I am the head
of a family ; that the ardent spirits so receiv ed
by me
were broug ht into the State on my writte n order,
and that I have not, within the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law, and that the
ardent spiriis so receiv ed by me are for my own
use, at
my own home, and th at the said arden t spirits
will not be u sed in violati on of law,:"""')
~~ #,~
-~ ~~ta
~:_J_~ ~~
Conah:nee.
�l'ORM 370-V A.
SOUTH ERN EXPRE SS COMP ANY
(Incorpor ated)
LIQUO f:l
RECO
•
- ~-=- -'---- - - -- - ' - -~ - ate
To
•
..__
·1 _,,{,i_ i
i
Shippem / 2, / (/VIJ,1 ..- ~
/
/
Atlvnnr e a t o
Co lle ct
- ]1 '-
I
D
7
Affidavit No.-_/_ _ _ _ _
191 _
EXPRESS C HA RGES
I
l'R E PAID
I
I
CO LL ECT
RECOR D OF NOTICE S
To Consigne e
tr
Add
Underc- har~ e
I
To Shipper_ _ _ _ _ _ __ _ _ __ __ _ _
AFFIDA VIT FOR ARDEN T SPIRIT S FOR PERSO
NAL USE .
( OV ER )
�ARDENT SPIRITS FOR
-
-
PERSON AL USE
~----,,...-L.-- "~.z_=----"--=-- --<--' - - - ' - ' - ' - - - ' - - - - - - - ,
being,i uly sworn, dep ose and say that I am
specified on other s"de of t is form, 1;his day
~
delivered to me by the Son1;hern Express Company, froi
- l
; tha1; I am no1; a
student or minor, and, if a female , I am the h ead of a family; that the ardent
spirits so received by m e
were brought inl;o the State on my wrHten order, and 1;ha1; I have not, within
the thirty days previous
hereto, r eceived any ardent spiril;s of any kind whatsoeve r, from any person or from
any place wha1;soever, in
excess of the quanUty allowed by the provisions of 1;he Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary 1;o law, and that 1;he ardent spiril.s so received by me
are for my own use , at
my own home, and 1;ha1; the said arden1; spiril;s will not be used in violation of law.
~1 :k eh
£ _,, .,.=:::,...A
;,.=-:___::______::___
Consie:nee.
�-
SOUTHERN EXPRESS COMPANY
FORM 370•V A.
(l nco rpo rnt ed )
SPECIAL LIQUOR
~~ CORD
Received al ___:'---'---,~~'-'=-=-='------'----'-'--'-- - - - - -Date )-
A tl vn n <' e s t o
Co llec t
19 ( /
Affidavit No.=c::___ _ __
E XP RESS CHARG ES
CO LLECT
Ad d
U uder c b a t Re
RECORD Of" NOTICES
To Consignee_ __ __ _ _ _ _ _ __ _ __ _
To Sh ip per _ _ _ _ _ _ __ _ __ _ _ _ _ _
Af"f"IDAVIT f"OR ARDENT SPIRITS f"OR PERSONAL USE.
(OVICR )
�AFFIDA VIT FO~ ARDEN T SPIRIT S FOR PERSO NAL
USE
STATE OF
'J~NlA, // '
couNTY OF
'il_§-u
/i.
c--0----;.:z
~
..J../ (1 /
I,
<
t'1 "
the consigne e of a certain shipment of ardent spirits,
, being duly sworn, depose and say that I am
pacified o other side of thi o/form, this day
delivered to me by the Southern Express Company , fro
1
"·
I
/ ; that I am not a
student or minor, and, if a female, I am the head of a family; that the
ardent spiri1/ so received by me
were brought into the Sbte on my written order, and that I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so received
by me are for my own use, at
my own home, and 1ihat the said ardent spirits will not e use z z :
:it1 of law.
/ .:::__
Conaienee.
Sworn to and subsc "bed before me
this£ _day of
.J..£
, 19,-_
,
Ai:ent for Southern Exvress Comvsny.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA .
(luco rpornted)
/ -SPECIAL LIQUOR
RECORD
'?--, ~
____:__c__ Date
A1l vn n("' C8 t o
Co ll ec t
\
19;[
Affidavit No.- - t - - - -
EX P RE S S CHARGE S
l'R EPAID .
CO LLECT
Add
Und er c h a rge
RECORD OF NOTICES
To Consignee
To Shipper _ _ __ _ _ _ _ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVE R )
�AFFIDA VIT FOP ARDEN T SPIRIT S FOR
r:
PERSO NAL USE
,
I,
~
t ..,,.._
being duly sworn, depose and say that I am
the consigne e of a ertaiil shipment of ardent l pirits, a~;,/.Specified, on
other side of this form, this day
I1
.
{
I
/' I
delivered to me by the Soul;hern EJ:press Company
, from
VI"" ,AA.,- , -:[ {. !
; thal; I am nol; a
studenl; or minor, and, if a female, I am the h ead of a family; that the
ardent spirits so received by me
were brought inl;o the Siate on my written order, and that I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri\s so r eceived
by me are for my own use , at
my own home, and l;hal; the said ardent spirits will not be u sed in violation
of law.
~G[ (d ~lt ( )1_r,
V
Sworn to and subscribe d before me ,
this_J_ _ day of j,_v?
/4)
19, -
·
er~
(/
A~eut for Southern E:x:press Company.
O
0-- -- -- - ~C_o_n _si-~u
- •- •-. -
�SOUTHERN EXPRESS COMPANY
FORM 370-VA.
$__
(lJlCO r porrit ed}
· SPECIAL LIQU
Received at.- - ~~ --"="- -=..-'~-
I
1
/
R
RECO.RD
Date.~_--_; _ __ ' ___ 191 ~
- Affidavit No.
Consign ee _ _ _ _ __:__:_-"---'::::..:...----:.-1.--C=- ---'--~''-"
/~~ /~ -- - -- - - - - - - - - ~- - -- - - -- -.
Way-Bill No._~,___ __ _ __
To -'-- - ~-'-'--=.:..=--=---" '-'-"'--'-~-~.,___-- '---
A d vnnccs to
Co l lect
EX P RESS CHARGES
PREPAID .
Add
Onder chtujil;e
RECORD OF NOTICES
To Consignee _____ __ _ _ __ _ _ __ _ _
To Shipper _ _ _ _ __ _ _ _ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVT<R )
�AFFID AVIT
STATE OF VIRGIN IA,
FZ
O ARDENT
-
SPIRI TS FOR
PERSO NAL USE
/
COUNTY OF•_!_JL"'--_ ,,,--'-/: _~ ~ ~ ~:_-
I
,
1
l, "
' (
/
I
being duly sworn, depose and say that I am
the consign ee of a certain shipme nt of ardent spirits,
as,, specifie d on other side of this fo
ibis day
deliver ed to me by the Souihe rn Expres s Compan y, from
~
m not a
studen1; or minor, and, if a female, I am 1;he head of a family;
tha1; the ardent spirits so receive d by me
were brough t inio the Sbte on my written order, and 1;hat
I have not, within th~ thirty days previou s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from any place whaiso ever, in
excess of the quantit y allow~d by the provisi ons of the Act
of the Genera l Assemb ly of Virgini a, approv ed
March 10, 1916, or contrar y to law, and ihat the ardent
spirHs so receive d by me are for my own use, at
my own home, and that the said ardent spiri1;s will not be
used in violatio n of law .
Sworn to and subscri bed before me ,
17
'-:LI
1
this ___ day of _ _ _ _ _ , 191_
·?-I,, ,,
I
Conaie-ne o.
,
~
Ai:ent for Southern Express Company .
�F"ORM 370•V A.
SOUTH ERN EXPRES S COMPA NY
(l uco r poru.ted )
IQUOR
RECOR D
-::?,- /Y 19
To
.A.llvnnres t o
Collect
Affid avit
N
o.--7--
EXPRESS CHARGES
P REPAID .
CO LLECT
Add
Underchnrge
I
RECORD OF NOTICES
To Consignee _ _ _ __ _ __ _ _ _ __ _ _ _ _
To Shipper _ _ _ _ _ _ __ _ _ _ __ _ _ _ _
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL
USE .
( OVER)
�AFFID AVIT FOP ARDE NT SPIRI TS FOR
I
PERSO NAL USE
I
I,
./
, being duly sworn, depose and say that I am
the eonsign ee of a eertain shipme nt of ardent spirits,
a.s 'specifi d on other side of this form, this day
deliver ed to me by the Souihe rn Eipres s Compan y, from
4
i,
'•
}
• that I am not a
studenl; or minor, and, if a female, I am the head of a family;
thal; the ardent spfrits so reeeivti d by me
were brough t inl;o the Siate on my written order, and l;hat
I have not, within the thirty days previou s
hereto, reeeive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
exeess of the qmmtit y allowed by the provisio ns of the Aet
of the Genera l Assemb ly of Virgini a, approv ed
March 10, 1916, or contrar y l;o law, and l;hat !;he ardent
spiri\s so receive d by me are for my own use, at
my own home, and l;hal; the said ardenl; spiril;s will not be
used in violatio n of law.
/
Sworn to and subscri bed efore
this /
7 day of~...__d~J -c;[/. 2
(/
m
/
- , 191_ ,
✓
Ai:ent tor Southern Express Company .
Conai2ne e.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(luco rporuted)
A,1vnnc-ee t o
Collect
EXPRESS CHARGES
PREPAID.
COLL ECT
Add
Under c h a rge
RECORD OF NOTICES
To Consignee _ _ _ _ _ __ _ _ __ _ __ __
To Shipper _ _ _ _ __ _ _ _ _ _ __ __ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVER )
�AFFIDAVI T FOP ARDENT SPIRITS FOR
PERSONA L USE
STATE OF
l
!NIA
~
,I')/
f,t:,,
COUNTY OF'J ..---""-"--~----'-"'- -=--· -=-'--
I
I,
., A/'11 ,.__, ,(,,f
.1
,t
, being uly sworn, depose and
say that I am
the consignee of a certain shipment of ardent spirits, as,.specified on other side of 1;his form, this
day
.,,,
delivered to me by the Southern Express Company, from ~ ~
t
; that I am not a
student or minor, and, ifs female, I am the head of a family; that the ardent spirits so received
by me
were brought in1io the 81.ate on my wri1iten order, and that I have not, within the I thirty days
previous
hereto, received any arden1i spiri1is of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quan1iity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that 1;he ardent spiri\s so received by me are for my
own use, at
my own home, and 1iha1i the said ardent spirits will not be used in violation of law.
I
Pi
Swor~ to and subsf::J. ~ ore ~/
this _ _ _ day of _ __ _~ , 191_ .
Ai;;ent for Southern Express Company.
Corui,i1:nee.
�SOUTHERN EXPRESS COMPANY
FORM 370-VA.
(I nco r po ra t ed)
SPECIAL LIQUOR
Received at _ _ __ _ _ _ _=-,_ _ _~ --
~ __
RE 9 0RD
I
Date
_.
1917
___,_/
_U
____
Affidavit No _
Way-Bil No,_ ___,__ _ _---"~To
1J_ ~
!
Shi pper '.t-' (
.A1lvnnces to
Collect
EXPRESS CHARGES
PREPAID.
Add
Un~er c-barge
<,
RECORD Of' NOTICES
To Consign ee _ _ __ _ _ _ _ _ __ _ _ _ _ _ _
To Shipper _ _ _ _ _ _ __ _ _ _ _ __ _ __
AF'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONAL USE.
( OV JIR)
�ARDENT SPIRITS FOR
-
PERSONAL USE
,. J
I, ----'-~--"------'--------'----------'-- - - " - - - - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, asZ ~ecifiedjon ot~er side oJ- this form, this day
that I am not a
delivered to me by the Southern Express Company, fromi;.J-1,1,v\, ,$ .,
student or minor, and, if a female, I am the head of a family; that the ardent pirits o received by me
were brought into the Siate on my written order, and that I have not, within the th rty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quan1dty allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that ihe ardent spiri\s so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
~ ~
u
i;
�SOUTHERN EXPRESS COMPANY
FoRM 370•V A.
(I nco rporated)
Affidavit
A1lvnnc e e t o
Coll e ct
P REPAI D .
No,---,1/L-'L,,._
___
COLLECT
Add
Und e r c ha.rJ!: e
RECORD OF NOTICES
To Consignee_ _ _ _ _ __ _ _ _ __ _ _ __
To Shipper _ _ _ _ _ __ _ _ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVER )
�~
AFFIDA VIT FO
{
ARDEN T ~Pl
ITS FOR
PERSO NAL USE
I
STATE OF
i
COUNTY o,---'----'-="-"'-'-------'"--'-''----------=--'------='--
f ,(
,
I,
the consign ee of a certain shipmen t
being duly sworn, depose and say that I am
spirits, a_s ':ecifieo /On oth_er side of this form, this day
delivere d to me by the Souther n Ex ress Compan y, frofil / (
1
t
; that I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spiri s so received by me
were brought into the Siate on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoe ver, in
excess of the quantity allowed by the provisio ns of the Act of
the General Assemb ly of Virginia , approve d
March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are for my own use, at
my own home, and that the said ardent spirits w~
tl
used : viol~ i:~ of lrJ-J, / '
..f "-
·
~
'
•
'
~ ~'----.f-'-~7- - -C-o_ns
_ iii_n_e_e.-
/v
�- -- - -- - - - - -~ ----- - - - ~~--~-:'.,.....,.........,_,,,.,,.....,......,....._ ,..r.=,,::--..,.,..,._..... - - -- - -,.,r-SOUTHERN EXPRESS COMPANY
FORM 370•V A.
(Inco rpo rate d )
,t_
Received at
~
-I
-lA- l
·,1
SPECIAL LIQUOR
,U /
) ,.
RECORD
cj/1 ~
llate
1
191_
(7
Affidavit No.,__)-"
,,.:.-_ __
e Jy ~
-'--,'-C--,(._ ,e;
-4---_Z_:___ ______ ______ _ _
Kin d of Ardent Spirits
~ ,J;/ t/
Amoun ' -_L__--'-~- - -,(.- - - -We ig h.___ -4-_lbs.
u
I
From _U/
_ _Oi-_ J _ _ _;,___
Way-Bill No. 7 /~ L
Date
2- - / )
To rll1~c..- ~
Co nsignee
Shipper
J..;
A
.A tl vm1ree t o
0-f- ~
EX PR ESS CHARGES
Ad d
Und ercharge
Coll ect
t
RECORD Or NOTICES
To Consignee _ __ _ _ _ __ _ _ _ __ __ _
To Shipper _ _ _ __ _ _ _ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(OVIIR }
�AFFIDAV 1T FOP ARDENT sP1R1ls
PERSON AL USE
STATE OF
COUNTY OF---'-'-
~--4-'-'------=----'-'-_:__--"-----"----
/
I, - -=~'-'-''--' -"''--'---=-_ ,_- -_----'---_ ____,,_ _ _ _ _ _ being duly sworn, depose
and say ihai I am
1
the consignee of a certain shipment ~f arde0:t spirits, as,1,:iecified/ m other ;!,ide
of th!s form, this day
delivered to me by the Southern Eipress Company, from ~
that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so eceived by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me
are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
~~
Sworn to and subscribed b{fore m e,
d
of
:A
. WA,
r
/
l ,
,
, .
I
-)
~
'CA, ) )( /
I
Ai:ent for Southern Express Compnuy.
✓
;
4*Cf47'? r•r; / r d
.f'",., f J }_',1, mi'[
thi, /
'{
Conai6:nee.
�FOAM 370•VA.
SOUT HERN EXPR ESS COMP ANY
(Incorpo
rat ed)
J,'
Received at
Consignee
f
vl/-)i"Z (
_
t-
J {
s ·PEC.P1':
,(,
f':i
LIQUO R
Date/ -
REC2 RD
',__.... L
/ J_
ii~ J ~.__ J~?.D~f~ft,
._'_,L_'/f_,
,c______ __ _,_ ___ _ _ _
t
Amoun t
Way-Bill No·- -'-"- -+--l, - ~-Oate'1___
- ~
'-)_ _
' __ _ _ _ _ 19
To'- f
-f/-A.A...
- --J \
"vl
.AtlVOll('
&.i=-&-
Shi : per
1-
•
2u '-/ ::1A.
/_'}.
I
~ ·c
~
e 8 to
Collect
191
Affidavit No.
1-0-:d
From,,(//
_ _ __
EXPRES S CHARGE S
l-'R~:PAI D.
-f-r-
we/ight
1
(
lbs.
_c__ _ _,.___
Arld
Underc:ha r1ee
RECOR D OF" NOTIC ES
To Consignee _ _ _ _ __ __ _ _ _ __ _ __
To Shipper _ _ _ _ _ __ _ _ _ __ _ __ _
AFFIDA VIT F"OR ARDEN T SPIRIT S F"OR
PERSO NAL USE.
(OVER)
_
�STATE OF
CouNTY
~s
~~.~-
oM
.D ~V•T
_
Z"
SPIRI TS FOR
PERSO NAL USE
~RD ENT
j;J ,
,,-vv-t,fl
I, J l ~ ,e,,l,._
/-"''j_=-'--=- ---''-+ ------ , being duly sworn, depose and say that
I am
the consign ee of a certain shipme nt of ardent spirits,
s ecified on' other side of this form, this day
t I
deliver ed to me by the Southe rn Expres s Compan y, from
.i...,~'.'k'.:\Q'.'.'.&~
hat I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so receive d by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatsoe ver,
from any person or from any place whatso ever, in
excess of the quantit y allowed by the provisi ons of the Act
of the Genera l Assemb ly of Virgini a, approv ed
March 10, 1916, or contrar y to law, and that the ardent
spiriis so receive d by me are for my own use·, at
my own home, and that the said ardent spirits will not be
used in violatio n of Jaw.
t
0
Sworn to and subscri bed before me
1
f
r
this ____ day of _ _ __ _ , 191_ .
I
A11ent for Southern Express Company .
Consie:ne e.
�SOUTHER N EXPRESS COMPANY
FORM 370•V A.
(Iu c o rpo rnted)
AtlvnlH"Cfl t o
Co ll ect
EX P RESS CHA R GES
A dd
P RE PAID .
Und er chorge
I
RECORD Of" NOTICES
To Consignee _ __ _ __ __ _ _ __ __ _ _
To Shipper _ _ __ _ _ __ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVItR )
�AFFIDAVI T FOP ARDENT SPIRITS FOR
PERSONA L USE
I,
, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits , as -:.pecifiJ d on other side of tp is form,
this day
£c.
delivered to me by the Soufoern Express Company, fro '
1 1
,1. Ir
f
/
\ ; that I am not a
student or minor, and, if a female , I am the h ead of a family; that the ard ent s~irits ~o r eceived
by me
were brought into the Sbte on my written order, and that I have not, within the thirty days
previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly.of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirits so r eceived by me are for my
own use , at
m·y own homo, ond th•t tho "id o,d,nt opi,i~ wili nn'ieed
~
violo~"
_w_.=-'l_a
- -- - - - - Consienee.
'/
/.
,,
Agent for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
l'ORM 370-VA.
( lucorpo rnted )
SPECIA,L LIQUOR
Received a,~"--'=- ----"cc::::...---"--:-------'-- __ _ _ __ _ Date
RECORD
I ,t
Co nsignee _ _[..
.....- ~~-...::.---'-~=~~ --'' _,t"--~=:..!'-.'.(;'.........
,.
_ __
Kind of Ard ent Spirits _
_:_-=::::....,_c...=~-
-
-
'. rn1f
I
_ __ _ _ __ _ _ _ __ __
~- - - - - -Amount_ _.c.../_
_ _ __ _ _rJ_
Affid avit No. _ L.
/_{;.
_ __
___
A tl vnn f'e s t o
Collect
_/_ _____ Weig htf ~ - :.
1
From--=U_ __-'-F _ _,_.J.
___,_
191..1.
EX PRE SS CHARGES
)'RE PAID .
A dd
CO LL ECT
/
U nd e rc h11 rge
f
RECORD Of" NOTICES
To Consignee _ _ _ _ _ __ __ _ __ __ __ · To Shipper_ _ __ __ _ _ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVJI R )
�AFFIDAV IT FOi" ARDENT SPIRITS FOR
STATE OF VI
COUNTY OF
✓
"
PERSON AL USE
I
I,
)
~~~ - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as ispecified on other side
of this form, this day
delivered to me by the Southern Express Company, from
~ ,
- -- - ~ - - ; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent
spirits so r eceived by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoeve r, from any person or from
any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri!s so received by me
are for my own u se, at
my own home, and that the said ardent spirits will not be used in violation of law
.
~
(U• J
Sworn to and subscribed before me ,
thi si
day of
~
µ
,
l!l -
·
{;,~J c'l.(') /
(/
A~ent for Southern Express Company.
/i'
r ~_,/ ~,,
:<.-
L""""""'::r.....L -.'--'t....cc......r:---''--"'::.:....,1=-.;...
�FORM 370•VA.
SOUTH ERN EXPRES S COMPA NY
(Iuc orporut.e d}
RD
Affidavit
Kind of Ardent Spirits_
WToay-Bj17 ~:
:= !/
__,'--'-;..-a.. ..._.-=scc--L ..'--=--'--
r:o.Q -- _
ount1~t--,; :.~:_::--:~:...!....-"'"'--
- --
,-I- ~----, ----- ----, .---- -,--- --
~ ~,,_ (!__
.A dvnn ce s to
Co ll ect
1
Shipper""""'--....L-.:......:_::.::___~ =,~--"- '=:__- --'
EXPRESS CRAllGJi:S
PU E PAID
I
RECORD OF NOTICES
To Consignee ____ ____ ____ _ _ _ __
To Shipper _ __ ~ - - ---- -- -- - --
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON Ai
USE.
(OVER)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
~/J
I, - - ~ -----~-+---- .<---'-''--- -~ /,,,..-,
'---___ _ , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits,
1Jified · n other side of t is form, this day
, i
delivered to me by the Southern Express Company, from
~
; that I am not a_
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on.my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of ·any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in vio lation of law .
Sworn to and subscribed before me,
this_;;_J_day of
.-Au
,t,d ,101L.
I /J /J t < ;,-, , .~ ~
Aeent for Southern Express OomVJ'DY,
Consienee.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(I n c o rporate d )
I
SPECIAL LIQUOR
RECORD
Affidavit No._:;_
; _ ' _ __ _
Way-Bill No·- - - - -- - - r To
j Iv
.Ad\tn n c-e s t o
Col lect
E X P R E SS C HARG ES
PR E PAID .
COLLEC T
Add
Und e r cha rge
RECORD OF NOTICES
To Consign ee _______ _ _ ~ -- - - -- - To Shipper _ _ __ _ _ __:__ _ _ __ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OV E R )
�AFFIDAVIT FOFI ARDENT SPIRITS FOR PERSONAL USE
k
I, ~ ~ -- ~ - - - ~ ~ -- - - - - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, a~ specified on other side of this form, this day
1
-
1
delivered to me by the Souihern Express Company, from
'
l
-"
; thai I am not a
student or minor, and, if a female, I am the h ead of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that 1ihe ardent spiriis so received by me are for my own u se , at
my own home, and 1ihat the said ardent spirits will not be used in violation of law.
i,/
@ , ~,~
rrl~~~-1 _-_ _
Conai1:nee.
�FORM 370•VA.
"'1 .
Receiv~d at
Consianee
JA.A,,,0-
L
$
SPEC A.L LIQUOR
'> •
cL
\
REC ~
2 -/ /
Date
D
1911
Affidavit No.~/,__JS
+-- - -
€: .{.~,.J,,~\'-"~=-,1::.c= =---- - - - - - - - - - - - - -
f~
U y[f
To ~ - < t 1
Shipper
(Incorpo rated )
JJ.~rl ,7
Kind of Arden t Spirits
Way-Bill No.
SOUTHE RN EXPRESS COMPAN Y
I -ct
,
.._..
Date
7&y--J~ ~
,
/
Amount
2: -/ -6
~
,:Z1,.-(;f't -:j
/ 191l
Weiah~
lbs.
From _ L _{ __:__~
__
/ _ /.
.::_
, -"
( ,._
~_
,
r-A-,l -vn-nc- e-, -, o- - , - -E-.X
-' P_R_E_'S_S _C_li_A_R_G _E S_ _..,...._.;_A_d_d _
-f~
Coll ec t
CO LLECT
___,
Und er c buge
RECORD Of' NOTICES
To Consign ee _ _ _ _ _ _ __ _ __ __ _ __
To Shipper _ _ __ _ __ _ _ _ _ __ _ __
Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR PERSONA L USE.
(OVl<R )
�AFFID AVIT FOP ARDE NT SPIRI TS FOR
PERSO NAL USE
-'-''-'--~ = --'-''--'c.._=---== "------"-~-'-'= - - - - - , being duly
sworn, depose and say that I am
_pecifiea _fin other si e o this form, this day
!
'---'--'-- --4
=c-_
, t,<t,,.,,,
_ >~1
,.f
\ ; that I am not a
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so r eceived by me
were brough t into the State on my written order, and that
I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind v,vhatsoever,
from any person or from any place what soever, in
excess of the quantit y allowed by the pro;,.isi ons of the Act
of the Genera l Assemb ly of Virgim a, approve d
March 10, 1916, or cont rary to l aw, and that the ardent
spiri1.s so receive d by me are for my own use, at
my own home, and that the said ardent spirits will not be
used in violatio of law .
..,.!/ X
-
I
r,.,
Sworn to and subscr "bed before me,
this _ __ day of J
,
19lz.
t
Agent for Sonthern Express Compan y.
/4/
Conaii:ne e.
�0
l'ORM 370-V A.
SOUTHER N EX PRESS COMPANY
{I n c orpo ra t e d)
Affidavit No__/ _ __ __
RECORD OF" NOTICES
To Consi gn ee _ _ _ _ __ _ _ _ _ _ _ _ _ __
To Sh ipper _ _ __ __ _ _ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVER )
�SPIRITS FOR
PERSONA L USE
,1
~-~ ~-~-~ -- - --+~- ------- , being duly sworn, depose and say that I am
a cedain
spirits, ay, pecifief on other side o this form, this day
cf-.v..,.
✓-,
delivered to me by the Son1;hern Eipress Company, from~~ --- - 1. /, (.
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the Si;ate on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spiri1;s of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that 1;he ardent spiri\s so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
. {7)
r::P /;{
-F'
- ~
-
~------t.. ~-,--'&6e,. ~ad
~.•.
�~-------------~~~-----~-~---~---------~--~ ~~-~FORM 3TO•VA.
SOUTHER N EXPRESS COMPANY
(Incorporated )
To
Shipper
~/l/l... A---
~
Allvo n r e a t o
Col lect
C
I
EXPRE SS CH A RG ES
P RE PAID
COLLEC T
~1
RECORD OF NOTICES
To Con sign ee _ _ _ _ __ __ _ _ _ __ _ _ _ _
I
Arl d
Unde r c harge
i
To Shipper _ _ _ _ __ _ _ _ _ _ _ __ _ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
(O VIIR )
�AFFIDAVIT FO~ ARDENT SPIRITS FOR
COUNTY OF
I,
the consign
::__
PERSONAL USE
_/
?["Cl
, b~ing duly sworn, depose and say that I am
of a certain shipment of ardent spirits, ass~~ified
other_~~~ of this form, this day
°P
delivered to me by the Southern Eipress Company, from ~
:c.-~=---+,f-- , that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spir
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirils so r eceived by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscrw
this~
before me ,
J:
, rnL.
'-) ~#g .,,, 1 ~
day of
')''1,,f
'
Ai:ent for Southern Express Company.
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 15
Subject
The topic of the resource
affidavits
ardent spirits
personal use
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Timberville in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Date
A point or period of time associated with an event in the lifecycle of the resource
1916
1917
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Relation
A related resource
<span>This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (</span><a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a><span>)</span>
Format
The file format, physical medium, or dimensions of the resource
PDF
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-011
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Timberville
Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/72941c8f713fb7681161dc0868f83682.pdf
64022484bdcf62aa49bd897097696f55
PDF Text
Text
SOUTHERN EXPRESS COMPANY
F"ORM 370•VA.
(Incorpo rated)
RECORD OF" NOTICES
To Consionee _______::...J.c...;jO,'.C~+-,__ ,__ __
To Shipper _ _______ __ __ _ _ _ __
AF'F"IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(OV • R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
I,
/(
the consignee of a cert ain shipment of ardent spirits, ?
PERSONAL USE
, being duly sworn, depose and say that I am
ified o~ other side of this form, t his day
delivered to me by the Southern Express Company, from~
-t:Z;,t -J 6., '• /i~/ that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent., spirits f.>. received by me
were brought into the State on my written order, and t'iat I have not, within tile tl:iirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place wh atsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for m y own use, a1.
my own home, and that the said arden1. spirits will not be used in violation of law.
Sworn 1.o and subscribed before m e,
- /1:
r:
1.hi s ~day of
I
I
, 191_ .
Ai:ent for Southern Express Company.
Consieneo,
�. EXPRESS COMPANY
(Incorporated)
_ __
- ~7',__
Affidavit No.,-J./
I
Advanc-et to
Collect;
RECORD OF NOTICES
To Shipper _ _ _ __ ___ _______ __ _
To Consignee
AFFIDAVIT FOR ARDENT .SPIRITS FOR PERSONAL USE.
'---
(OVIIR)
�AFFIDAVI T FOR ARDENT SPIRITS FOR PERSONAL USE
I
~
t::f'}' , ~ ...,-,
15TATEOFV1 ~0 ~
--
COUNTY OFI/&
,
I,
being duly sworn, depose a:ad say that I alll
the consignee of a {';tain shipment of ardent spirits, as specified on,_ other side of thi s form, this day
~
delivered to me by the Southern Express Company, frdrp'X /4;
<. •
; th at I am not a
student or minor, and, if a fem~
al'.ll\ the head of a family; that the ard ent spirits so r eceived by me
were brought into the State on my writtet order, and t l:i at I hav~ not, within tlte thirty days previ•ns
hereto, r eceived any ardent spirits of any ki.J;id whatsoever, from any person or from -any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General A.s embly of Virginia, approved
March 10, 1916, or contrary to law, and t hat t he ardent spirit s so received by me ·are for my owrr'll_se, at
my own home, and th at the said ard ent spirits will not b e u sed in violation of law .
Sworn to and subscribed before m e,
this.1_,.._day of
/ It,./
, 191-j- ,
.A2ent for Southern Express Company.
Consiltneo,
�FOAM 370-VA.
SOUTHER N EXPRESS COMPANY
(Inco rpo rated )
Advau<"e1 to
Collect
COLLECT
A dd
U nderc harge
RECORD OF NOTICES
To Consianee _ _ _ __ _ __ _-+~""--<IJ-- - - - -
To Shipper _ _ __ _ _ __ __ _ _ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVIIR)
�AFFIDAVI T FOR ARDENT SPIRITS FOR PERSONA L USE
~TA'l'E OF
COUNTY
I
£
VIRGJNU.,j ,
o-( r::,, ' ,. {,
OF / ~
)
'
of
the consignee
1
-ifa. u-,.:;/
a certain shipment of ardent spirits,
, being duly sworn, depose aad say that I am
specifie 'On other side of this form, this day
hat I am not a
delivered to me by the Southern Express Comp any, fro ~ -- - - - -~ - - - -- by me
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
previeus
days
thirty
tlte
within
not,
have
I
t!Jat
and
order,
written
my
on
were brought into the State
in
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
approved
Virginia,
of
Assembly
General
the
of
Act
the
of
provisions
the
by
excess of the quantity allowed
own use, at
March 10, 1916, or cont rary to law, and that the ardent spirits so received by me ·are for my
.
law
of
violation
in
used
be
not
will
spirits
ardent
said
tbe
at
tb
my own home, and
Consieneo.
Sworn to and subscribed before me,
.A11ent for Southern Express Compan y,
�SOUTHERN EXPRESS COMPANY
FORM 3TO•VA.
(Incorporated)
Affidavit No.
To
<.A.
Advance • to
Collect
Sh;pp,,4 6-~t:l :0,
,J ~
Add
Under charge
RECORD OF NOTICES
To Consionee
To Shipper ________ ____ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVBR)
,_
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
~TATE OF Vrnq rnu.,
COUNTY O F - ~ - - ~ - - - _ ; __ _
'It ('
I, l •
,.,f
'-, being duly sworn, depose a:ad say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, fro ~ -~---~--'----'--i'J ____,_(__'; th at I am not-!'
student or minor, and, if a female, I am the head of a family; that th~ ardent spirits so received by me
were brought into the State on my written order, and t'iat I have not, within tl10 thirty days previ1rns
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of th e General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that th e said ardent spirits will not be used in violation of law.
~
,+7,,,-::;_.,,___;,;.-i• _-r. .,. A
"'-,. ._.J<---+.(j):
~·~✓--~
~='- -'-'---'-'l---"'-"J_ _
F--1'==
Consh:neo,
this
,
.Aeent for Southern Exvress Comvsny.
�l'ORM 370•VA.
SOUTH ERN EXPRE SS COMP ANY
(Incorpor ated )
Affidavit No.__~ - -- -
RECOR D OF NOTICE S
To Consionee
To Shipper _ __ _ _ _ _ __ __ _ _ __ _
(OVBR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I , ----.-- - - - - - - - - -- - - - -- - - - - -, being duly sworn, depose aad say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form , this day
delivered to me by the Southern Express Company, from J(, I
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within tlae thirty days previeus
hereto, received any ardent spirits of any kind what soever, from any person or from any place wh atsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiri~s so received by me are for my own use, at
my own home, and that the said a.rdent spirits will not be used in violation of law.
( V.
Sworn to and subscribed before me,
this--7--day of
:I/. /-
/2:Fef
Ji
•
, 191
A11ent fo r Southern Express Company.
I
/2:
·Conshineo,
�F08M 370-VA.
SOUT HERN EXPR ESS COMP ANY
(Incor
por at ed)
Affidavit No._....,/..__ __
Ad vauree to
Coll ec t
RECOR D OF NOTIC ES
PREPAI D
J
To Consignee___ ___ ___.:. _z__."""'_____
_
To Shipper _ _ _ _ _ _ ____ __ _ _ _ __
AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE.
( OV IIR)
�AFFIDAVI T FOR ARDENT SPIRITS FOR PERSONA L USE
STATE OF VIRGINLA,
COUNTY OF-----=- =---===--.: :=-
I, - - - - --=----'=-- ~ - --'--- - - - - - - - , being duly sworn, depose a:ad say ihai
I am
the consignee of a cert ain shipment of ardent spirits, as specified on olher side of this form,
ihis day
l
delivered to me by the Southern Express Company, from _ _ _ _ ______ __ __
; th at I am not a
student or minor, and, if a female, I ain the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and · t ':Jat I have not, within tli e thirty days
previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from -any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my
own use, at
my own home, and that th e said ardent spirits will not be used i~ violation of law..
Sworn to and subscribed ·before me,
,,
this _ ___day o.___ _ ___ , 191_ .
.A i:ent for Southern Express Company.
Consh:neo.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(Incorporated)
LIQ 4,0R RECORD
Date;:
, ,_ ,Y·~ '1/1
.
1/
/
~ind of Ardent Spirits _ _.,/c.:v,::_'--"'== '~ ,!..l:.....&#d<;L- - - - - 'Amount
Way-Bill ~
/
i'~ ~
To
, I
2 h';r7
Date
.;l~,vt-fj,(/
Shipp~<l'<'\c4,,JU.
A., .
V ~·,. -2
•/
a
t
-
1-
,
)
J
191- / Affidavit
/
I
No._ -11'...
:2, ~"'--_I- l'
(,'f ~t('
Weight-~,,_
cr_ _ lbs.
/ l,I: ~
From /:, • , · UL
, ... ~-<,
. I"
C
191....::2
,------,---"-E--x'"'P""R""'E""'s..,.s""c""'a--A""'R,..G_E_s_ _.,....__•_d_d_ ' - .
~
Advau<'e • t o
CoUect;
.,4
PREPAID
COLLECT
Undercbar1e
I
RECORD OF NOTICES
/
To Consionee _ _ _ _ _ ____--11Ic.,;g."'~_,r..1~ ,-r4,..,.,--1
' !- --
To Shipper _ _________ _ _ _ __ _ _
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVSR)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR PERS ONAL USE
~TATE OF
VmmN U,
COUNT Y OF\+-,- ----''---- - _ ; _---=-- ----'--
l, ""-" --"- ---- ---- ---- -'~- ~------ , being duly sworn , depose aRd say that
I am
the consig nee of a certai n shipm ent of ardent
spirits , as specif ied on other side of this form,
this day
delive red to me by the South ern Expre ss Comp
any, from
l
;- that I am not ;1
studen t or minor , and, if a female , I am the
head of a family ; that the arden t spirits o receiv
ed by me
were broug ht into the State on my writte n order,
and that I have not, within tile :thii·ty days
previe us
hereto , receiv ed any ardent spirits of any kind
whatso ever, from any person or from any pmce
whatso ever, in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly ,o f Virgin ia,
approv ed
M_arch 10, 1916, or contra ry to law, and that
the arden t spirits so receiv ed by me -are for my
own use, at
my own home, and th at the said ardent spirits
will n t be used in violati on of law .
Sworn to and subscr ibed before me ,
this
Ai:ent for Southe rn Expres s Compan y.
ffi
Consieneo.
�..------ --- --SOUTHERN EXPRESS COMPANY
FORM 370-V A.
(ln <'orpo r ated )
LIQUOR RECORD
Date
M I jJ
19Lf
Affidavit No.
I
If
RECORD OF" NOTICES
To Consignee _ _ _ _ _ __ ___,.__,_...,,._ __ __
To Shipper _ __ _ _ _ _ _ _ __ _ __ __
AF"F"IDAVIT F"OR ARDENT SPIRITS F"OR PERSONAL USE.
(OVllR)
�Af'f'IDAVIT f'OR ARDENT SPIRITS f'OR
PERSONAL ,U ~E
I,
/
, being duly sworn, depo'se aRd say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side qf this form, this day
~
delivered to me by the Southern Express Company, from
\ that I am not 13
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have n ot, within tile thirty days previ•us
hereto, received any ardent spirits of any_kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or cont rary to law, and that the ardent spiri\s so received by me are fo r my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to an d subscribed before m e,
J1J,111~0/V\, a
.A i:ent fo r Southern Express Company.
/~
Consh:neo,
�SOUTHERN EXPRESS COMPANY
FORM 3T0•VA.
(Incorporated)
RECORD OF NOTICES
To Consignee ________ ~,__~~--- - - To Shipper _ _ __ _ _ _ _ _ __ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(ov • R)
�------ ------ ------- ------- ------~ ---~~------ .-..,<"=--AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I, _ ...,,:....,..~_ _.,__ __:____:c::..:.._:__!..__ _ _ _ _ _ _ _ , being duly sworn, depose alid say ihai I am
the consignee of a certain shipment of ardent spirits, as s~ ecified n other side of this form, ihis day
~
* '
delivered to me by·the Southern Express Company, from 1/~
"1 ',:,,-, h .-,,,
; t at I am not a
student or minor, and, if a female, I am the head of a family; that the frdent spirits so received by me
were brought into the State on my written order, and t11at I have not, within tile thirty days previ•us
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, i916, or contrary to law, and that the ardent spirits so received by me ·are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and s!¾bscribed before me,
this,:}./
day
o~f/
_✓~-Ai:ent for Southern Express Company,
Conshineo. _
�FORM 370•V A.
SOU THE RN EXP RES S COM
PAN Y
(luco rpora.
ted)
Arld
Under charg e
111
REC ORD OF NOT ICES
/;
~
To Consignee- - -- - -~-,..~
1---~
.,, - -fl()--~----'--4--.I"'- ., _ _
~ !f:
r
•
To Shipp er _ _ _ _ _ _ __
_ _ _ __ _ _ _
AFF IDAV IT FOR ARD ENT
SPIR ITS FOR PER SON AL
USE .
( OVER )
�AFFIDAVIT FOP ARDENT SPIRITS FOR
PERSONAL USE
I, ~.---- - - - - - - - - ~ - - - - - - - - - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specifie - on other side of this form, this day
delivered to me by the Southern Express Company, froM
· vvt--~ Y~ '
; that I am no~ a
student or minor, and, if a female, I am the head of a family; that th ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed hy the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirit.a so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
Conai1:nee.
Sworn to and subscribed before me,
thisJ - +day of- .....,__-'-- - , 1911
.
)
Agent, for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(Incorporated)
LIQUOR
---~~<;:--1"~'--'-"'----''--- - C.....:::-'---~-Date
7
RECORD
M-,1,-
Advan("e • t o
Collect
/
L...o~--
191-1 Affidavit No. __
PREPAID
Add
Undercbar1e
RECORD OF NOTICES
To Consionee _ __ _ _ _ _ ___,__,'---1----'--_,___ To Shipper _ _ _ _ _ _ _ _ __ _ __ _ __ _
,\F'FIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVBR)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
I, - - - - - - - - - - -- - -- - - - - - - - , being duly sworn,
depose a:ad say that I am .
the consigne e of a certain shipment Qf ardent spirits, as specified on
other side of this form, this day ·
delivered to me by the Southern Express Company , from ____ ____
____ __ ; that I am not a
student or minor, and, if a female, I am the head of a family ; that the
ardent spirits so received by me
were brought into the Stat_e on my written order, and tliat I have not,
within tile thirty days previeus
hereto, received any ardent spirits of any kind whatsoev er, from any person
or from any place whatsoev er, in
excess of the quantity allowed by the provision s of the Act of the General
Assembly of Virginia, approved
11:larch 10, 1916, or contrary to law, and that the ardent spiri\s so received
by me are for my own use, at
my own home, and that the said ardent spi rits will not be used in violation
of law.
I
Sworn to and subscribe d before me,
Aeent for Southern Express Company.
Consli:neo.
�SOUTH ERN EXPRES S COMPA NY
FORM 3TO•VA.
(Incorporate d)
Affidavit No. __,? :~.../' - - - -
Advanc-e1 t o
Co llect
PREPAID
RECORD OF NOTICES
To Consionee _ ____ __--#-c.L.'--""~ _,_4-- -+-- To Shipper _ ____ ___ ____ _ __ _ _
\.,
AFFIDAV IT FOR ARDENT SPIRITS FOR PERSON AL USE
.
\
,,
(ov • R)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
depose aRd say 1iha1i I am
I, - - - - - - - - -- - - - -- - -- - -- - , being duly sworu,
on other side of this form, 1ihis day
specified
as
spirits,
ardent
of
shipment
certain
a
of
e
consigne
the
_ __ _ _ __ that am not a
delivered to me by the Southern Express Company , from ____ ___
arden1i spirits so received by me
the
that
family;
a
of
head
the
am
student or minor, and, if a female, I
not, within t:110 thirty days previeus
have
I
1i'ia1i
and
order,
written
my
on
State
the
into
brought
were
or from any place whatsoev er, in
hereto, received any ardent spirits of any kind whatsoev er, from any person
Assembly of Virginia, approved
General
the
of
Act
the
of
s
provision
the
by
allowed
quantity
the
of
excess
by me lire for my own use, at
March 10, 1916, or contrary to law, and that the ardent spirhs so received
f
o---'flll:::!"~~:__::::::...::....:~~ - ·o~nl-v io~J~a=t1::..
d~i~n~·~
my nwn hnm, , ,nd th.t th• "id .,d,nl opidto will n~.t b6R~
Sworn 1io and subscribe d before me,
this1-.Lday o
/r
K
, 191 f.
Ai:ent for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
FORM 370-VA.
(Incorporated)
Affidavit
Kind of
No.1'4-----
~ Amount~l---(J
,,...___
;L:_ _
~w~~~-~41."#------
~---->.J..-.'F-- - --Date,.U~~.,._~l- 'f+-- - - - 1 9 1
Fro=~-~ldl,.,--~~!!'.LI;.L...l..:
. Add
Advrmre1 to
Collect
PREPAID
COLLECT
Underchor1e
RECORD OF' NOTICES
To Consianee _ _ __ _ ____+JL.J.L-~'----JL__ __
To Shipper _ __ _ _ ___ ______ __ _
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
,_· . .
(OVRR)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
PERS ONAL USE
I, ---- ''---'-....;_- -=--=-=-=-=~ =--'-- - - - - - - , b~ing duly sworn , depose aRd say that I am
the consig nee of a certai n shipm ent of ardent
spirits , as specif ied on other side of this form,
fais day
f
delive red to me by the South ern Expre ss Comp
any, from ___ ___ ____ _ _ __ ; that
I am not it
studen t or minor , and, if a female , I am the head
of a family ; that the arden t spirits so receiv ed
by me
were broug ht into the St ate on my writte n order,
and tliat I have not, within tke thirty days
previe us
hereto , receiv ed any ardent spirits of any kind whatso
ever, from any person or from -a ny place whatso ever,
in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law, and that the
ardent spiriis so receiv ed by me are for my own
use, at
my own home, and that the said ardent spirits
will not be used in violati on of law.
!f )hvt t
Sworn to and subscr ibed before me,
this /
l.
day of
/
Ji
I,
'._..._. . . . .
Conshrneo.
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(Incorpo rat ed )
LIQUOR
RECORD
Received a~~ ~~"3,,~:::_::.:__~ J ._ __:__ _ OatP~
w~
T
1
191 -/-
/ 3
-all,,//?'_
Shippe ( A / ~ /
&
Advanre • t o
CoJlect
A dd
Underc b ar1e
RECORD OF NOTICES
To Consignee _ _ _ _ _ _~ ,--~~~ ~"'--- - - - To Shipper _ _ _ _ _ __ _ ____ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
-·.
( OV BR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
STATE OF VIRGINU., '
COUNTY OF r
[l--r- /t,,t,.,
I, /
1 (
I ,
.J
the consignee of a certain shipment of ardent spirits,
, being duly sworn, depose aad say that I am
specified on other side of this form, this day
delivered to me by the Southern Express Company, f r o m ~ - - - - - - - - -- - -- ; that I am not!'
student or minor, and, if a female, I am the head of a family; that the ardent spirits s.o received by me
were brought into the State on my written order, and t'1at I have not, within tlae thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from ·any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly .of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me -are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw.
QI' :,
Sworn to and subscribed before m e,
f
Ai;:ent for Southern Express Company,
t,
/
I
r
7
Consiiineo.
�SOUTHERN EXPRESS COMPANY
FOAM 370-VA.
(Incorporated)
RECORD OF' NOTICES
To Consionee _ _ _ _ _ ___ ~~...r.::.¥'--fi ~-.1-- To Shipper _ _ _ _ _ _ ________ _ __
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
(OVIIR)
�AFFIDAVI T FOR ARDENT SPIRITS FOR PERSONA L USE
I am
I, - ---'---'---'----=---~-=:c._- _:c__-"---"-------'----'---=---=---:.....:---=-- - - , being duly sworn, depose a11d say that
this day
tlie ()Onsignee of a cerfain shipment of ardent spirits, as specified on ot her side of this form,
1
delivered to me by the Southern Express Company, from-M
ardent spirits so received "by me
the
that
family;
a
of
head
the
am
I
female,
a
if
and,
minor,
student or
previ•us
were brought into the State on my written order, and tl-iat I have not, within tlae thirty ·days
in
whatsoever,
place
any
from
or
person
any
from
whatsoever,
kind
any
of
spirits
ardent
any
hereto, received
approved
Virginia,
of
Assembly
General
the
of
excess of the quantity allowed by the provisions of the Act
own use, at
March 10, 1916, or cont rary to law, and that the ardent spirits so received by me are for my
.
law
of
violation
in
used
be
pot
my own home, and that the said.ardent spirits will
t
Conshrneo,
Sworn to and subscribed before me,
this
.A 11ent for Southern Express Company,
�SOUTHERN EXPRESS COMPANY
FORM 370-VA.
( Incorporated)
191
.Ad-.an<'ea t o
Collect;
.Add
U ude r ch a r1e
RECORD OF NOTICES
To Consianee ___ _ _ __ _ __,,____c......._ __ _
To Shipper _ __ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
( OVBR )
_ _ __ _ __ _ _
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
I, - - ~ - " ~ ----""=-----"-'--'-"'-'------'~ --==--- - - - - - , being duly sworn, depose aRd say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Exp1·ess Company, fro
t
at I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and t'1at I have not, within tile thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, ond th, t tho ""id "'dent spfrits
: sod in viol,tion low. ,
•i1a
..
Sworn to and subscribed before me ,
A2ent for Southern Exvress Comvany.
j
, ~c:_
Consi~neo,..,
�SOUTHERN EXPRESS COMPANY
FORM 370•VA.
(Incorporated)
RECORD OF NOTICES
To Consianee ________,~'--"'<-,- -+---- To Shipper ______ __ ____ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OV• R)
�--------------------- - - ------------·=-=-=-=-,=-~-- -----AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
b
~TATE OF # ~
COUNTY OF.
/.
~ ~,._,v,
'J-:lJ,~2/t:,; 1,/h~J
I
, being duly sworn, depose aRd say that I am
'
the consignee
of a certain shipment of ardent spirits , as specified on other side of this form, this day .
/_ r
I
•
delivered to me by the Southern Express Company, fromrV ?v? ,. 1.- - '~_, t• --; :hat I a m not \t
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and t'iat I have not, within tlte :thirty days previ•us
hereto, received any ardent spirits of any kind whatsoever, from any person or from -any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own hom e, and that the said ardent spirits will not be used in violation of Jaw.
-+
.J
Sworn to and subscribed before me, .
thi
dayofM.6---
, 191?2- .
Ai:ent for Southern Express Company.
Conshtneo.
�FORM 370-VA.
SOUTHERN EXPRESS COMPANY
(Incorporated)
RECORD
Affidavit
N
o._~c
____
Add
Undercharge
RECORD OF NOTICES
To Consionee _ _ _ _ _ __ __,<-l~- - -- - - - To Shipper
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OV• R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
~TATE OF VIRGI I.A, /.
COUNTY
~ -=---"------ . • ,
OF-l'-lt,,....._l".~C
, being duly sworn, depose aBd say that I am
,
{>I,
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
; that I am not a
f
delivered to me by the Southern Express Company, fro
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within tlae j;hirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of Jaw.
1
I
Sworn to and subscribed before me ,
this; _ _day of
, 191/ - .
&J,
/.l s;- /L, ..
.Ae:ent for Southern Express Company.
�FOAM 370•VA.
SOUTHERN EXPRESS COMPANY
(Incorporated)
Affidavit No ~ / /
\
RECORD OF NOTICES
To Consionee _____ ____~'-1-'"""-- - --
--
.."
{
To.Shipper _ _ __ _ __ _ __,__ _ _ _ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVBR)
�AFFIDAVIT FOR ARDENT SPI RITS FOR PERSONAL USE
I, ~~- - -~~- - - -- - - - - - -- - -- , being duly sworn, depose aiad say that I am
the consignee of a cert ain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, fro
/.
C
' ""
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and t!1at I have not, within tile thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of t he General Assembly of Virginia, approved
March 10, 1916,· or contrary to law, and t hat the ardent spirits so r eceived by me ·are for my own u se, at
my own home, and that the said ardent spirits will not be used in violation of law.
Sworn to and subscribed before Ille,
this /
C
day of_.__, _ _ _ 191
/'
, I
A11ent for Southern Express Company.
Consie-neo,
�FORM 370•VA .
Add
Undercb ar1e
RECO RD OF NOTIC ES
To Consignee - - -- - ---- -.~- --_.
""-- ---- To Shipper _ ___ ___ _ ___ __ _ __ _
. AFFID AVIT FOR ARDE NT SPIRI TS
FOR PERS ONAL USE .
: r
( OVB R)
..
�AFFIDAVIT FOR ARDENT S~IRITS FOR PERSONAL USE
~TATE OF VIRGINU.
COUNTY OF
.Jt. I"
~t--(:;Z
,
I, ~ / (
being duly sworn, depose aB.d say tha1; I am
the consignee of a certai£ shipment of ardent spirits, as. specified on other side of this form, this day
?✓tC
delivered to me by the Sout~ern Express Co~any, from~
,
.
( <•
;• that I am not a
student or minor, and, if a female, I am the head of a famP,Y; that the ardent spirits so received by me
were brought into the State on my written order, and iliat I have not, within tae thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of _the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March IO, 1916, or contrary to law, and that the ardent spirit.a so received by me ·are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
.,
Consh:neo.
Sworn 1;o and subscribed before me,
this _ _day of
1J/~
;(.191
�FORM 370•VA .
SOU THER N EXPR ESS COM PANY
(Incorp orated)
~:zs~: ()"'~
Xind of Ardent Spirits _ _~ ~1£J"'-""""-.L...--""'=e ,;,.-
- - --
Ship per~ (.).(, ,.,../ - 1:-">-D~
RECO RD OF NOTIC ES
To Consionee _ _ _ _ _ __ _ _,,___-"".-.- - - - - To Shipper _ _ _ _ __ _
AFFID AVIT FOR A,RDE NT . SPIRI TS
FOR PERS ONAL USE.
( OVBR)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
I , - - ~ - - - - -- -- - - -- - - -- - - - , being duly sworn, depose aad say that I am.
the consignee of a certain shipment of ardent spirits, as specified on ot her side of this form, t his day
; that I am not a
delivered to me by the Southern Express Company, from ~
student ·or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and t 1rnt I have not, within tke thirty days previtius
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of t he quantity allowed by the provisions of the A.ct of the General Assembly of Virginia, approved
March 10, 1916, or .contrary to law, and t hat the ardent spirits so received by me ·are for my own use, at
my own home, and that the said ardent spirits will n t ~e used in violation o law.
I
Consh:neo,
Sworn to and subscribed before me,
Ai:ent for Southern Express Company,
�FORM 370-VA.
Received at
LIQU?'~
R:CORDf
Date
,._
191-f
Add
Underchar1e
RECORD
To Consianee _______~ + ---",l'4'-----c'-1--4'....._- To Shipper ___ _ ____ _ _ __ _ __ _ _
AF'F'IDAVIT F'OR ARDENT SPIRITS FOR PERSO,!"'AL USE.
{OVBR)
�AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERSO NAL USE
I, _ .....," - - - - ---"'----'-- - ·-'---- - - - - - - - , being
duly sworn, depose asd say that I am
the consign ee of a cert ain shipme nt of ardent spirits,
as specifie d on other side of this form, this day
deliver ed to me by the Southe rn Expres s Compan y, fro
I
; that am not~
student or minor, and, if a female, I am the head of a family;
that the ardent spirits so receive d by me
were brough t into the State on my written order, and t~at
I h ave not, within tile thirty days previeu s
hereto, receive d any ardent spirits of any kind whatso ever,
from any person or from •a ny place whatso ever, in
excess of the quantit y allowed by the provisi ons of t he Act
of the Genera l Assemb ly of Vir.gini a, approv ed
March 10, 1916, or contrar y to law, and that the ardent
spirits so receive d by me ·are for my own u se , at
my own home, and that the said ardent spirits will not be
used in violatio n of law .
i
Sworn to and subscri bed before m e,
Ae:ent fo r Southern Exvress Comvany.
Consie:neo,
�Ad'Tanc-e1 to
Collect
RECORD OF" NOTICES
To Cons[anee _ _ __ _ __ _ --J,___.""----_.__ _ _ __
Add
COLLECT
UndeTcbaTge
To Shipper _ _ _ _ _ _ _ _ _ __ _ __ __
AF"F"IDAVIT F"OR ARDENT SPIRITS F"OR PERSON AL USE.
(ov • R)
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
I,
•/ I
, being duly sworn, depose aiad say that I am
the consignee of a certain shipment of ardent spirits, as specifie
ot her side of this form, this day
delivered to me by the Southern Express Company, from_---=--"===--'<-=-=:.:'--'-'----"'-- ; that I am not~
student or minor, and, if a female, I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and tl:iat I have not, within tlle thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, ·from any person or from any place wh atsoever, in
excess of the quantity al.lowed by the provisions of the Act of t he General Assembly .of Virginia, approved
March 10, 1916, or cont rary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violat ion of law.
Sworn to and subscribed before me,
this j _ _day
OL..C...c.L=..:.=:=....:.
.A~ent fo r Southern Express Company.
t
p.
C
.
I
�-~--·- --------~=~--------FORM 3TO•VA.
SOUTHER N EXPRESS COMPANY
(I n corporated)
Affidavit
""--~t&.-- No.,~2
EXPRESS CHARGES
COLLECT
To Consignee
Add
Undercbar1e
To Shipper _ _ _ __ _ __ __ _ _ _ __ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OVBB)
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
~TATE OF VIRGIN!£ ,
COUNTY OF /r& ('
j
A'r
I
1
----1
If
/
, being duly sworn, depose aB.d say 1.hai I am
t he consignee of a certain shipment of ardent spirits, as specified on other side of thi s form, 1.his day
delivered to me by the Southern Express Company, from_-=-..,=:.c- '--"--'-- _;_~--- i th at 1 am not !,t
student or minor, and , if a fem ale , I am the head of a family; t hat the ardent spirits so r eceived by me
were brought into the State on my written order, and t l:i.at I have not, within til e thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and t hat the ardent spirits so received by me are for my own use, at
my own home , and th at th e said ardent spirits will not be used in violation of law .
I
Sworn 1.o and subscribed before m e ,
l'}J--"
1
this _ _ _ day o~f_ _ _ __
, 191 ~
/2
.A l?ent for Southern Express Compa ny,
Consh:neo,
�FORM 370- VA.
SO UT HE RN EXP RE SS
CO MP AN Y
(Inco rpora
ted)
Affidavit No.,_ ,.-#
-- - - -
REC ORD OF" NOT ICE
S
To _Consignee __ __ __
___,..s...____,_-4--~ -- - - To Shipper
__ __ __ __ __
AF"F"IDAVIT F"OR ARD
ENT SPI RIT S F"OR PER
SON AL USE .
{OV • R)
__ _ __ __
�(
AFFIDAVIT FOR ARDENT SPIRITS FOR
~TATE OF VIRGINIA, /
/_c_ _,,._
~ (>-C
COUNTY OFr-'/
PERSONAL USE
______,___
J,,,__J/4 ~
,
'-
being duly sworn, depose aiad say that I am
on other side of this form, this day
ecified
s
as
spirits,
ardent
of
shipment
certain
a
of
the consignee
= ~T;
~~
that 1 am not ~
J;;-tf" ,_..., .
delivered to me by the Southern Express Company, from
student or minor, and, if a female, I am the head of a family; that the ardent spiritt to received by me
were brought into the State on my written order, and tliat I have not, within tlie thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from -a nY. place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spiriis so received by me are for my own use, at
my own home , and that th e said ardent spirits will not be used in violation of law .
I
f
1 ;,
,..
Conshtneo,
Sworn to and subscribed before me ,
t ~ (;_ _ , 191_
thisL Lda)'lof...,..._~
.
.A i:ent for Southern Express Company.
�l'ORM 370•V A.
SOUT HERN EXPR ESS COM PANY
( Incorpor a ted)
SPEC IAL LIQU OR RECO RD
Received at.----::a.,,..~J4 ~=-"""--=-- - - - ~ ~ ~
- -Dat e ~
RECO RD OF NOTIC ES
r
191-- J Affidavit No._.J.J -- - -
7f.,----
To Consion ee ___ __ __ __~...,#.....,'lf
---<- -- - - - - To Shipper_ __ _ _ __ _ ____ __ _ __
AFFID AVIT FOR ARDE NT SPIRI TS FOR
PERS ONAL USE.
;
(ovza )
.
�AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
l!TATE OF VIRGINIA.,,
COUNTY O F ~ - ~ -'~ ~-'--',.---"-~ - -
-
,&.../\
,4.,
- I,
I
!
/
, being duly sworn, depose aBd say that I am
the consignee of a certain shipJent of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from/
';
'-'
; that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and tliat I have not, within tlte thirty days previeus
hereto, ·received any ardent spirits of any kind whatsoever, from any person or from -any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly .of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law .
Jtl
t
.
Consie:neo.
Sworn to and subscribed before me,
this ___day OLf--== '---, 191_,
,'/'
Ai:ent for Southern Express Company.
�FOIIM 370•VA.
RECORD OF NOTICES
To Consionee
SOUDIER N EXPRESS COMPANY
(Incorporated)
To Shipper _____ ___ ____ _ ____ _
AFFIDAVIT FOR ARDENT SPIRITS f'OR PERSONAL USE.
(ovaa)
�AFFIDA VIT FOR ARDEN T SPIRIT S FOR
PERSO NAL USE
duly sworn, depose aad say that I am
I , - ~ - - - -'--- - - - - - - - -- - -- - -, being
ecified on other side of this form , this day
the consign ee of a certain shipmen t of ardent spirits M
,;H I
; that I am not a
~
t
f
t'.-/-L' I,
delivere d to me by the Souther n Express Compan y, fro
received by me
so
spirit~
ardent
the
that
famiiy1
a
of
head
the
am
I
student or minor, and, if a female,
days previeu s
thirty
tlte
within
not,
have
were brought into the State on my written order, and that I
ver, in
whatsoe
place
any
from
r
person·o
any
from
ver,
whatsoe
kind
any
hereto, received any ardent spirits of
d
approve
,
Virginia
of
ly
Assemb
General
t he
excess of the quantity allowed by the provisio ns of the Act of
own-use , at
my
for
are
me
by
received
so
spirit.s
ardent
the
that
and
March 10, 1916, or contrary to law,
in violation of law.
my own home, and th at the said ardent spirits will not be used
Conshineo .
Sworn to and subscrib ed before me,
this
t(
r:
I
Ai:ent for Southern Express Company .
�SOUTHERN EXPRESS COMPANY
f'ORM 370-VA.
-
'
j.'J
SPECIAL
~~:~;:> "= if "'i'
<
,.,.je,1..-6c
~ECORD
~,;_e. t, \.)
~ ~ &, Lh::. ._~Consignee
, ...;,.a
Kind of Ardent Spirits
N
~~
--.~ - ----,--.-:.,:~D a~e
Att;o,.;, , ,.
:I ,-...
~ - - - - -- - - -
Amount
)i..;{;
2
/
191
i;_,--
_
EX P RESS CHARGES
RECORD OF' NOTICES
lbs.
'-d
From N ~
PREPA I D
To Consignee _ __ _ __ __ __ __ _ __ _ _ _
¾
W~ ~L
A dd
Underc har1e
To Shipper _ _ _ _______ _ __ _ _ __
AF'F'IDAVIT F'OR ARDENT SPIRITS F'OR PERSONAL USE.
( OVJIR)
�---------- - ------------~------------------AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
~TATE OF VIRGIN!~ / ,,
COUNTY
o.,/? ~-
t.-
1, .,1
, being duly sworn, depose aRd say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
% '~'
C
delivered to me by the Southern Express Company, fro
t
-,: ,.
that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and t 1iat I have not, within tae thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the qu antity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own ·home, and that the said ardent spirits will not be used in violation of law.
·
Sworn to and subscribed before me,
,'
day of-'-'-~ ' __,(,_ _ , 191_ .
.Ai:ent for Southern Express Company.
Consi2neo,
�SOUTHERN EXPRESS COMPANY
F'ORM 370•VA .
(Incorpo rated)
~
Received
~
•
$
SPECIAL LIQU9_R, RECORD
Date~~ / t1
1917"
Affidavit
No._'#-/_O
~_
C o n s i o n e P . ~ ~~
Advanre 1 to
Collect
PREPAID
.Add
Underc bar11e
RECORD OF NOTICES
To Consionee ______~H'-"''--,~'---c,__ _ __
To Shipper ____ __ ____ __ __ _ __
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE.
(OV&R)
�r
AFFIDAVIT FOR ARDENT SPIRITS
OR PERSONAL USE
==_,______________________ , being duly sworn, depose aBd say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
4
~
delivered to me by the Southern Express Company, from
/i ", that I am not ,~
student or minor, and, if a female, I am the head of a family; that the ardent spiritslo r eceived by me
were brought into the State on my written order, and tl:Jat I have not, within tile thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March IO, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home , and that th e said ardent spirits will not be used in violation of law .
Consh~neo.
Sworn to and subscribed before me ,
this.{!_day
or~/:
-✓-~-,
1917- .
.A11ent for Southern Express Company.
�rORM 370•VA.
SOUTHERN EXPRESS COMPANY
(I nco rporated)
RECORD OF" NOTICES
__ ___ __ _ _ __ _
To Consionee ________,__ . . . , ~ - - - - - - - To Shipper ____ _
AFFIDAVIT FOR ARDENT SPIRITS F"OR PERSONAL USE.
( OVBR )
�--- - --
------
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE
~:::::~;%A
J~,: ~ ~
1
~
I, , •
,,
, being duly sworn, depose a11d say that I am
the consignee of a certain shipment of ardent spirits, as specified on .other side of this form, this day
',
delivered to me by the Southern Express Company, front
l-' t1fat I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, with\n tile thirty days previeus
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and t hat the ardent spiriis so received by me -are for my own use, at
my own home, and that the said ard ent spirits will not be used in violation of law.
Sworn t o and subscribed before me,
t his
r
day of
d { ,191.i - .
r
£
Ai:ent tor Southern Express Company.
Consi~neo,
�l'OIIM 370•VA .
SOU THER N EXPR ESS COM PAN
Y
(Incorp o rated )
Affidavit No.
;:1-
¥'
RECO RD OF" NOTI CES
To Consignee _ _ __ _ __ _ __ _____~,.,_.
.__ _ To Shipper _ _ _ _ _ _ _ _ _ _ __
__ _
AF"F"IDAVIT F"OR ARDE NT SPIRI TS
F"OR PERS ONAL USE.
(OVKR)
_
�AFFIDAVIT FOR ARDENT SPIRITS FOR
PERSONAL USE
I, ~ - ~ ~ - ~ - - - - - -- - - - - - - - - - , being duly sworn, depose a:ad say that I am·
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
/.re<,
C, that I a.m not a
delivered to me by the Southern Express Company, from VY'
t
student or minor, and, if a female, I am the head of a family; that the ardent spirits s.o received by me
were brought into the State on my written order, and that I have uot, within tl10 :thirty days previ•us
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in
excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
.
0c , /
Sworn to and subscribed before me ,
this~
day of
/r,vU-- , _191/ 7
.
W~v>~
.Airent for Southern ·Express Company.
I
Consi~J?eo.
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 10
Subject
The topic of the resource
affidavits
ardent spirits
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Linville in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (https://creativecommons.org/publicdomain/mark/1.0/)
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-005
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Linville
Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/60862cb71f64294f8f41d640a61bc59a.pdf
781b47df01413d64cb8a3fe42cbcd377
PDF Text
Text
Commonwealth of Virginia,
County of Rockingham, to-wit:
In the Circuit Court of said County:
The jurors of the Commonwealth of Virginia, in and for the
body of the County of Rockingham, and now attending the Circuit
.
at its . Sept a..l'...e.r.m 191 6 ,
,
.
Court of said county,/ UPUJ.'f 'TH.IHK
bATHS PRESENT, that FranK Fi t zwater
on the _ _ _ _ _ __ day of _ _ _ _ _1,. 916 , in said County , near
Dovesville , i n Plain s
11
a giste i all District , the sai d Distri ct be i ng
no li c ense territ ory"did unlawful l y sell to .I . L . Reedy , ardent sp irits ,
against the peace and dignity of the Commonwealth of Virginia.
UPON THEIR OATHS AFORESAID, BO
a ~~
- t
-f t-he Comm
This indictment is found on the testimony of _ _ _ _ _ _ _ __
,
witnesses sworn in Court and sent before the Grand Jury to give
evidence.
�Sept . ~e r m, 1 916 .
sell ing of arde nt s p iri ts
COM MON WEA LTH
vs.
Indic tmen t
Frank Fit zwat er
~
For Misd emea nor
A TRUE BILL
u
Forem an
!
Harr y k • . 0tri ie: kB r
Att y . fo _. ,c11e Jor•1 .
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 11
Subject
The topic of the resource
affidavits
ardent spirits
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to McGaheysville in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (https://creativecommons.org/publicdomain/mark/1.0/)
Format
The file format, physical medium, or dimensions of the resource
PDF
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-006
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
McGaheysville
Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/4922b1bf6091d3e7d1aa828b0254435f.pdf
a5990668f8e87ef96b81c6f75a2bff99
PDF Text
Text
��
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 12
Subject
The topic of the resource
affidavits
ardent spirits
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Melrose in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (https://creativecommons.org/publicdomain/mark/1.0/)
Format
The file format, physical medium, or dimensions of the resource
PDF
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-007
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Melrose
Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/3d19368e0c8c801b559e5e04bca66cbd.pdf
dc5f283cf6d1575b6bb2524e8e167152
PDF Text
Text
Form 743 10-1 6
·'vvells Fargo & Co
Express
.
Consig nee's Affida vit of Intox ~
~!:!:y O~~~~~
....
~
~
uor
SS j
I .............. ····•········•················
and say: That I am the
day deliver ed to me by Wells Fa rgo & Co
... .......... ······•···········-\-··········· ;
that I am not a s tud e nt or a minor, and, if a fem e, I am the head
of
a family ; that such ardent spirit s were Rh.pped on my written order .
and that I have not, within t. he t hirty days previou s hereto , receive d
any ardent spirit s , contra r y to l a w, a nd that such ardent spirit s
are for my own use at my own home .
thi s ...... .
................ day
��Form 743 10-1'6
'"V ells Fargo ,& Cp Express
Consignee's Affidavit of Intoxicating
.·
County
i B, .
'
J#
)
.. ············t r:;......
)
,,,,-....
ss i
..
..
e:;vr~-4
/ fi
·quor
~
,
~
,l
lJ
I .. .............. ..... _. .. ..........,:. ....! . . i ... ../: :". ................. .... ... being duly. sworn, depose
and say: Tha~ I a
th~ consigne e o f a shipment of ardent spirits th i s
/.~~~
~ ~
day delivered to me by Wells Fargo & 'Co fr ~m.....
......... ...... ............. ;
that I am not a s tudent or a mi nor, and, ir a femaYe, I am the he a d o f
a family; that such ardent spiri t s were ~hipped on my written order
and that I have not, within the thirty days previous hereto, received
any ardent spirit H, c ontrary to law , a n d that such ardent spirits
are for my own use at . my own home .
.. .... ,Q. .
Consignee.
.
f
.. .............day
1-I7
Sworn to and subsc r ibed befor e me thi s .....;;:_:··············!-·········,..
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· Agt. for Wells Fargo ~ ~co
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Form 743 10-16
Consignee ' s Affidavit o f In toxic~tin
State of V
in
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·... ... ., ./ .... ~
:................... .....................being duly sworn, depose
and say: That I am he consigne e o f a s hipment o ardent spirit s this
'47'
day delivered to me by Well s.. Fa r go & Co f rom ../.0......................
~ hat I am not a s t ud en t or a minor, ~ n d, if a fem
I am the he a d of
a family; that such ardent s pi rits we re s hip p ed on my written order
and that I have not , wi t hin the thi r ty days previous hereto, rece ived
any ardent spirits , c ontrary t o law, a n d that such ardent spirits
are for my own use at my own home.
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-----··········-·-·-··········--------,----- ---.;,,~- ····#····- .. ./'!
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Form 743 10-1 6
Con sign ee' s Affi davi t
Stat e of /{2
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and say': Tha\ ··· ... ~~ ·\,-b~---~-~-~ ;·i~ n e e o f a s hip:
; : f d; [rds: ;:;ns, p:re· ptsse
from j~ -~ --
day deli vere d to me by Well s Fa r go & Co
that I am not a s t u d e nt or a min or , and
, if a fema le, I am the b ead of
a fami ly; that such a r dent s piri ts were s
hipp ed on my writ ten orde r
and that I have n o t , with in the t hir ty days
prev ious here to, rece i ve d
any arde nt spir it s, c ontr ary to l aw, a nd
that such arde nt spir its
are for my own use at my own home .
s u bscr ibed
�.
.,,
•
�Form 743 10-16
'"Vells Far go & Co Express
Cons ignee 's Affid avit of -Intox icatin g Liquo r
State of Virgi nia, )
Count y o~... :............!...!......... ~ ss !
iJ
I .......':':........ ./1.. .........~...:.... ~ ..
t
/
~·•····· · v --••~·! .. L ............ .being duly sworn ,
depo s.e
and say: That I am the consi gnee of a shipm ent of arden
t spiri ts thi s
day deliv ered to me by Wells Fargo & Co from ..... •······ ·········-r·
·__(.·· .. ...... ....... ... ......... ......... ...... . ;
that I am not a s tuden t or- a mino r, and. if a fe ale,
I am the bead o f
a famil y; that such arden t spiri ts were ~hipp ed on my
writt en order
and that I have not, withi n the thirt y days previ ous
heret o, recei ved
any arden t spiri t ~ , contr ary to law, and that such arden
t spiri ts
are for my own use at my own home.
I
Consi gnee.
Agt. for Wells Fargo & Co
•
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�Form 743 10-16
\V ells Fargo &_ Co Express
Cf nsign ee' s Affid av i t of
State of JV, /
Count y 'Q.t'...L
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I ...... ..... -···············:·.. ·············· · ....t ...... !. ..~..................being duly sworn , depos
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and say : That I am t he consi tn e e o f a s hipme ~ , of arden
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spiri
ts
t his ,~
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day deliv ered to me b y Well s Fargo & Co f r olll.,.~,
...'.... J..... .L,..../ ... ...........h ..... ~ ....... ····~·-······;
that I am not a s t u de n t or a mino r, a n d, if a femal
e , I am he he ad of
a famil y; that s u c h a rdent spi rits we re shipp ed on
my writt erV ord e r
and that I have not , withi n th e thirt y days previ ous
heret o, recei ved
any arden t spiri t s, contr ar y to law, and that such
arden t spiri ts
are for my own use at my own hom e .
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Sworn to and subsc ribed befor e me thi S .....
..... ·~·········r ····· ......... ········: 5-········· ····day
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Agt. for Wells Fargo & Co
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��·Form 743 10-16
'"V ells Fargo & . ~o Express
. "
Consignee's Affidavit of I ntoxicating Liquor
/
State of VJirginia , )
County o:f. ...........................;;: ss %
I/
.
.
I
I ..............~ ...............................;:..~ ......... ~ ....,............. being duly sworn, depo s e
and say: That I am the consig n e e of a shipment of ardent spiri ts th is
day delivered to me by Wells Farg o & Co from ................................. ... ,.. .. .., .~ ......................... ;
that I am not a s t u den t or a minor _, and, if~ fema i e, I am th~ h ead o f
a family; that s uch ard ent s pi rits were s h i pped on my written order
and that I have n ot , wi thin t h e thi rty days p revious her~to, re c eived
any ardent spirit R, c ontrary to law , and that such ardent spirits
are fo r my own use at my own home.
>1-
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~2...........Ir;,,,·························· ····················································
--..------- .---... ---··········-·······---------- ........... ········.... --- ...·--...........----.
~
Agt. for Wells Fargo & Co
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Co ns ig ne e' s A ff id av
it of
St at e
SS !
I ..... ....... ~. .!. .... 1. ..... .... ..........
...... .......................be in g du ly sw
an d sa y: Th at I am
or n , de po s e
th e co ns g n e e o f a
s hi pm en t of ar .en t
sp ir it s t h is
da y de liv er ed to me
b y W ell s Fa rg o & Co
fro m ..... ..... .
th at I am no t a st u
de nt o r a mi no r , an
d, if a fe ma l
a fa m ily ; th at s uc h
a rd en t sp ir i ts we re
s hi pp ed on my
an d th at I ha ve n ot
, wi th in th e th ir ty
da ys pr ev io us he re to
an y ar de nt sp ir i t s,
, re ce iv ed
co nt ra ry to law , a n
d th at su ch ar de nt
ar e fo r my own us e
sp ir it s
at my own ho me .
/4.. . . . . .
be fo re me
of
��'..Vells Far go & .,Co
Express
.
Form 743 10-1 6
Cons ignee 's Affid avit of Into xica ting Liqu or,,;
;
~!:!:Y o~~
~-~~ '.J s;
-4./4. .l/.L. ... .....~...~.. .
}1{7J
fj;7,- () / (
I .............
·~··•······~···········b eing duly swor n, depo se
and say: Tbai I am the con ~ gnee of a shipm ent
o arde nt spir its thi s
day deliv ered to me by ; ells Fargo & Co from./
............ ., .... .."'."." . ... , ......~.·-·······~······•······ ···· ;
· that I am not a stud ent or a mino r, and, if
a f male , I am the he ad of
a fami ly; that such arde nt spir its were shipp ed
on my writ ten orde r
and that I have not, with in the thi r ty days prev
ious here to, rece ived
any arde nt spir its, co n trary t o l aw, and that
such arde nt spir its
are for my own use at my own home .
Swor n to ~nd subs cribe d befo re me
0
..., ....i
f ············ ··········· ············· ··························· ······'
�•
�'"Vells Fa rg o & Co ~Express
Form 743 10-16
Co nsi gne e's Aff ida vit o
Sta te of Vir gin ia,
Cou nty
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cz········) s ,()?
ot: ...............
c..9. . .....·..
I .......
e...............' ........................... ein g dul y swo rn, dep ose
and say : Tha t I am t b e con sig ne
e of a s hip men t o
rde nt spi rits t his
day del ive red to me by Well s Far
go
:...... ...... ............... L.\..... ;
tha t I am not a s t ud e n t or a min & Co f'rom ... ................f ... ~
or , and , if' a fefu ale , I am the
a fam ily; tha t suc h ard ent s pir
h ead o f
i ts we re shi ppe d n my wri tten
ord e r
and tha t I hav e not , wit hin th
e t h irt y day s pre vio us her eto ,
rec eiv e d
any ard ent spi ri ts, con tra ry t
o law , and tha t suc h ard ent spi
rit s
are for my own use at my own hom
e.
f .....
Swo rn
"tin ~ sub scr ibe d bef or e me
of ....................................................... ............. , 191
/
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r
r We lls Far go & Co
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�\V ells Fargo & Co Express
O
Form 7 4 3 10-16
State
and
is
day delivered to me b y Well s Farg~ & Co from ...................... ... .. ... ~ .1/.. ............:............... ; ,
that I am not a s t uden t o r a minor , an d , if a fem e, y am the head of
a family; that such a rd en t s p iri t s were s hipped on my wr i tten ord er
and that I have n o t, wi thi n the thi r ty days previous hereto, rec eived
any ardent spirit s, riontrary to l a w , a nd that such ardent spirits
are fo r my own use at my own home .
1
Sworn to and sub s cribed befor e me
0
.~y4'.W.. ......
,
191 7
I
Agt. for Wel s Fargo & Co
��\Vells Fargo &_Co Express
Form 743 10-1 6
State of Virginia, )
County o f' ..............................r)
I .......................................................................................being duly sworn , depose
and say: That I am tbe consignee o f a shipme
ardent spi r. its
1.L.., ·-·-·· .......,-...,. ....................;
day delivered to me b y Wells Fargo & Co from ... ..._. ...
that I am not a s tud ent or a mi nor, and, ·r a female, I am the h ead of
a family; that such a r dent spiri ts wer e shipped on my written ord e r
, and that I have not, within the t hir t y days previous hereto, rece ived
any ardent spiri ts, con tr a ry to law , and that such ardent s p irits
are for my own use at my own home .
. ..... . . ..& . . . . . . . . ... . . . ... . .. . . . . .... . .... . .. . .... ... . .. .
Consignee·.
Sworn to and subscribed befo re me
,
-
-,
of ....................................~........... ............. , 191
.
��
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 13
Subject
The topic of the resource
affidavits
adrent spirits
personal use
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol to Mount Crawford in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Rights
Information about rights held in and over the resource
This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (https://creativecommons.org/publicdomain/mark/1.0/)
Format
The file format, physical medium, or dimensions of the resource
PDF
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-008
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Mount Crawford, Virginia
-
https://omeka.lib.jmu.edu/erp/files/original/c1cf01f5b1d5778b4fc0b5aae81c0e29.pdf
d06a18b2719914bab5f45374e1aaeaed
PDF Text
Text
. ·
---~~-·~-~~-~~~--·---·-.......·~-~-~-
Form 746 8-17
Wells Fargo & Co Expres~
SPECIAL LIQUOR RECORD
Received at.- - -- -- - - - --Date
: ; a r•ch
~p.,_r,_.,_O_p_ 0. Addres
_ r_U
, _ _A_V_i_s_'~t__D
Consignee _ _J___f_
Kind of Ardent Spirits
Way-bill No.
al ~n ho 1
5(Hl1
Date
Advances
to Coll ec t
To
Shi pper
P.
o.
191- From
PRF PA 1D
AddresJ
I
I
RECORD OF NOTICES
T o Shippi,r
To Consigne
,
(OVER )
_ _
,,~..,,r
1;W Jight-1S__lbs.
al t.:.·TJoce, ' [d
l~l~
E X PRESS CHARGES
.\Iutl1 llros
al ti.more, hl' d
t;ity
41 / :1
Amount
ar 711 p.
l_
Affidavit No, __
O /b.91...._
r? i,:;
WarTax
Add
Coll ec t Undercharge
I o-t
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STATE O F Y ! RG INf A•
COUNTY OF
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- . I . ~ - ---~-~ _:~'-~,!___ , being duly sworn, depose and say that I am
I
the consiine'e of a certain shipment of ardent spirits, as specified on other side of this form, this day
11
delivered to me by Wells Fargo & Co Express, from I?; I'.<
i..{ L \,
1tr.;f that I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so ' received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from · any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approve d March 10, 191 6, or contrary to law, and that the ardent spirits so received by me are to be .
ff,
used h y me fo r
,,;
• •
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(St ate whether for Scienti fic , Sacram ental, Medicinai!o r Mechanical)
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Witness :
I
pu rp,Jses.
t l( _J
(Sig nat ure of Con signee)
�f"0RM 370-VA .
Revised J une . 1917
iot!JfrFJERff.~EXPR ESS
Well s
r
r
si E
Received at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Datf
L • H• 0 t t
Consignee
Kind of Ard ent Spirits
F eb .. 1 s t
To _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ __
191..g...
'
Advances to
Collect
Shipper
Cl t.j I
47 /8 Gal
P. 0. Address
_ _ _ __ Quantity
__ Date
.,1 U th hro s Co .
I
P. 0. Add ress ___ ___ __ _ _ )_,_ _ _~~
RECOR D Of" NOTICE S
To Consignee
1
191_. Affidavit No._ _ _
___
eb 7 /l S •
rug Co
1 coli O 1
Way- Bill No. _ _ _5_4
_ g_9_
COM PANY
O
(Incorpora ted)
IAL LIQUO R RECO RD
To Shipper
,
(OVER)
I
I
From
Weight~_ _ _ lbs.
!..- , ~- •
EXPRESS CHARGE S
PREPAID
COLLECT
I
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_,
Add
U ndercharg e
I
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�STATE OF VIRGINIA,
I,
,::_, /-~.
,·being duly sworn, depose and say that I am
the consignee-'ol a ce rtai n shipm ent of arde 't spirits ; as specified on ,other side of this form, this day
--
delivered to me by the Southern Express Company, from I J
f -,
; that I am not
a, student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, rEceived any ardent spirits of any kind whatsoever, from e.ny person or from any place whatso·
ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
) '1, c "I· .
J
--; ,
,
...:_
urposes.
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
Consi2nee.
Sworn✓t
and subscrihed before me,
,✓_;..,.---
/
this__day o_ _ _ _ _ , 191_.
}.
Aeent for Southern Express Company.
�FORM 3 70 - VA .
Revised J nne, 1917
S OUTH ERN EXPR E SS COMP ANY
(Iu co rpore.ted)
SPECIA L LIQUO R RECOR D
2 ~/ jlg
Received at_· _ _ _ _ _ _ _ __ _ _ _ _ _ _ Da te
Consio nee _ _
T_._ _ll_•_ _C_l_a_ t_t_e_r_b_u_c_k_
~ -Affidavi tNo. _ __l_ ___
___ ___ p, 0. Ad dress _ _ _l_t__l ___ _ _ _
Way-Bill No._ _~g
~___ _ Date _ _---'-2-'-'/~ 'l___ ___
To_ _ _ _ _ _ _ __ _ _ __ _ _ __ _
Sh ipp e1:- hilon
Advances to
Collect
LObe u-~ S
~ o=n~ - -- -
I
P. 0. Add ress ____ ____ _ _ _ _ _ __
RECORD OF NOTICE S .
To Consignee
To Shipper
(OVER )
EXPR~JSS CHARGES
J>Rll:PAID
I
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COLLECT,
129
I
Add
U udcrcharge
Taf 02
�I,_.,_ _,__~ -~--- ---~ - -- - +---- - , being duly
sworn , depose and say that I am
the consign ee of a. certain shipmen_t of ardent spirits, as sp
ified on other side of this form, this day
f;
delivere d to me by the Souther n Express Compan y, from •/.
'• ' . _
\
that I am not
a student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by me
were brought into the State on my written order, and that
I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoever, in excess of the quantity allowed by the provisio ns of the
Act of the General Assembl y of Virginia ,
approve d March 10, 1916, or contrary to law, and that the ardent
spirits so received by me are to be used
by me for
, I '
(State whether for Scientific, Sacramen tal, Medicinal or .Mechanic
al)
purpose s.
I
! •
\
Consi2nee .
�F"ORM 370-VA.
Revised June, 1917
SOUTH ERN E~PRE SS COMP ANY
(In corporated)
SPECIA L L QUOR RECOR D
(
Co~.sip ·1e~.~--- ------- --'---- '--=--- --=-... :._---'"'f', 0. Address,,__
_ _ _ _ _ _ _ _...:,___ _
Kind oi Ard ent Splrits _ _w
~ h_s_ i _k_y
~ ----,---- ---,---,-- Ouantity _ _ _l_q
_ t____ _ Weigh~4___ ibs.
3 85
J an 2 3 /1 8
u 8 _gers
to,m
Way-Bill No.
Date
191 _. Frnm
_ _ _ _ _ _ _ _ __
To _ _ _ _ _ _ _ __ _ __ _ _ _ _ __ _
}~XPRESS CHARGES
Advan ces to
Ad d
Collect
PREPAID
Undercharge
I COLLECT
Ship11iro~o~ r~e ~ ~ E~ - - - - -- - - - - P. 0. Address _ _ _ _ ____ ____ ____
I
I
RECORD OF" NOTICES
To Consignee
To Shipper
(OVER)
I I
rd
I
�COUNTY
I,.L.- ==-- ------ -_._- -"--- ==-- ------ ---~
the consig nee of a certain shipi;p ent of ardent
deliver ed to me by the Southe rn Expres s Compa ny,
from -~~ -~-~ ---~ ---i that I am not
a studen t or minor, and, if a female , I am the head
of a family · that the ardent spirits so receive d by
me
were brough t into the State on my written order,
and that I ave not, within ~he thirty days previo
us
hereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quanti ty allowe d by the provisi
ons of the Act of the Genera l Assem bly of Virgin ia,
approv ed March 10, 191 OJ contra ry t6 law, and ·that
the ardent spirits so receive d by me are to be used
by me for
State whether for Scientifi c, Sacrame ntal, Medicin
al or Mechani cal)
purpos es .
�FORM 370 - VA .
R evised J u ne, 1917
SOUT HEit :N EXP RES S COM PAN Y
( I nco r porat ed )
SPEC I AJ_ LIQU OR RECO RD
Received at _ _ __ _ __ ___ _ _ __
Consionee ___ _.J_.__J_._
Kin d of Arde nt Spirits
l_i'_r_Y
_·_e_,_ ___
Date _ _e_C
_· _•__
2_4_/~ ~ 1~ . Affidavit No._ ~ "'-"-- - __ __ __p, 0. Ad dress I arr ioo n bur g:,
vhis _k_y___ __ _~__ _ Quantity_ _ _ _l~ q~
t__ __ Weigh
Way-Bi ll No. _ _ 23
_ _ _ _ __ Dee
lfate 21/1 7 •
To _ _ _ _ _ _ _ __ _ __ _ _ _ _
__
Shipp er
Fra nk O' Lau gh lin
P. 0. Add ress _ _ _ __ _ _ _ __ _ __
_
RECO RD OF NOTIC ES
To Co nsig nee
191 _ .
.Advanc es to
Coll ect
EXPRE SS CHA RGES
PREPA ID
I CO l,LEC'l'
I
I
To Shipper
I
4
lbs.
Fro mP
nt,_ _ __
_iec:"
_ _1.mo
___
I
I
Add
U nderch arge
130
1'a.,,
I
a,
�., .Y OF
!!A
,
/(;C:
1\
1
I
'
•
f '
the con~ign ee, of a cer,ain shipme nt
, being duly sworn, depose and say that I
am
rdent spirits, as spec· ed on other side of this form, this
day
eel tte .
delivere d t me by the Southe rn Expres s Compan y, from
'
l_ ; that I am not
a student or minor, and, if a female, I am the head of a
family; that the ardent spirits so receive d by me
were brough t into the State on my written order, and
that I have not, within the thirty days previou s
hereto, receive d . any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quantit y allowed by the provisio ns
of the Act of the Genera l Assemb ly of Virgini a,
approve d March 10, 1916, or contrar y to law, and that the
ardent spirits so receive d by me are to be used
by me for
7·, '
.
_
(State whether for Scientific , Sacrame ntal, Medicina l or
Mechanic al)
Sworn to and subscri bed before me,
tbis_ day o ~ - - - - - , 191_.
Apnt for So~thern Express Company .
urposes .
Consie-nee.
�f"0RM 370-VA.
Revised June, 1917
SOUTH ERN EXPRE SS COMP ANY
( In corporated)
SPECIA L LIQUOR RECOR D
2 fli i1: 7 ." AllidavitNo.,_-----'C--- - Nov•
Consignee ___J_ .__
A_.__M_o_u_s_e~,____ ____ __ P. 0. Address ____ ____ __ _ __
Kind of Arde nt Splrits _ __,w~h....s-i,zky..,._____ ____ Quantity
l'a t
WeiohtL___;::,:.___
Receivedat _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date
Way-Bill No., _ __ 4
_ 6_ _ _ Date _ __:1=.:!:1!./..:.2~6~
To _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ __
Sh ipper
N.
s.
Muns_o_n___ __
===~1~9~1==:~~a/lc
~ ro~~~r~s~t~o~wn
~ :::;:::-;;E.~~:=
Advances to
Collect
EXPRESS CHARG~S
PREPAID
P. 0. Address _ _ _ __ ____ ____ __
RECORD Of" NOTICES
To Consignee
To Shipper
49
(OVER)
�I
STATE OF VIRGIN IA,
'
I,
the consign ee of a certain shipme n
//
1
0./\
:::=::::::-;- being duly sworn, depose and say that I a
of ardent spirits, as specifie d on other side of this form,
this day
'
delivere d o me by the Southe rn Expres s Compan y, frozp'. /
I
,2.
; that I am not
a studen1 or minor, and, if a female, I am the head of a
family; that the ardent spirits so receive d by me
were brough t into the State on my written order, 1.nd
that I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatso
ever, froin any person or from any place whatso ever, in excess of the quantit y allowed by the provisio ns
of the Act of the Genera l Assemb ly of Virgini a,
approve d March 10, 1916, or contrar y to law, and that the
ardent spirits so receive d by me are to be used
Sworn to and subscri b d before me,
this J _day of~_/_ _
c--.A
~, };_9Y7
I
/{
V
-
�FORM 370-VA.
Revised June, 1917
SOUTHE RN EXPRESS COMPAN Y
( I uco r porated)
SPECIAL LIQUOR RECORD
OCt • 3 / 1 791_. Affid avit No._ _ __ _ _
J_ ._ _\_'_•__C_C
_a_r_y~ ,_____ _ p_ 0. Address _ _ _ _ _ _ _ _ _ __ _
Received at._ _ _ __ _ _ __ _ _ _ _ _ _ _ Date
Consionee _ _ _ __
Kind of Arde nt Splrits_----"
W'-"h-"'-"'
i '-"s""k= .i
l - - - -- - -- - Ouantity
l ot
Weioh ~ 4_ _ lbs.
Way-Bill No, _ __ -1. .1c._9
..,__ _ Date _ _ ..,,lec0cc.,../_:J.,___ _ _ __ 191_. ~~ ~ers tm,n M4
To _ _ _ _ __ _ __ _ _ _ _ __ _ _ _
EXPRESS CHARGES
Advances to
Add
Collect
PREPAID . I
U ndercharge
COLLECT
M
oor
e
&Eransh
aw
Shipper _ _ _ _ _ _ __ _____ ____
; I
I
I
P. 0. Address _ __ _ _ _ ______ _ __
RECORD OF NOTICES
To Consi gn ee
To Ship pe r '
49
/
(OVE R)
I
I
128
I
�V
.
, .,.
}:}' 'fa
I,
the cons·
shipment of a:fdent spirit
/ ·
7-being duly sworn, depose and say that I am
as sp~ ci d on other side of this form, this day
~
·~
~-~-
~
delivered to me by the Southern Express Company , from
,
, ,,
-~
; that I am not
7
a student or mfnor, and, if a female, I am the head of a family;
tliat the ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty days previous
hereto, r6ceived any ardent spirits of any kind whatsoev er, from any
person or from any place whatsoever, in excess of the quantity allowed by the provision s of the Act of
the General Assembly of Virginia,
approved March 10, 1916, or contrary to Jaw, a~ ;hat the ardent spirits
so r eceived by me are to be used
by me for
~
l
1,
I
•µU
t
(State whether for S cientific, Sacram8nt al. Medicinal or Mechanica l)
Sworn to and subscribe d before me,
A11ent for Southern Express Company.
urposes.
�FORM 370-VA.
Revised Jnne, 1917
SOUTHER N EXPRESS COMPANY
(I nco rporated}
SPECIAL LIQUOR RECORD
t •_ _
1 C_ _ 191_. Affidavit No. _ _ _ _ __
Received at ______ _____ _ _ _ _ _ Oate _ _ _
Consionee _ _ _J_ a_c_ o_b___
A_ l_J _a_r_ t _x_ _ _ _ _ _ _ _ P.
o. Address _ _ __
Kind of Ard en t Splrits____
w_h_s_ i_k_.c,_y__ _____ Quantity _ _ _ _ _ _l_
_ _ _ _ _ _ __
. _, t__ Weioh ~_4._ _ lbs.
Way-Bill No, _ _
C_____ Oate_ _ _ _J'----0_,/__1_ t ___ 191_. FromWashin t; ton
To _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ __
EXPRESS CHAUGES
Advnnces to
Add
Collect
Shipper _ _ _C
_ o_n_r_a_~c_l _P__a~g~e__C_o_ __
l
P. 0. Address _ ______ _ _ _ _ _ _ __
RECORD OF NOTICES
To Consign ee
To Shipper
(OVER)
PREPA ID
I
COLLECT
I
I
I
I
I
Pd
U nderc harge
I
�STATE
COUNTY
'h {I ~
I,
({
<
, boing dnlyswo, (},,,., &nd s,y th•t I &m
the consignee of a certain shipment of ardent ~ a s specified on othe side of this for£, this day
delivered to me by the Southern Express Company, fro
v
1/ /. ,,
r' ~ at l '1tm not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits ~so receiyed by me /
were brought into the State on my written order, and that I have not, within the' thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved ;¥a-rch , 1916, or contrary to law, and that the ardent spirits so received by me are to be used
(
by me for -'--L-->.E=---""=--..,'-="--""'c...::,:= - -- - - - - - - - - ----PUrposes.
)
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
I
�F'OR M 370-VA .
Revised J u ne , 1917
SOUTH ERN EXPRES S COMPA NY
( I nco r po rn.t ed)
SPECIAL LIQUOR RECORD
Receivedat _ _ __ _ __ __ _ _ _ _ _ _ _ OateOOt •
Consignee _ _ _W
_ a_r_d___E
_i'_ -ll_:V
~
. _e_I_.._s_,.___
/
13 / 1
_ ____ p, 0. Add ress _
Ki nd of Arden t Sp lrits _ _ _~ ~- - - -- - - - - -0 uan ti ty
Way-Bill No. _
_ _ __ _ _ Oate
10/13
To _ _ _ _ _ __ _ _ _ _ _ _ _ __ __
s.
~Junson
Sh ippe r _ _ __ _ __
_ _ _ _ _ _ __ _ _
_r ..
/
Fro nf
Weig ~~ - --lbs.
a,;erst won
EXPRESS CHA RGES
P REPA ID
I COLLECT
Add
U nde r c h a r ge
I
I
P. 0. Add ress _ _ _ _ _ _ _ _ _ _ __ _ __
I
RECORD OF' NOTICES
To Consignee
_ _ ____~ - - - -
l "1 t
191_.
Advnuccs to
Collect
J/
1 1'9 1_ . Affidavit No.~
To Shipper
49
(OVER)
I
I
I
8
I
�~
---.-~----=
STATE OF V1 ? ~
COUNTY OF
'.
t1
j/
L- 1c
,b
1
f
(
I
I,
I
t
, being duly sworn, depose and say that I am
the consigne e of a certain shipment of ardent spirits, as specified on
other side of this form, this day
delivered to me by the Southern Express Company , from _ ,
1
/7
/
; that I am not
a student or minor, and, if a female, I am the head of a family; th f t the
ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any
person or from any place whatsoever, in excess of the quantity allowed by the provision s of the Act of
the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are to be used
by me for /
/
.I
(
/,
(State whether for Scientific, Sacrament al, Medicinal or Mechanica l)
urposes.
Consi2nee.
L
�FORM 370-VA .
SOUT HERN EXPR ESS COM PANY
Revised June, 1917
(I n corporate d)
SPECI AL LIQUO R RECO RD
Received at _ _ _ _ _ __ _
A.
/
O t . 4th '1aF •. Affid avit No. _
_ _ _ _ _ _ Date
Rho des ,
Consignee _ _ _ _ _ _ _ _ _F
_._ _ _ _ _ _ _ _
~ _ ~ :___
_ _ P. 0. Address, _ _ _ _ _ _ _ __ __ _
_h_s_i_k~y~ _ ____ __Quantity _ _ _ _ _ _t___
No., _ _ _ _l_7_9__ Date
10/~ flll_.
Kind of Ard ent Splrits_ _ _ _
W_.
Way-Bill
To _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _
N
_o_rm
__a_n_ __S_ ,_ u_n_ s_o_n__
Advances to
Col lect
Shipper _ _ _
I
COLLECT
I
l2s
I
I
P. 0. Ad dres s----- - - ·- -- - - -RECOR D OF NOTICE S
To Consignee
EXPRESS CHARGE S
PREPAID
To Shipper
(OVER)
I
I
Add
Underc harge
I
�k2
STATE OF VIRGINIA ,
I
V.
_, ___ t
COUNTY. OF~ _ _ _ _ _ _
cl
I,
/ ,
r
, being duly sworn, depose and say that I am
the consigne e of a certain shipment of ardent spirits, as specified on
other side of this form, this day
delivered to me by the Southern Express Company , from
,,.
I r- :.i that I am not
a student or minor, and, if a female, I am the bead of a family; that
the ardent spirits so received by me
were brought into the State on my written order, and that I h.i've not,
within the thirty days previous
hereto, received any ardent spirits of any kind whatsoev er, from any
person or from any place whatsoever, in excess of the quantity allowed by the provision s of the Act of
the General Assembly of Virginia,
approved March 10, 1916, or contrary to Jaw, and that the ardent spirits
so r eceived by me are to be used
by me for
)
1
1
I
l
I
•
)
\
(State whether for Scientific, Sacrament al, Medicinal or Mechanica l)
urposes .
(,
f
Consh:nee .
�FORM 370-VA .
Revised June. 1917
SOUT HERN EXPR ESS COM PANY
( J ncorporat ed)
SPECI AL LIQUO R RECO ~D
/)
t. 20;1 ,.
Re ceived at _ _ _ _ _ __ _ _ _ _ _ _ _ OateOc
/ ,,,,
_ _ _ _ _ _ _ J91_. Affidavit No. __..,....-_ _0
__
Consignee _ _ _ _ _ _ _C
=-=-h=-a=...cs=----=H.,_o"-"''-==-==-=-=-- ---P . 0. Address _ _ ___ _ ____
__
Kind of Ard ent Splrits _ _ _~~h~s~ i~l_
ry
v--_ ____ __Quantity
l q_ t
Weight~_4
=--__ lbs.
Way-Bill No. _ _8_ __ _ _ 0ate _ _ _ _l_ 0~/_1_C
_J _ _ J91 _. FrJ~ shin gt n
To _ _ _ _ _ _ _ _ _ __ _ _~ - - - EXPRESS CHARGE S
Advtrnces to
Add
Collect
Pl!EPA ID
U nd er charge
I COLLECT
Shipper _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
P. 0. Address
Conr ad Paff
I
Co
~~~~---
RECOR D OF NOTICE S
To Consignee
To Shipper
40 K
(OVER)
I
i
I
I
Pd
I
�, , - - ·- - --•---=- - =-
STATE OF VIRGIN I A,
1 , - - - - -- - - - - - - - -- - - - -- - - ,
being duly sworn, depose and say that I am
the consign ee of a certain shipme nt of ardent spirits,
as specifie d on other side of this form, this day
delivere d to me by the Southe rn Expres s Compan y, from
_ _ _ _ _ _ _ _ _ _ _ _ _ ; that I am not
• a student or minor, and, if a female, I am the head of
a family; that the ardent spirits so receive d by me
were _brough t into the State on my written order, and
that I have not, within the thirty days previou s
hereto, receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quantit y allowed by the provisio ns
of the Act of the Genera l Assemb ly of Virgini a,
approve d March 10, 1916, or contrar y to law, and that the
ardent spirits so receive d by me are to be used
by me for _ ___ ___ ____ ___ ____ ____
__ _--vurpo ses.
(State whether for Scientific , Sacrame ntal, Medicina l or
Mechani cal)
Sworn to and subscri bed before me,
,
tbi!(___
,
L_day o..__ _
I
_ _ , 19LL..
Apnt for Southern E:<vress Company .
Consie-nee.
�FORM 370-VA .
Revised J nne, 1917
SOUT HERN EXPR ESS COMP ANY
(I n co r porat ed )
SPECIA L LIQUO R RECOR D
Received at _ _ _ _ _ _ _ _ __ _ __ __ _ Date
t l ,./17 f!l 1_ . Affidavit No. / ,· /
H
·
Consignee _ _ _ _John
1
_ _ _ _ _ _ _ __ __ _ _ _ _ _ p_ 0. Address _ayotn
_ _ _ _ _ Va~
___ _ __
Kind of Ardent Splrits _ _
h _1·k•
W_
_~J:'_
. _ ___ _ _ __ Quantity_ _1__
~t _ _ _ _ _ Wei oh~ _ __ lbs.
Way-Bill No._=
' -~2~8~ _ _ _ _ Date ~1'-'0~/ ~1,___ _ ____ 191_. From _H_a_,g
=---'e-'r_s_t _o__c\c_m___
To _ _ _ _ _ _ _ __ _ __ __ __ _ _
. EXP RESS CHARGE S
Advance s t o
Coll ec t
Shipper _ _ _ _ _ __ _ _____ __ _ _
L
ii eyer s,
I
P. 0. Addres s - - - -- -- ·- - -- - - -
PREPA ID
I
R-ECORD OF NOTICE S
To Consignee
To Shipper
9
(OVER)
S ti kley
I
I
I
COLLECT
I '"'8
A dd
U nd erc h a rge
I
�STATE OF V IRGINIA,
'• .,
,,.-~ tl·I'
I, - ~µ...::...cc..L...:..:- -'LL--= - - "----'
1
'"--'"'--'--""-''-- --- - , being duly sworn , depose and say
th at I am
the consig)l e of a certain shipmen t of ardent spirits , as specifie
d on other side of this form, this day
delivere d to me by the Souther n Express Compan y, from Jl/.,,
,._
; that I am not
a student or minor, and, if a femal e, I am the he ad of a family
; tnat the ardent spirits so received by m e
were brought into the State on my written order, and that
I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoever, in excess of the quantity allowed by the provisio ns of the
Act of the General Assemb ly of Virginia ,
approve d March 10, 1916', or contrary to law, and that the ardent
spirits so received by me are to be used
by me for
LII
,,
J
\
(State whether for Scientific, Sacramen tal, Medicinal or ll1echanic
al)
,
,
Sworn to and subscrib ed before me;
/
thi~
y
...
day of !.,
f /
urposes.
, 19 /
I
A111ent for Southern Express Company .
Con siiinee.
�FORM 370'-VA.
Revised June, 1917
SOUTHERN EXPRESS COMPANY
(In corpo rated)
SPECIAL LIQUOR RECORD
Oat 1 st,
•
2
Received at _ _ __ _ __ ~ -= - - - - - - ate _ _ _ _ _ _ _ l91_. Affidavit No, _ _ _ _ __
Consignee--'C'--h---'a'---s_ _S
-'--i'--'P
..___s
lll _o
_ n___________ p_ 0. Address_~-~~~ ~~- - - Kind of Ardent Splrits _ __r_ a_n_d~ y- - - ~- -- -Way-Bill No._7_ O
_ _ __ _ _ Date_
9 _/ _2_ 9
___
To _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Shipper
0uantity _ _ _ _l_
____
.Advances to
Col lect
Conra d Pagt:. Co
I
P. 0. Address _ _ __ _ _ _ _ __ _ __ _
191_.
·_t____ Weigh _ _4__ Jbs.
p Jil,Sbing ton
EXPRESS CHARG ES PREPAID
I
I
I
I
COLLECT
IPd
RECORD OF NOTICES
To Consignee
To Shipper
49
(OVER)
Add
Undercha r ge
I
�r- -
-
- -
-
-
-
-
-
- ===-==-·------ ~
.,.;;--;,...._ - - - - - -
STATE OF VIRG INIA,
COUNTY OF_ -<-/_ _ _ _ _ __ _ _
_
__.l__f___ ___ ___' _ ___ _____ ,
I, __
being duly sworn , depos e and say that
I am
the consi gnee of a certa in shipm ent of
arden t spirit s, as specif ied on other side
of this form, this day
deliv ered to me by the South ern Expre
ss Comp any, from ___ ___ ___ ___
__ ; that I am not
a stude nt or mino r, and, if a femal e, I am
the head of a famil y; that the arden t spirit
s so receiv ed by me
were broug ht into the State on my writte
n order , and that I have not, withi n the
thirty days previ ous
heret o, receiv ed any arden t spirit s of any
kind whats oever , from any p_erson or from
any place whats oever, in exces s of the quant ity allow ed
by the provi sions of the Act of the Gene
ral Assem bly of Virgi nia,
appro ved Marc h 10, 1916, or contr ary to
law, and that the arden t spirit s so receiv
ed by me are to be used
by me for
1
l
/_.
urpos es.
(State wheth er for Scienti fic.
}i
-{_
Sacram ental, Medici nal or Mecha nical)
I
Consi2nee.
�FORM 370-VA.
Revised June, 1917
SOUTH ERN EXPRE SS COMP ANY
(lucorporo.te d)
SPECIA L LIQUOR RECOR D
Received at _ __ _ _ _ _ _ ._ _ _ _ _ _ Date
Oc t • 8 /:\~-•-·
._s_ ._ _S_n_e_l_l_____
Affidavit No._ __ 1
_ 3__
Con signee _ _ _ _ _ _ _ _ _
Kind of Ard ent Splrits _ _ _ _
lV_l_l_i_s_k~ y____ ___ Quantity _ _ _ __ _
Way-Bill No._ _ __
,6_6_·___ Date _ _ _ _
191_.
1_,.~/_6____
To _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ __
Advances to
Co ll ect
Shipper - - --=N
-'-=-.-----"s:C...:..---"C,[_u
=n=s=o-=-n=--- - -
a g,~_s_t_w_o_n___ ___
EXPRESS CHARGES
PREPA ID
I
I
P. 0. Add ress _ _ _ __ _ ____ _____
t ____Weioh ~ _4__ lbs.
I
I
I
RECORD OF" NOTICES
To Consignee
To Shipper
4fl S ti ley
(ovEB,)
COLLECT
I
Add
O nderc ha.rge
28
I
�STATE OF VIRGINIA ,
COUNTY OF_ _ _ __ _ _ _ _ __
! , - - - - - - - - - - - - - - -- - - - - - - , being duly sworn, depose
and say that I a.m
the consignee of. a certain shipment of ardent spirits, as specified on other side
of this form, this day
delivered to me by the Southern Express Company, from _____ _____
____ ; that I am not
a student or minor, and, if a female, I am the head of a family ; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or
from any place whatso·ever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received
by me are to be used
by me for
.
-
(State whether for Scientific, Sacramental , Medicinal or Mechanical)
Sworn to and subscribed before me,
,1/ ,-
this.___d ay of
;/(c {/•
·
, .,
,.
, 191L.
l/1 , /;7
z
\.,
Apnt for"s ~uthern Express Company.
urposes.
Consienee.
�F'ORM 370-VA .
Revised J nne, 1917
SOUTHE RN EXPRESS COMPAN Y
( Incorporated )
SPECIAL LIQUOR RECO
0 t 29
u,D
'.1
Received at _ _ __ _____ _ _ _ _ _ _ _ Date_ _ _ __ _ _ l91_. Affidavit No
____ ___
:.J_
. _r;_. G
Sprink
, _ _ _ _ _ _ _ _ _ _ P, 0. Address _
Con s1gnee
_._
_ _ _ _le
__
1
_
_ _ _____ __ __
Kind of Ard ent Splrits ___
Wh
_ i_ s_k_ e _y~ -- - - - -Ouantity _ _ _ _l__
Q_t___ Weiuh ~ __4_- _lbs.
7
6
Way-Bill No. _ _ __ _ _ _ _ liat'e _ _ 27
, _ _ _ __
,_ _ _ _ _ __ __ 191_. From _Washn
____
To _ _ _ _ _ _ __ _ _ _ _ _ _ _ __ _
EXPRESS CHARG ES
Advan ces to
Add
1n/
n. c
Col lect
PREP A.ID
I
I
Sh ipper _ _ _ __ _ ______ _ _ _ _ _
P. 0. Addre s s - - - -- - - ·- - - - - - RECORD OF' NOTICES
To Consignee
To Shipper
#
49 S
(OVEit)
I
COLLECT
P~iil.1
U nde r charge
I
�STATE OF VIRGINI A,
COUNTY OF
~&,., ~f,,l
I, __,__,__-=:..__:~r--"--=---=----=--====--=--------, being duly
sworn, depose and say that I am
the consign ee of acer in shipmen t of ardent spirits, as specified
~b'other side of this form, this day
~~Ct.,c.,._2(:'.;
delivere d to me,by the Souther n E:irpress Compan y, from
that I am not
a student or minor, and, if a female, I am the head of a family;
that the a%nt spirits so received by me
were brought into the State on my written order, and that
I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatsoever, in excess of the quantity allowed by the provisio ns of the
Act of the General Assemb ly of Virginia ,
approve d March 10, 1916, or contrary to law, and that the ardent
spirits so received by me are to be used
lk.~& 'l-J
by me for
pnrpose s.
(State whether for Scientific. Sacramen tal, Medicinal or l\1ech_a_n_i_
caA'--)-f
_· _ _
l
_J
--;...µccc.._
! j_ _,--=c.:....--....:::,-,..,.=
4
Sworn to and subscrib ed b fore me,
thi~
day of
I
tJ~ , 1911
,)
.
V
�f'ORM 3 7 0-VA .
R evised J une, 1917
SOUTHER N EXPRESS COMPANY
(I ncorporated }
SPECIAL LIQUOR RECORD
O c<.t • 1 6 • l
Received at _ _ __ _ ____ _ _ __ _ _ _ Date
Consignee ___W
_i_·_l_l__T
_ am
_ _s_,_
,.
. ....
f9 1_ . Afli ~a:it No.
_ _ _____ _ __ P, 0. Address _
/
_ _ _ _ _ __ __ _ __
Ki nd of Ard ent Sp lr its _ _ _W
-'• _
t _ _ _ We igtil~
,1
_ - _S~ l·~ky
_ _ __ _ _ _ _ Quantity_ _ _ _1_
___ lbs.
Way-Bill No,__
t _
O_ _ _ _ _ Date _ _7~/_1
~ 3~ _ ___
il) P,: ttiMl_____ ___ _
,_a_~'f
To_ _ _ _
~
_ _ __ __,__ _ _ __ _ _
Advanc es to
Collect
Sh ip per - - - - - - ~ , . , - - - - - - - - - Conrad
P a__
g_e _ __ _ _ _
P. 0. Address _
_ _ _ __
I
R-ECORD Of' NOTICES
To Consignee
To Shipper
(OVER)
EXPRlJSS CHARGES
PREPA ID
I
I
I
I
I
COLLECT
I
Add
U ud er cha.rge
Pa
I
�STATE OF VJROINIA,
COUNTY
I,
'--"--"' - --"' , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from ...- / / /
Y
; that I am not
a student or minor, and, if a female, I am the bead of a family; that the ard ent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from a.ny place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
.approved March 10, 1916, o:r contrary to law, and that the ardent spirits so received by me are to be used
by me for
L
- .,,___
"!.- •
(State wheiher for Scientific, Sacramental, Medicinal or Mechanical)
purposes.
�F'0RM 370- VA.
Revis ed June, 1917
SOU THE RN EXP RES S COM
PAN Y
(Incorp orate
d)
SPE CIAL LIQU OR REC ORD
= .=. .r__:_
c. /_
- _"'-----,_1 91_ .
I '-I
Affidavit No,_ _ _ _ __
:~::i:;::d-e.;.n_t_S.,_pl'""ri.,_ts~--""_~_""_-_""'~"'-~_....~~-..-,_..::_;i:::_~_-_-~--~=--.3.-~----~--~--___.._·__, P. O Add / 4/
~
Way-Bill No. _ _~-+-- - - , ~ - - -
Wei /,
')
7:_
L- - lbs. /
- -'----- '--- --- -f - - -- 191 _.
From _ _ _ _ _...,__ _ _ __
To _ _ _ _ _ _ _- _ _ _ _ _ _
_ _ _ __
EXPR ESS CHAR GES
Adva.n ces to .
Collect
RECO RD OF' NOTI CES
To Consignee
To Shipper
(OVER )
PREPA ID
Add
U nderc ha.rge
- - -~ ~, --- --
I
�STATE OF VIRGINIA,
-
1,- - -- - -- - -- -- - - - - - -- -- - , being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on ot~er side of this form, this day
f ;
delivered to me by the Southern Express Company, from
th; t I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and th~t I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
/7
by me for
I '
'
-
(State whe\her for Scientific, Sacramental, Medicinal or Mechanical)
urposes.
J
Sworn to and subscribed before me,
this
day of_._
{ _ _ __
I
Aient for Southern Express Company.
Consignee.
�F"ORM 370-VA.
Revised J nne , 1917
SOUTHERN EXPRESS COMPANY
( I ucorporated}
SPECIAL LIQUOR RECORD
O
Receivedat _ _ __ _ ____ _______ Date
t • 2 ?9't1' 7 AffidavitN o._ "'_l_ __
_
G ._ _
Anderson
Con signee _ _ _ _ _ _A
_•_ _
_ _ _ _ _ _ _ _ _ P. 0. Address,_ _ ________ __
Kind of Ard en t Splrits_ _~
-w~b~;,~·~i~k...,y,.___ _____ Quantity _____l _'l_t____ Weigh c_____ lbs.
Way-Bill No._ __ _ _ _ _ _ Date _ _ _1r/1<1
_ _ _ _ _ _ _ 191 _ .
To _ _ _ _ __ b_- ~Jl'. ------<s,,......t~e..--4i ~11~bh,.
e~1.......
r-~
.e~1..... ,
Advances to
Colle ct
Washin
From, _ _ _ ton
_ _ _ _ _ __
EXPRESS CHARGES
PREPAID
COLLECT
I
I
I
Shipp er _ _ _ _ __ __________ _
I
P. 0. Address _ _ _ _ _ _ ___ _ _ _ _ __
RECORD Of" NOTICES
To Con signee
I
To Shipper
(OVER)
I
I
Add
-r QU nderchuge
-
I
�- -- ~ -~~.....,._--,,o.-,;-----,,,;.,ao,.....,.~ ~ ~ -#C
- ~- -- • - - , being duly sworn, depose and say th at I am
ardent spirits , as specified on other side of this form, this day
--~
delivered to me by the Southern xpress Company , from,,,.,___= --''-4 '-c---.,,:..:,.....,...
..,...----'c...:c.:ao...,,;:._; that I am not
a student or minor, and, if a female, I am the head of a family; that
the ardent spirits so received by me
were brought into the State on my written. order, and that I have not,
within the thirty days previous
hereto, rqeeived any ardent spirits of any kind whatsoev er, from any
person or from any place whatso·
ever, in excess of the quantity allowed by the provision s of the Act of
the General Assembly of Virginia,
approved Marc~ O, 1916, or ~ontrary to law, and that the ardent spirits
so received by me are to be used
by me for
/ /
,-(,/
e (I'.- C<,-
(State whether for Scientific, Sacrament al, Medicinal or Mechanica l)
urposes.
�f"0RM 370-V A.
Revise d June , 1017
SOU THE RN EXP RES S COM PAN
Y
( Incorpo rated)
SPE CIAL LIQU OR REC ORD
Received at _ _ _ _ _ __ ___ _ _ _
___
Date Oct • ?0 / 1i91•_ . Affid avit No ,___
~- - . _Car
Consign ee _ _ _-rs
rie
Las
___
sfo
___
_ _ _ _ __ rd,
__ __ p, 0. Address _ _ _ _ _,ity
_ ____ __
- ~ =~ ~ - - - -- - - - - -0uantity
_ _l_ rt~t__ __ __ Weigh L........_ _ _
lbs.
Way- Bill No._ __ ~
O_t_•_ __
,~ _ _ _ _ Date _ _ _
~7 ___ J91_ . From _Wa
_ _shin
_ _ _ _ _ __
To _ _ _ _ _ _ _ __ _ _ _ _ _ _
__ _
Advanc es to
•m,o s <Rm '" ~
.J.dd
Coll ect
PREP.J.ID
I COLLECT
Un de r ch arge
Ship pe r - --1c~o~1~
n~-~a~d- -._,.>
. ~a;~g~e~ _,C
,.......,o~ - - P. 0. Address _ __ ___ __ _ _ _ _
_ __
I
RECO RD Of" NOTI CES
To Consig nee
I l Ip
To Shipper
40 Sti kle y
(OVl'lR)
I
�- - ~ ~ ~- ~ - - ~ ~ -- ~ - - - ~~ - - - , being duly sworn, depose and say that
I am
ardent spirits, as s nJed on other side of this form, thi s day
~L~ tt?~ ;
delivered to me by the Southern Express Company, from,
that I am not
a student or minor, and, if a female, I am the head of a family ; that the ar
t spirits so received by me
were .brought into the State on my written order, and that I have not, ,rthin the thirty days
previous
hereto, rE;ceived any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved Marc
O, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
~
by me for
I~
purposes.
ic-d:~, el , '
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
.I, Z-vl,
.)
I
7
1 ,
<
Allen( for Southern E:,:press Company.
�f"0RM 370-VA .
Revised June , 1917
SOUT HERN EXPR ESS COMP ANY
(In corpo rated )
SPECIA L LIQUO R RECOR D
Received at _ _ ____ ___ _ _ _ _ _ _ _ Date _
0 _t __
. 20/17
.
_ _ _ J91_.
. .
~2
Affid avit No. _ _
_ _ __
Consig nee _ _ _ _ _ _ ____ ___
. _ .u_e_e_r___.y_,
.,. ,_____ P. 0. Address _ _ _ _ _ _ _ _ _ _ __
t
Kind of Ardent Splrits _ _ _~ \\~'1=1=8~1-•=
4k,.,y,_______ __ Quantity _ _1_ _
_ _ _ _ _ We ig hL____
Way-Bill No._~
8~7_ __ _ _ _ 0ate _ _ ~1~ /~ l _fl___ _ 191 _ . Fro1
To _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ __
EXPRESS
Advance s to
Shipper
P. 0. Add ress _ _ _ __ _ ____ _____
I
I
I
!
To Sh ippe r
(OVER)
CHARGES
P REPA ID
RECORD Of" NOTICE S
To Consio nee
as b ine:t on
Coll ect
-----C
...,o...n
.......r...a...c...l ~ P...,a...,p'--r~e.,..._....c,..,o- - - -
lbs.
COLLECT
Pel
I
Ad d
U nderc harge
I
�STATE OF VJRGINIA,
/
1
I,
'
, being duly sworn, depose and ·say that I am
the consignee of a certain shipment 9f Jardent spirits, as specified on other side of this form,
this day
Qk<-
kt. \
delivered to me by the Southern Express Company, frow
J.r
,- 1.. J<J{_ ; that I am not
a student or minor, and, if a female, I am the head of a family; that the irdent spirits so received
by me
were brought into the State on my written order, and that I have not , within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are
to be used
I
by me for
~e:-
(State whether for Scientific, Sacramental, Medicinal or lllech a nica[}
J
Sworn to and subscribed before me,this_da y o ~ - - - - - , 191_.
AIIOnt for Southern Express Company .
purposes.
(/
Coosi2nee .
�f"ORM 370-VA.
SOUTHER N EXPRESS COMPANY
Revised June, 1917
( I ncorporated)
SPECIAL LIQUOR RECORD
3/17.
7 _ __
Received at _ _ _ _ _ _ __ __ _ _ _ _ _ _ Date _Oct.
__ _ __
_ l 91_. Affid avit No _ __
c.
Con signee _ _ _ _ _ _ _ _ _ _ _ _ _ _hryan
_ _ _ _ _ _ p, 0. Address _ __ _ _ _ _ _ __ __
Kind of Ard ent Splrits_____W
__h~1
=·-s~k~y
.,_ ___
Way-Bill No,_ __
___Quantity _
3~?_ _ _ Date Oct 3/, 7
To _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ __
Shipp er
Conra
_ ___
l _q~t___ Weight~_4__ ibs.
191 _
Advances to
Coll ect
I
COLLECT
I
i
I
I
I
RECORD Of" NOTICES
2
f o Shipoer
,1t('HH e
(OVER)
FWifltshing ton
PREPA ID
P age Co
P. 0. Address _ _ _ __ _ _ _ _ _ _ _ __
To Consignee
.
EXPRESS CHARGES
I
Add
Uodc rcba.rge
id I
�,.
I,--~-' '(---- - - " -- -- - - -- - - -- - - , being duly
sworn, depose and say that I am
the consign ee of a certain shipme nt of ardent spirits,
as specifie d on other side of this form, this day
I
j
/
deliver ed to me by the Southe rn Expres s Compan y, from
11. /..
~
; that I am not
a student or minor, and, if a female, I am the head of a
family; that the arg_ent spirits so receive d by me
were brough t into the State on my written order, and
that I have not, within the thirty days previou s
hereto, ri;ceive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quantit y allowed by the provisio ns
of the Act of the Genera l Assemb ly of Virgini a,
approv ed March 10, 1916, or contrar y to law, and that the
ardent spirits so receive d by me are to be used
by me for
/
}/,t oi :.c
(
(State whether for Scientific , Sacrame ntal, Medicina l or
Mechani cal)
'
Sworn to and subscri bed before me,
this...__.!L_day of
0/ ,
191_ {
/
Ae:ent for Southern Ex-press Company .
urpo ses.
,
) IJ~/?
�FORM 370-VA .
Revised J nne, 1917
. ./
SOUTHER N EXPRESS CQMPANY
(Incorporated)
SPECIAL LIQUOR RECORD
Receivedat _ _ ______ ___~_ _ _ _ Date Q c t
1._ _
A_
. _
Eye
Consignee _ _ _ _ _ _ _
_ _ _ __
Kind of Ard ent Splrits _ _w_h_s_i_k
~y_
3 /l 7 • 191_.
Allid avit No, _ _B___
_ _ __ p, 0. Address _ _ _ _ _ _ _ _ _ _ __
_________Quantity _ _ _l__t _____Weight_4~-- - -1bs.
191_ ~'{ 1fo~_i_n_g_t_o_ n _ _ __ _
Way-Bill No. _ _
7_2_ __ __ Date _ __ _l_0_/_3 _ __
To _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ __
Shipper
Adv nnces to
Co ll ect
Conrad Pa ge Co
E XPRESS CHARGES
PRE PAID
I
I
I
I
P. 0. Address _ _ _ __ __ _ _ _ _ __ _
R-ECORD OF NOTICES
To Consignee
_
To Shipper
21
(OVE R)
I
I
COLLECT
r
.Add
U ud e rc ba.rge
I
�STATE OF VJROINJA,
COUNTY OF
fi :d.t- ,,//
J >-
I
•
/6U ~ /4 ?"-
£:/
J ,,,_,,. •
I,
1
I
, being duly sworn, depose and say that I am
the consignee of a certain shipmen/ of ardent spirits , ·a s specified on other side
of this form, this day
Q,f /.
t_< ~- "~
l,
delivered ·to me by the Southern Express Company, from
2
j
; that I am not
a student or minor, and, if a female , I am the head of a family ; that the ard ent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, r6ceived any ardent spirits of any kind whatsoeve r, from any person or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 10 1916, or contrary to Jaw, and that the ardent spirits so r eceived
by me are to be used
by me for
}7 ~
L •f
{
(State whether for Scientific. Sacramental . Medicinal or Mechanical)
pnrposes .
_/-4
{
/
�F'ORM 370-V A .
R evised June. 1917
SOU THE RN EXP RESS COM PAN Y
( I ncorpora ted }
SPEC IAL LIQU OR RECO RD
Received at _ _ _ _ _ ___ __ _ _ _ _ _ _
Date
Consignee _ _ _ _ _ _ _
O_t_h_o__E_•y~ e___ ___
0 t . 4th , 191_. AffidavitNo.-l ~l~ - - ___ P. 0. Address _ _ _ _ _ _ _ _ _ _ __ _
Kind of Ard ent Splrits _ _w
_ l_lS-----=-i~k~-.y,___ __ ___Quantity
=
n~/~A
Way-Bill No. __3
~ 8~ __ __ 0ate_ _ _
To _ __ _ _ _ _ __ _ _ _ _ _ _ _ _
_
Shipper
191
Adv an ces to
Co llect
Con rad Pa ge Co
P. 0. Address _ __ _ __ __ _ _ _ _ _ __
I
RECO RD OF' NOTIC ES
To Consignee
l rt
Weiohf_i_ __
FroJla shin ~ton
To Shipper
(OVE R)
E XP R E SS CHARG E S
PREPA ID
I
I
i
I
C OL L ECT
f
Add
Unde r charge
I
lbs.
�STAT E OF VJ RG I IA,
COUNTY OF
A ' J-~-.,
- 'f:. ~·C ,,,_ ___
~ 1&=='---. .
,
I,
bein g duly swor n, depo se and say
the cons ignee of a certa in shipm ent
that I am
of arde nt spiri ts, as specified on othe
r side of this form , this day
/_
/',
deliv ered to me by the Sout hern Expr
ess Com pany , from ·
,?'c
, -7/. ; -that I am not
a stud ent or mino r, and, if a fema le,
I am the bead of a fami ly; that the
arde nt spiri s so recei ved by me
were brou ght into the State on my
writt en orde r, and that I have not,
with in the thirt y days prev ious
here to, recei ved any arde nt spiri ts
of any kind what soev er, from any
perso n or from any place what soever, in exce ss of the quan tity allow
ed by the prov ision s of the Act of
the Gene ral Asse mbly of Virg inia,
appr oved Marc h 10, 1916, or contr ary
to law, and that the arde nt spiri ts
so recei ved by me are to be used
by me for ~ / 4 - ~ ~ 0
-\
C. .,, ~' ,
purp oses.
(State wheth er for Scien tific, Sacr\
menta l, Medic
)
inal or M~~ cal)
Swor n to and subs cribe d befo re me,
thi ~d ay of _ _ _ _ _ , 191
_,
Ae;ent for South ern Exvre ss Comp
any.
�FORM 370 - VA .
Revised June, 1917
SOUTH ERN EXPRE SS COMP ANY
(Incorporate d)
SPECIA L LIQUOR RECOR D
Receiv1:d at _ _ _ _ _ _ __ _ _ __ _ _ Date O t • 3 / 1 f
191_ , Affi dav it No. _ _9
~ - - Consign ee _ _ _ _ _ _ __ _ __ _ C'_. _ O
_. _ G
_a_i_n_ef c!. Ad dress _ _ __ ____ __ __
Kind of Ard ent Splrits_ --'w--=
-' h=s=--=
i =-k~~y,__ _ _ ___ __
Way-Bill No. _ _
5_ 0___ __ Date
Quanti ty
10/ 3
To _ _ __ __ __ _ _ _ _ _ _ __ _
lq t
191~
Advance s to
Collect
Shipper _ _ _ _ _ __ _ _ _ _ _ _ _ __
r. o. Ad dress __C
_o_n_r_a_ d_ P_a_..,._g_·e_ _C_o___
I
.s l}:;t~~
g~t _o_
n _ _ _ __
EXPRESS CHARG~S
P REPA ID
I
RECORD OF NOTICES
To Co nsig nee
To Shipper
1!1
(OVE R) ..
Weidli ~ - - -lbs.
A oore ,
I
I
I
COLLECT
I Pd
Add
O nd c rc ha.rge
I
�STATE OF V!RGlN IA,
I,~
- - ---- -'------~ ----. ..;..+ --- ="- ,
being duly sworn, depose and say that I am
the consig nee of a certain shipme nt of ardent spirits,
as specifi'ed on other side of this form, this day
"":e '
deliver ed to me by the Southe rn Expres s Compa ny,
fr;;;;
c
¾..i.J.ha t I am not
a studen t or minor, and, if a femal e, I am the head
of a 1family ; that the arde spirits so receive d by
me
were brough t into the State on my written order,
and that I have not, within the thirty days previo
us
hereto , r €ceived any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quanti ty allo ed by the provisi
ons of the Act of the Genera l Assem bly of Virgin ia,
approv ed
ch 10, 1916, or contrar y to law, and tbat the ardent
spirits so receive d by me are to be used
'"J,;
by m /
orW , Sci~,,.
/ ,, - /
IS"~ w
""~ ,o,
&~om, o!M,
M,a, ,.,...,,.
Sworn to and subscr ibed before me,
this.£ _day of /( tJ J
, 191
I ,
I
Al?ent for Souther n Express Comp&uy.
Moooooo~,f i
urpose s .
~
�FORM 370-V A .
SOU THE RN EXP RESS COM PAN Y
(In co rporated )
SPEC IAL
f-~-+- --~ ~........--1 91_
. Affi davit No·- - - = -- -
- ~~ - - - -77'-- --r--r--- - ---'~ ~~ -- P. 0. Address _ _ _ _ _ _ _ __ _ __
To _ _~- ---+--
- -- ~------.'--- - - - -
Ad vance s t o
Co ll ect
PREPA ID
Shi ppeJ '---JL
b--- -,-\.l,,C..__ __J:.._"'-"'"--'"'- '!,--...:._ ;:--'--=:- --'
0. Address _ _ _ __ ___ __ _ _ _ _ _ _
,____ ___ ___ ___ ____,__. .__
........_
P:
RECO RD OF NOTIC ES
To Con signee
To Ship pe r
(OVE R)
___,
�STATE OF VIRGINIA,
COUNTY OF- --
~ -- - -- --
/_ • (}./, (, ' t.
I,
t
, being duly sworn , depose and say that I am
the consignee of a certain . shipment of ardent spirits, as specified on other s·ae of this form, this day
I
/ 1
?
)
delivered to me by the Southern Express Company, from u·
!' ' / l --1_
-;t that. I am not
a- student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, re ceived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrarY., to law, and that the ardent spirits so received by me are to be used
~
by me for
_
,
(State whe\her for Scientific, Sacramental, Medicinal or Mechanical)
urposes.
,{ .
~L
Consie-nee.
�f"ORM 370-V A.
R evised June , 1917
SOU THE RN EXP RESS COM PAN Y
( I ncorpo rated)
SPEC IAL LIQU OR RECO RD
Received at _ _ _ _ _ __ __ _ _ _ _ _ _ _
Date
Consignee _ _ _ _ _ _I_•_N.
_ _ _owl
_ _ _ _ __
Kind of Ard en t Spirits _ _ __
whs
_ iky
_ _ _ _ ____ _
Way-Bill No. _ __ f:_
. 6'---- --- Date
10L1
To _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _
_
Shipper
•.l •
O t . 15/1191•_ . Affi davi tN o._ 1_6_ _ __
_ __ P. 0. Address
Weig t4~ ___ lbs.
olil twon
A dvn ncee t o
Coll ect
S. i unso-n
-- - - - - -
I
RECO RD Of" NOTIC ES
To Shipper
4 9 S.tte le
(OVE R)
2,- d
mnRE S S CHA RGES
PRE PAID
I
CO L LECT
i
P. 0. Address _ __ _ _ _ _ _ _ _ _ _ _
_
To Consignee
l"'t
Quantity
I
I
I
Add
Unde r cha rge
28
I
I
�,._ -
-- -- ·-. - -,a .,..._ - - ---
~
- ·- -- - - - -.
-'~--~---------,.,...----~.--
- - =-==~=~=...
STATE OF VIRGINIA,
~i
\
r,
I,
I
, being duly sworn, depose and say that I am
the consignee of a certain shipment of arden.t spirits, as specified on other side of this form, this day
delivered to me by the Soutberu Express Company, f r o m ~ - - - - - - - - - - - - - ; that I am not
a student or m,i nor, and, if a female, I am the bead of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place wbatso·
ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
.
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
urposes.
I)
~J l
CollSi&"nee.
�,I \
f"0RM 370-VA .
R evised June . 1917
,.
SOUTHE RN EXPRESS COMPAN 'X
( I ucorpornted)
SPECIAL LIQUOR RECORD
Received at _ _ _ _ _ __ _ _ _
_ _ _ _ Date 0 t
Consign ee _ _ _ _ _ _ __ _w
_a_d_e__l_
•
.._ 'i.
.
13/1 7'1~~·.
l_
_G
_o_w_l___ P. 0. Address _
1 __ __ _
. Affi davit No._
_ _ _____ __ _ _
Kind of Ard ent Splrits_"----- =-=---"-- - - - - - -- - 0uantity _ _ l_ Cl_t____ __
41
Way-Bill No. _ _ ~
_ _ _ __ 0ate _· _ _ __ 10/19
_ ,___ _ _ _ 191_ .
To _ _ _ _ __ _ _,--_ __ _ _ __ _
Shipper
Advnucc s to
Co ll ect
U ud er chsrge
Pen-r ar Dis ti l l i n,:; Co
P. 0. Address _ _ _ __ _ ____ _ _ _ _ _
RECORD Of" NOTICES
To Consignee
28
I
~---- ----- -!_______________,
~
To Ship per
-)
--,
•.
',,
L
( OVE R)
,. .
�STATE OF VIRGINIA,
= ~Lz ,
tz
COUNTY OF1-'~ ~ ~~ -~ ~~ -
rlt1.
I,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form,
thi s day
• delivered to me by th e Southern Express Company, from /f..,.a__g ~~.uv lf...;
that I am not
a student or minor, and, if a femal e , I am the he ad of a family ;tJ:«7the ' ardent spirits so received
by me
were brought into the State on my written order , and that I have not, within the thirty days
previous
hereto, !'€Ceived any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are
to be used
Sworn to and subscribed before me,
this...l_Q__day of
&J.-
'1911.
J f ~ ~/
Aitent for Southern Express Company.
�F"ORM 370-VA.
Revised June , 1917
SOUTHE RN EXPRESS COMPAN Y
\ I ncorpornted)
SPECIAL I.IQUOR RECORD
Se P • 2 , /il 7: "Affidavit No. __2_1____
Re ce ived at _ _ __ _____ _ _ _ _ _ _ _ Date
Consignee _ _ _A
_._
L
_ a__,p=-----i_n_____ _____ __ P, 0. Address _ __
Kind of Ard ent Spirits
whs iky
____ Date() / 27
Way-Bill No. _ __9_3
_
To _ _ _ _ _ _ _ __ _ _ __ _ _ __ _
Pa~e
Co _ __
Shipper _ __Conrati
_ _ _ __
______
Quantity
191
Advance s to
Collect
I
P. 0. Address _ __ __ __ ___ _ _ _ __
RECORD OF" NOTICES
To Con sign ee
_ _ ___ __ _ __
1qt
Wash
DC
From
~i~ - --
E XP R ESS CHA RGES
PREPAID
I
I
COLLEC T
!I
4 9
(OVER)
Add
Un de r charge
I
To Shipper
1~
�STATE OF VIRGINIA,
1 , - - - - - - - - - - - -- - -- - - -- - - , being duly sworn, depose and say that
I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form,
this day
delivered to me by the Southern Express Company, f r o m - - - - ~ ~ - - - - - - - i t)lat
I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are
to be used
by me for ______ ______ ______ ______ __,,urposes.
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
Consi~nee .
�F"0RM 370-VA .
Revised June. 1917
SOUTH ERN EXPRE SS COMP ANY
( 1 ncorporatcd)
SPECIA L LIQUOR RECOR D
Received at _ _ _ __ _ _ _ _ ____ ____ Oate ·~• (l V • 1 •)/1 ....
1~ !"_ . Affidavit No.·--= =- Consionee _ _ _ _ _ _J_n_O
_ .__\_'_._ ,_,_c_C
_a_r_v_,:.._____ P. 0. Address _ __ _ _ _ _ _ _ _ _ __
Kind of Arde ~t Splrits. _ _ _ _ _w_l_
l_s~i=·=k~Y
~ ____ __ Quantity_ _----'1,._r,._,,_,tu.-,____ _ Weioht...::4,.___ _ lbs.
Way-Bill No. __<:>_O
_ f _l _ _ __ _ Date _ _
{_o_v_ .__1_r_1-'/--__~_ . _ _ 191 _ .
To ~
·- - - - - -- - - -- - - - -;o_r,nan
u ns
Shipper _ _ _ _
_ _ _c..
___
_ _on
_ _ __ _
Advnnce a to
Co ll ect
I
P. 0. Add ress _ _ _ __ _ _ _ __ _ _ __
1,;o,.·,~
6~_
r _s_ t _o_,_v_n.
__d____
EXPRESS CHARGES
PREP.AID
I
RECORD OF" NOTICES
To Consig nee
To Shipper
4()
(OVE R)
COLLECT
I
I
1R
Add
U nderch a rge
I
�STATE OF VIRGINIA ,
C OUN TY OF
&
~
_,,.,.J...._-,,-lll~ "'P',...
,,.
~ 'Yi(, ?-,/f / .n ,~/ ,being duly sworn, depose a
I,
the consigK e of a certain shipm ent of
~~s sp
ifi. d on other side of
--r--:_ ___-.. .:_
delivered to me by the Southern Express Company, fron:f..L~ UC~'J,::_ :1,,~~~~:
:::j~~lhrl I am not
a student or minor, and, if a female, I am the head of a family; tha
were brought into the State on my written order, and that I ha not, within
the thirty days pr.evious
hereto, received any ardent spirits of any kind what soever, from any p erson or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 10, 1916, or contrarx
,. and that the ardent spirits so received by me are to be used
P2~
by me for
(S~w . ,..
,M ''" Scioo.,,, ,~•=••w,, ,,.,.,,••, ..
sw7J_:/!
thi~da y of---......, ..---
,
M~"Jt'JG,~ YJI . Jit.s:,t' r .
urposes.
t,'
Con.lignee.
�F"0RM 370-VA .
Revised June, 1917
SOUT HERN EXPR ESS COM PANY
( In corporated )
SPECI AL LIQUO R RECO RD
ffl
Received at _ __ _ _ _ _ __ ____ ____ Date
J_
otin
Consignee _ _ _ _ _
n_
orris
on
_ _ _C
__
___
_ _ _ _ _ _ P.
Kind of Ard ent Splrits ___w
_I_ s~·-k_y~
OV • 19' i l.¼ffidavit No. _ _ _ __
0. Address _ _ _ _ _ _ _ __ _ __
___ ___ _ Quantity _ _l_r_ ___ ___ Weioh ~
re
-
Way- Bill No ._ __,,_J_ _ _ _ _ _ Date _ _ _1_,/------'
0'--------- To _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ __
Advance
s to
Coll ect
Shipper _ _)_ o_a_n
_ r_k_ e__t'_'_1_· 1_1_0__r_o_ •___
I
P. 0. Address _ _ _ ___ __ ___ ___ __
RECOR D OF" NOTICE S
To Consignee
1
To Shipper
(OVER)
EXPRESS CHARGE S
PREPAID
I
I
I
COLLECT
I
lrd
I
I
_ __ lbs.
Add
U udercharg e
I
�delivered to me by the Southern Express Company, from~L.._~~---'"" "'-----=---'-'-=-- i that I a not
a student or minor, and, if a female, I am the head of a family ; that the a1·dent spirits so received l:iy me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the arden't spirits ·so received by me are to be used
•
I
,~m;poses.
'
Medicinal or l\lechanical)
Consie-nee.
�f"ORM 370-VA .
Revised June, 1917
SOUTH ERN EXPRES S COMPA NY
( I n corporated}
SPECIAL LIQUOR RECORD
Received at _ _ _ _ _ _ _ _ _ ____ ___ Date
{ OV • l " / ~ (~ . Affidavit No._ _ _ _ __
Consianee _ _ _ _ _ _ _ _ _ _i_._o_l _l_e
_ r_, ____ __ P. 0. Address,_ _ _ _ _ _ _ _ _ _ __
Kind of Ard ent Splrits ___,--"v__,_r-s~ii.,l..,r~y,____ ____ _ Quantity
Way-Bill No.~-- -~_ J _f_, _ _ __
1 t
-'1'-'-,__/_l_fl_.____ _ 191 __!:laFro~ r
Date _ _
To _ __ _ _ _ _ __ _ _ _ _ __ _ __ _
PREPAID
I
I
RECORD Of" NOTICES
To Consignee
To Shipper
,1 (
(OVER)
s
t mm rd
E XPRESS CHARG ES
Advnncc s to
Col lec t
-Shipper - - -- - ~~'~·O
~ rr:
~ .1~a,~1=1~'-=·•~l=l=D~~
~,~O~D
~ P. 0. Address _ _ _ __ _ __ ___ _ _ _ __
1 _ _ _ lbs.
WeiahL',1..:._
I
I
I
COLLECT
J~a
Add
Und er charge
I
�-----=---------~
f(
,
I,
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form,
this day
delivered to me by the Southern Express Company, from ~ / 0
/,
; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
pr.evious
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of
Virginia,
approved March 10, 1916, or contra! y to Jaw, and that the ardent spirits so received by me are
to be used
by me for
,
(State whe\her for Scientific, Sacramental, Medicin11l or Mechanical)
urposes.
I ( JII
C
Sworn to and subscribed before me,
thi
day 9
/ "
,J 1.__.
1 ?
~
Apnt for So,hern Express Company .
/,
Consi~nee.
�f"0RM 3 70-V A .
Revise d .Tune, 1917
SOU THE RN EXP RES S COM PAN
Y
(Iucorp ornted)
SPE CIAL LIQU OR REC ORD
Received at _ _ __ _ _ _ __ ___ ___
_ Date
fJ
v
•
~n I ,
19 _!__~
Affida vit No.,_-=-_ ..:..,.:.:::___
Consionee, _ _ -"'-.___ ..___ .,.__...c0_1.:.,'_,i~t"'-=
z ....,c"""'
' :......,,,_ _ _ __ _ P. 0. Address ,., • t)
Kin d of Arden t Splri ts,_ ___,_V
,__,_?~
,_ 9,...J·,..~k,.,y,_____ __ _ __ Qua ntity
1"' 1.,
Weigh ._1_ _ _ lbs.
Way- Bill No. _ _.,_ _"'_ _ _ _ _ Date _ _1_1
_-~/_l_·_•_
191 .La rJ:nii Or(, '
- ·
To_ _ _ __ _ __ _ _ _ _ _ _ _
_ __ _
EXPRE SS CHARG ES
Advanc e s to
Add
-Co ll ect
PREPA ID
U nd er c he.rgc
I COLLE CT
~h-ipper ea·l
0
I
,,
P. 0. Add ress - - - - -- - -- - ----'
~ - -RECO RD Of" NOTI CES
"
To Consignee
I
To Shipper
(OVER)
I
I
I
'l l
I
I
�STATE OF VIRGINIA,
~
COUNTY OF ' ~
~ ~
4~ ,
I,
"'
being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
(c ~ ~
;
delivered to me by the Southern Express Company, from
that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days p1'evious
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so re·c eived by me are to be used
by me for
Y>\£. ~ -
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
urposes.
'
�FORM 370-VA .
R evised June, 1917
SOUTH ERN EXPRE SS COMP ANY
{I ncorporu.tedJ
SPECIA L LIQUOR RECOR D
4;/ 1191'_ .
1 OV •
Affidavit
Consignee _ _ _ _ _
P_a~y_l_l_e__·•·- • - - -- - " - - - - - P, 0. Address i ty
Kind of Ardent Splrits ___,_v_l_
l s_ i _k--=-Y--"'-- - - - - ~- Ouantity ___
l _·-:'--t___
/J,-n_e______.;:.. .__
___ Weigh L -_ _ _ lbs.
1 _ _ _ _ 0ate _ _
ha.r.;e
Way-Bill No.,_
rstwon
' _ _ __
_ _ _ __ _ _ __ 191 _.
From _ _ _ _ _ _ _ _ _ __
11/"
.Advan ces to
Coll ect
EXPRESS CHARG~:s
PREPAID
Shipper _ _ ____ ____ ____ ___ _
I
I
P. 0. Address _ _ _ _ __ ____ _ _ _ __ _
RECORD OF NOTICES
To Consig nee
I
To Shipper
49
(OVER)
I
I
I
COLLECT
l?,8
Add
Underc harge
I
�STATE OF'"VIRGIN IA,
•
!ut7l /(,
COUNTY OF
I,-~'---'-" -'-+--= - ---'-'---'---''-------''------''-'---'e..,.~- - -- - , being duly sworn,
depose and say that I am
the consignee of
certain shipment of ardent spirits, as specified on other side of this form, this
day
~o, ~
Llm
,'h1tl • ;
delivered to me by the Southern Express Company, from
j,,( (
that I am not
a student or minor, and, if a female, I am the head of a family;; at the arden/
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received
by me are to be used
by me for
'
l \ I (:.
LL.u tG
(State whether for Scientific, Sacramental , Medi cinal or 111echanical)
purposes.
¾o/,.k.
(
,
Consienee.
�F"ORM 370- VA .
Re,ised Juue, 1917
SOUT HERN EXPR ESS COMP ANY
( I n corporated )
SPEC IAL LIQUO R RECP RD
2.
0 Ct • 20 / 17 •
Receive d at, _ _ _ _ _ _ __ __ _ __ _ _ Date,
_ _ _ _ _ _ _ 191 _ , Affidavit No ._ __'::::-_,,/=
~Consig nee _ _ _ _ _ __ _:-'
__• _ _ _ _e_c
_ h_e_r_t_,_
P. 0. Address,_ ----=Cc.=i:....ct:...,___ _ _ _ __
Kind of Arde'nt Spirits, _ _
W_h_ s~i=
•k
_~~Y~ ___ ____ Quantity _ _ _
Weigh t .1.
lbs.
Way-Bill No. _ _ _ _ _ _ __ Date _ __ _ _l_ 0~/_2_
"'__ 191 _ , From
ashin
-.£..
~l~q=n;"--___
w
To
Shi ppe-r
.Advance s to
C\) lle c t
The Sh omak er Co
gotn
EXP RESS CHARGES
l:'RE I•.A ID
~
p
Add
Uud erc hnrge
co me,
I
P. 0. Address
I
I
R E CORD O F" NOT IC ES
To Consignee_ _ _ __ _ _ _ __ __ __ _
To Shipper
0
(OVER)
Stik e y
I
�STA'rE OF VIRGIN IA,
11
C OU :-!TY OF
I, ✓,_·
?cc ,/4
1,u ~
I { ( ,,
c[,/ / /! '
, being duly s worn, depose and say that I am
the consig nee' of a certain shipme nt of ardent spirits
, as specifi ed on oth er side of this form, this day
deliver ed to me by the Southe rn Expres s Compa ny,
from / I :'
,,/
/1 / ; th at· I am not
a studen t or minor, and, if a female , I am the head
of a family ; th at th e ardent spirits so receive d by
me
were brough t into th e State on my written order,
and that I have not, within the thirty days previo
us
hereto , r eceiv ed any ardent Epirits of any kind wh
ateoev er, from any person or from eny place whatso
ever, in excess of the quanti ty allowe d by th e provisi
ons of the Act of the Gen eral Assem bly of Vitg inia,
approv ed March 10, 1916, or contra ry to law, and
that the ardent spirits so rec eived by me are to be
used
~
,.
by m e for
J
'
_
,,
,
/
(S tate whether for Scientifi c, Sacrame ntal, Medicin
al or ~fechan icall
Sworn to a nd subscr ibed before me,
this_1 - -day of
l/
{16
/
C:
191 --A.
/:: /~, /?;
A2ent ro'i:- Souther n Expref:s Compan y.
purpos es .
Consign e6.
�F"ORM 370 - VA.
Revised June , 1917
SOUTHER N EXPRESS COMPANY
( l ncorporated)
SPECIAL LIQUOR RECORD
Received at. ___ _ _ _ _ _ _ __ ______ Date
•
1
ov 13/1
Way Bill No •
.Advnuces to
To
Sh ipper
• S ••1lunson ,
P. 0. Ad dress
Collect
~
I
RECORD OF" NOTICES
To Consig nee
To Shipper
(OVE R) .
EXPRESS CHARGES
PUEPLllD
I
I
I
I
I
CO LL ECT
I
R
Ad d
Unde r charge
lo
�- - -- - - - - - - - =-=-,=~~~-~---- ~-- - -__,___________. ., ._. . . . . . .----~
delivered to me by the Southern Express Company , from~~ ~~:...,~
~-ei~C....e~~;? "
a student or minor, and, if a female, I am the head of a family; t,),i t
the ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty days previous
hereto, rEceived any ardent spirits of any kind whatsoev er, from any
person or fr~m any place whatsoever, in excess of the quantity allowed by the provision s of the Act of
the\ General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits
so received by me are to be used
by me for
/;7:7? .Lc /;:r C (.,./
urposes.
(State whether for Scientific, Sacrament al, Medicinal or Mechanical ~
•·
/, t
d' y of~~ ---
('-;";(J ..
/,'
/
/_
,/1:a--t--:~
Consienee.
Sworn. to and uj scribed before
Is ,3,
-"' /
-------
A11ent for Southern Exvress Comvany .
�F'ORM 370-V A.
R evised J nne, 1917
SOU THE RN EXP RESS COM PAN Y
( I ncorpora ted)
SPEC IAL LIQU OR RECO RD
Re ce ived at _ _ __ _ __ __ ___ ___
_ DateQct •
• Ga.add.en,
Con sig nee
3l/1 7 19 1_.
P. o. Address
Affi davit No. _ _ _ _ __
Ci tv
Ki nd of Ard ent Splrits_ _~W
~l~l ~S.._1.....
·~k...,Jr1 _ _ _ _ _ _ _ _ Quantity
1 r1 t
Weiu h1~ _ _ _ lbs.
___l_o
~ /_3_0__ __ 191_. Fro m Ila ers t own
To _ _ _ _ _ __ _ _ __ _ _ _ _ __
EXPRES S CHARG ES
_
Advance s t o
Way-Bill No, _ _
5_5___ __ Date _
Ship per _· _ _ 1{_.__S_. _ !_
.U
_ n__s__o_n___ __
P. 0. Address ___ ___ __ _ _ _ _ __
Collect
_
I
I
I
_
RECO RD OF' NOTIC ES
To Co nsignee
PREPA ID
To Shipper
( OVE R)
I
I
I
COLLEC T
12
Add
Underch a rge
I
�STATE OF V!ROI IA,
I
COUNTY OF_ _ _ _ _,,_~-,,.~ - ~
I, ,
, being duly sworn, depose and say that I am
the consign ee of a certain shipme nt of ardent spirits,
as s ecified on other side of this form, this day
/
delivere d to me by the Southe rn Expres s Compan y, from~
~~_.£_~~~:!'.:_!!-__::::..:_...:.::~~:""littat I am not
a student or minor, and, if a female, I am the head of a
family; tha the ardent spirits so receive d by me
were brough t into the State on my written order, and
that I have not, within the thirty days previou s
hereto, r€ceive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quantit y allowed by the provisio
ns of the Act of the Genera l Assemb ly of Vi;gini a,
approv ed Ma~ 10, 1916, or co1?trary to law, and that
the ardent spirits so receive d by me are to be used
by me for
/ JZ.?£ l--tZ.,..t .,,,{__,.
(State whether for Scientific , Sacrame ntal, Medicina l or
Mechani cal)
,
urposes /"
(
Sworn to and~ bscribe d before me,
this
day
7 / ')
, 191_,
)
.,
"',
for
A11ent
Southern Express Company .
�FORM 370-VA .
R evised J nne, 191i
SOUTHER N EXPRESS COMPANY
( I ucorporated)
SPECIAL LIQUOR RECORD
Received at _ _ __ _ __ _ _ _______ _ Date _ _ __ _ _ _ 191 _ . Affid avit No. t.,I
I
._
• _J _
o hn
<!On
Consignee _ _ _II
_._ _
__
_ _ _ _ _ _ _ _ _ _ P. 0. Address _ _ _ _ _ _ _ __ _ __
wh s i ky
_____ Quantity ____l_r•_t_ _ ___ We igh
,1 lbs.
,t_
1,:,
1
/11:J
Ha
erc;tuo
1 ,, d
Way•Bill No._ __
__ ___ Date _ _ _1_
_ _ _ _ _ __ 191_. From _ _ _ __ _ _ _ _
__
To _ _ _ _ _ _ _ __ _ _ __ _ __ _ __
EXPRESS CHARGES
Advnnces to
Add
Kind of Ard ent Spirits
L
Collect
.• eyers ,
PREPA I D
I
I
I
I
RECORD OF NOTICES
To Consign ee
I
COLLECT
Unde rcharge
I
Shipper •.- - -- - - - - - - - - - - - - -P. 0. Address _ _ _ _ _ _ _ __ _ __ _ _
To Shipp er
D
(OVEll)
I
' 8
I
�STATE
COUNTY
I, ,
t «9
, being duly sworn, depose and say that I am
the consigne of a certain shipment of ardent spirits, as specified on other side
of this form, this day
1/
. . ,. . . ._______
delivered to me by the Southern Express Company, from
,,.
; that I am not
a student or minor, and, if a female, I, am the head of a family; at the ard ent
spirits so receiv'ed by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or
from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Vir.ginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received
by );Ile are to be used
by me for
hu,_c:£,, (!!A~~
(State whether for Scientific, Sacramental , Medicinal or Mechanical)
_ __.,_______ _____ ___,L--...:...;:c......-=--==-=---- Aeent for S uthern Express Company.
urposes.
�FORM 370-V A ,
Revise d Jnne, 1917
SOU THE RN EXP RES S COM PAN
Y
(Incorpo ro.ted)
SPEC IAL LIQU OR ~ECO RD
Received at _ _ _ _ _ _ _ _ __ _ _ _
_ _ Oate
31 /1 i9 T_.
OCt
Consi gnee _~l~l~i ~c=l=1=a=r~ d ~ I=C~o~h~l~ 1~a~
_ _ _ _ _ __
P. 0. Address _ _ _ _ __ _ _ __ __
Kind of Ard ent Spirits
Way- Bill
l''h S iky
_ _ _ __ Quantity_
No. _ ~,~!l
~ _ ____ Oate OCt • :10 / 1, .
To _ _ _ _ _ __ _ _ _ _ _ _ _ _
_ __
__1.,_,
q_~i~,__ ___ Weight<l~-~ - -lbs.
191 _.
Advances to
Colle ct
Shippe r - - - -~~5~, ~ -',~=
U=n=s~o=n=--
--
P. 0. Addr ess-- - -- -- ·- - - -
I
I
RECO RD Of" NOTIC ES
To Consignee
'6',ge rsto wn
EXPRE SS CHARG ES
PREP AI D
I COLLE CT
I
--
Affidavit No.__2_8
__ __
I
I
1~8
To Shipper
49
(OVER)
.,
Add
U nd e r c harge
I
�STATE OF VJROINIA,
COUNTY OF . ~
{;
c,,.j
r}(tC,,/2~t
j t, '
,v ,Jr J.
1
("
l.
I,
d"
it,, [
·, being duly sworn, depose and say that I am
the consigne'e of a certain shipment of ardent spirits , as specified on other side of this form, thi s day
,@c
h
delivered to me by the Southern Express Compan~, from
5".,!,t. ,J- t ,._ l,.. ; that I am not
a student or minor, and, if a female, I am the head of a family ;,c1th at the ard ent spirits so received by me
were brought into the State on my written order, and that I have not , within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any pe1·son or from any place whatso·
ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
by me for _ _
-"-/---'/'-"l-=,_/._,_,_.'_,-'1--'-,_c-=-'-/___ _________ __.,urposes.
(State whether for Scientific, Sacramental, Medicipal or Mechanical)
/,,,.JI,'
�'"""",J3t
Advnncea to
Collect
To Consionee _ ______ ______ __ _ __
Acld
PREPAID
Unde r charge
To Shipper _ _ _____ _____ ______
Af"f"IOAVIT f"OR ARDENT S PIRITS f"OR PERSONAL USE.
( OV ER)
�AFFID AVIT FOR ARDE NT SPIR ITS
FOR
STATE
PERS ONAL USE
o~• VI RG INI A,
COUNT Y OP-
-
- -- -- - - ~ ~
i,
1
--;- being duly sworn , depose and say 1;hat I am
ihe consig nee of a certai n shipm ent of ardeni
spirits , as specifi ed on other side of this form,
this day
delive red to me by 1;he South ern Expre ss Comp
any, from _ ______ __ _ _ _ __ ; that
I am not a
studen t or minor , and, if a female , I am the head
of a family ; that the ardent spirits so r eceive d
by me
were broug ht into the State on my writte n order,
and that I h ave not, within th e thirt y days
previo us
hereto , r eceive d any ardent spirits of any kind whatso
ever , from any person or from any place whatsoever
, in
excess of the quanti ty allowe d by the provis ions
of the Act of the Gener al Assem bly of Virgin ia,
approv ed
March 10, 1916, or contra ry to law , and that the
ardent spirits so r eceive d by me are for m y own
use, at
my own hom e, and that th e said ardent spirits
will not be used in violati on of law.
Sworn to and subsc ribed before m e,
this _ _day oL
/4
Consicn ee.
,
191_
" "'C nress Cowvao y.
�SOUTHERN· EXPRESS COMPANY
FORM 370-VA.
(Incorpo rated )
SPECIAL LIQUOR
RECORD
Received at, _ _ _ _ __ _ _ _ __ _ _ _ _ Oate Feb .
Co nsig nee _
Kind of Ardent Spirits _ __ _ w
=-=h=1=· ~
s~ky
~ _
Way-Bill No,_ _
Affidavi t
_____ Amoun tL_ _ _ __l- q-'4--'t...___ _
N✓/ 11=
I
Weigh tcc4X".-.-_ _ lbs.
~ 3=6~5~ _ _ Date___2__,/~1~
_ 7~ - -- - - 191_Iashc1i11n
lU~g~t.....
.o.....n~~
o'-'-c,___
To
Shipp er
19/171@1 _
Mason
Boggs ,
_ _ __ __
_ _
Conrad Page Co
Adv.i,n ce s to
Collec t
.
I
EXPRESS C HAl<GES
.PR E .PAID
COLL EC T
!
I 28
_
A <l<l
Unde rc har ge
I
RECORD OF NOTICES
To Consig nee ~ - - - - -
To Shi pper _ _ _ __ _ _ _ __ __ __ _
AFFIDAVIT FOR ARDENT SPI RITS FOR PERSONAL USE.
4 9 lfard
(O VER)
�AFFIDAV IT FOR ARDENT SPIRITS FOR
STATE o;•
COUNTY
PERSON AL USE
Ym
m •- ~ - ~.
;2
RJ ,
I,
t
I ";I /
being duly sworn, depose and say that I am
the consiguee of a cc rtaiu shipm ent of arde,~t ~~irits, as specified 011 other
sid of this form, this day
1/.,
delivered to me by the Southern Express Company, from
l) J l I
, that I am not a
student or minor , and, if a femal e, I am the hev.d of a family; that the ard( nt
spirits so received by m e
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person or fro
m any place whatsoeve r, in
excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia, approved
:\larch 10, 1916, or contrary to law, and that the a1·dent spirits so received by
me are for my own use, at
my own home, and that the said ardent spirits will not be used in violation of
law ,
71¼c
.A~en f for Sontl1el'• Ex).)res-e Compauy.
�-------- ---~--- ----FORM 370•V A
SOUTHERN EXPRESS COMPANY
(Incorpo rated )
Advnn.-ee t o
Colle ct
Add
COLLECT
Unde r chnrge
RECORD OF
To Consignee _ __ _ _ _ ____ _ _ _ _ _ _ __ To Shipper_ _ _ ________ _______
AFFIDAVIT FOR ARDENT SPIRITS FOR PERSONAL USE .
( OVRR)
•
�-= -
- =-==-=....,,--=-=----.,....---~ - - - AFFIDAVI T FOR ARDENT SPIRITS FOR
PERSONA L USE
STATE OF VJRGINIA,
COUNTY OF_
/ ~/~ -'c
"~ -
- - - --"------ -:,--
-..
i, ., /-
I '
...__
, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as pecified on other side of this form,
this day
1/2 • / ~ •
delivered to me by the Southern Express Company, fro
I'
/ /; lttiat I am not a
student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever,
in
excess of the quantity allowed by the provisions of the Act of the Gener al Assembly of Virginia,
approved
March 10, 1916, or contrary to law, and that the ardent spirits so received by me are for my
own use, at
my own home, and that the said ardent spirits will not be used in violation of law.
✓, (7/?.,-,,,, ~
Colls1cnee.
'd before me ,
- --C-1,
{
191 -
1
/
A2ent for Southern Express Company .
•
t.p
�,I
F0R!YI 370- VA .
Revised June, 1018
SOUTHERN E XPRESS COMPANY
(Incorpornted )
0
SPECIAL LIQUOR RECORD
W• M . Heatwo ) e,
Kind cl Ard ent Spirits _ _
~
Apr i l 5 /iU.!__!_ Affidavit No.
P. O. ·Address .HintonVa
Received at----c=--- ----- _ _ _ _ _ _ Date
C~nsignee
ne
_ __
~b~e~ e~r-~---- - - - Quantitv---3.ga~ _ _ _ _ Weiuht&f}-_ _ lbs.
____ 19l.9.. From »a l tim-o~t...d...- - -
·· \ vay- Bill No._·_ 1_ _ _ __ _ Date __
4../_4
,. ~
To
Shi pper
R
Advances to
Collect
Francion
P. 0. Address
EXPRE SS C HARGES
PUEl>AID
I
/
I
r
I
COLLE CT
f4
\YarTu
Collect
04
Add
Und er c hnrge
I
RECORD OF NOTICES
To Consionee ________ _ _ _ _ _ _ __
To Sh ipper _ _ __ __ _ _________
(on&)
�,--- ~-==- ==-~----------- ----- - --- - ---- -------~------ --.
.
S'TA'U 9F V rnGJNfA,
COUNT-Y ~F~ -
-~-
- ~ - - --
)
•
I
I
being duly sworn, d.epose _and say that I am
/
I, 1
the consignee of a certain shipment of ai-dent s vi rits, as spe~ified on other side of this form, thi s day
I'
/
; that I am not
delivered to me by the Southern Express Company, from J ( , I.
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so r eceived by me
were brought into the State on my written order, and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or- fro)!! any place what~o ever, in excess of the quantity allowed by the provisions of th e Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for _ _ _ _ ___________ _ __ __ __ ____ purposes at my own hom e, and in con(S tate whether for Scientific , Sacramental, Medicinal or Mechanical)
formity with law .
Coosi2nee.
Sworn to and subscribed before me,
this _ _
day of _ __ _ , 191_
.
Agent for Southern Express Compau,-.
�FORM 370- VA.
SOUTHERN EXPRESS COMPANY
(Incorporated)
Rev ised June, 1918
SPECIAL LIQUOR RECORD
April 28fi[.19_._
Cons ignee _ _ _T
_b_o_s__R_ L
_ o_k_e~y_____ ____ P. 0. Address _ _
Received at _ _ _ _ _ _ _ _ __ _ ___ Date
Affidavi t No.
l
....,C
= i '-"tC.Oy,__,_
, _ _ _ __
Kind Ill Arde nt Spirits _ _ _w
~h~ iecs=c.k
==..Y<--------- Qua nti ty _ _~l~C+J~t<--____ Weigh t~4"0e-- -lbs.
Way-Bill
No._•_1~3~1~ ____
To
Shi pper
Advances to
Collect
J _. J. stumn
FrnrCnmberland Md.
Date_ ~ 4._,-/
~2~ 6
~ _ _ _ 191___
&Co
EXPRESS CHARGES
COLLECT
I
I
I
I
P. 0. Address
WarTu
PREPAID
Collec1
31 02
Add
Underchnrge
I
RECORD OF NOTICES
To Consig nee _ _ _ _ _ _ _ __ _ _ _ _ _ _~
To Shipper _ _ _ _ _ _ __ _ _ _ _ __ _
(OT'ER)
�delive red to me by the South ern E
~ "'---'=---'='--'--""'-""'-'"=---- =--- ,
a studen t or minor , and, if a, fema
that the arden t spirits so receiv ed by me
were broug ht into the State on m writte n order,
and that I have not, within the thirty day s
previo us
hereto , receiv ed any ardent spirits of any kind
whatso ever, from any person or from any place
what~ oever, in excess 'of the quanti ty allowe d by the provis
ions of the Act of the Gener al Assem bly of Virgin
ia,
approv ed Marc
18 or cont ry to law, and that th e ardent spirits
so receiv ed by me are to be used
,___:_...: _.:::t'. :!.~'.'k '~~== ::::=-- =~:__ ::~-==
~- - - - PUTposes t my own hom e, and in con-
r Mechan ic111)
Sworn to and subscr ibe
ihidJ J._day o>J.},,.~-; C_~~ _,,.
Consien ee.
�FO RM 370- VA .
Revised J une, 1918
SOUT HER N EXPR ESS COM PANY
(I n co rpo rated)
SPEC IAL LIQU OR RECO RD
Receive d at _ _ _ _ _ _ _ _ _ _ _ _
Consignee
Ur. w•
26 / 1!9...f.._
_ _ OateA p r i
L
Kin d of Arde nt Spirits _W
_ h_ i_s_ k_ y~ - - - ~ - - - - Quanti ty
7_S__ __ __ 0ate __ 2_ 5
__ __ 191~
To
.Advanc es to
Collect
Shipper R F ran cio n
P. 0. Addr~
12q t
Weight 50
FromBa l tim o r e ,Md
4_/_
Way- Bill No._
l
ti ore
I
I
Md .
RECO RD Of' NOTIC ES
To Consignee _ _ _ _ __ _ _ _ _ _ _
J. Sid ney
EXPI\E SS CHARG ES
PREPA I D
Pe t ers
_ _ __
I
I
I
I 86
WarTu
Collect
05
Add
Unde rc h a rge
I
To Shi pper_ _ _ _ __ ___ __~ ---
per mit # 265 6
(on&)
COL L ECT
lbs.
Apr il 21s t , l!H 9 .
�---- ---- --~- --- --- -----,-- -=---- --- --- --- --- -COUNTY
6'/'\ J
OF
-==--~-"'- '-'- .c. . c'- =-----'1---·'-""" -=-m✓iag
duly sworn, g,epo.se and
a1·d,j spirits, as s p e < J ~ of this f
si:
that I am
, this day
1/r' ·
delivered to me by the Southern Express Company , from ·
~_
', -that I am- not
a student or minor, and, if a female, I am the head of a family; that the
ardent spirits so received by me
were brought into the State on my written order, and that I have not,
within the thirty da)'.s previous
hereto, received any ardent spirits of any kind whatsoev er, from any
person or from any place whatEo ever, in excess of the quantity allowed by the provision s of the Act of
the General Assembly of Virginia,
approved March 19, 1918, or contrary to aw, and that the ai;Jl,nt spi~its
so received by me are to be used
1
.
_/_.
by me for
(State whether f
formity with law.
._ ,_-
-~~
//
-'
Sc en!- fie, Sacrament al, Medicinal or Mechanica l)
Sworn to and subscribe d before me,
this _ _ day of _
-·
_ _ _ , 191_
Agent for Southern Express Compan~.
purposes at my own home, and in con-
�FORM 3 70- VA.
Revised June, 1018
SOUTH ERN EXPRESS COMPANY
{ In corpornt cd )
SPECIAL LIQUOR
RECORD
Received at_~_______________ Oate_ _ _ _ _ _ _ _ 19·1~
Affid avit No._ l _,_ _ _ __
d.
~ -- - - - .,.~
1'....,__ _ _ _ _'-.:''. --l. p_ 'Ad~ress ____·?_ •...,t._,·:J
.lc;cl;__=Consig nee _ __ _a______r,_, _,,a"'l=-c'".;;;
., _ _ _ _ _ _ _ _ _ _ Qua ntity_ __.__.,....._,___ ____ Weigh ~ - -+-lbs.
Kind .!lf Arde nt Spirits_ ,~ ]~!~S_1~· ="-. ;,_
Way-llill No. '
0
Date
~
Froml..:_L...__..,....__,_,_~ - -•~,:i~ - - -
191 _
'1
Advance s to
Co ll ect
To
Sh ipper l,
1 .1
ra1 cion
I
CO LLECT
PREPAID
I
I
P. 0. Add ress
EXP RE SS CHARGES
I
1 ~~
I
I
..,. ~
Collect
Add
Uud ur cho.rge
~
I
RECORD OF NOTICES
To Consig nee _ __ __ _____________
To Shipper_ _ _ _ _ __ _ _ _ _ _ _ _ _ __
.I
(OTER)
�STATE OF VIRGINIA , /
COUNTYOF~,c. . . dl...a-~~'-,+✓-+~~-I, ----=~- - -- - ~ ~ ---'--~ - - - - -- -, being duly sworn, depo se and say that I am
the consignee of a certain shipment of ardent spirits, as specifi e..(l on other side of thi s form , this day
delivered to me by the Southern Express Company, from
'
; th at I am not
a student or minor, and, if a female, I am the head of a family ; that the ardent spirits so r eceived
by me
were brought into the State on my written order, and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatEoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
)
}(
L
(State whether for Scientific, Sacramental , Medicinal o, Mechanical)
purposes at my own home, and in con-
formity with law.
_/.
Sworn to and subscribed before me,
thi L
-1-1
,,,
- 1/(A
(
day of __ ~~ - - 191'
·\ :-·
ConsieDee.
_.,.
/ (
-+
Aeent ~o';;thern Express Com11u1 . ( f l
t,6tk::; / f~ , '£, 7-/-
✓---
p...rr>(
�FORM 3 70- VA .
R evised J un e, 1918
SOUTHERN EXPRESS COMPANY
(lncorporn t e d)
SPECIAL LIQUOR RECORD
I
r
1-1/10
Received at_______________ __ 0ate_ _ _ _ _ _ _ 191 _
~ _ _ _ _ _ _ __ _ P. 0. Ad dress _ __ _ _.............."--"~ ~ - - ~tl
Consion ee _ _ _ __ ~ =~ ~a- S~O
4
b_s_i _Jc~y.,_________ Quan tity_ _,1'-'q+-+t~ -- - - Weioht
Kin d ol Ard ent Spiri ts_ _ _\_f_
Way-Bill No. 4
To
Shipper
" 'l 98
u.
p
.Date
./1 0
Fro~ al ti mn P
191_
Advan ces to
Co ll ec t
Gi l :Qi ,- Co
EXPUESS CH AUGES
I
I
P. 0. Add ress
I
War Tu
CO L LECT
PREPAID
I
I
I
Un
32
Coll ect
2
lbs.
Add
Unde r c ha rge
I
RECORD OF NOTICES
To Consio nee ________ ________ _
To Shipper _ _ _ _ __ ___________
(Ol'ER)
�~-
- -
-
- -
-
-
-
-- --
-
-~
---- ~--- ---- ---- -- --~----- - ----..
.,
STATE OF VIRGINIA/ '
COUNTY OF
/L.
U
l,
I
the consigt /e of a certain shipment of ardent s pirits, as
delivered to me by the Southern Express Company, from LJL~~"" "'==.~~_
:_- - -~ i that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent
spirit o received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person
or from any place whatrnever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 19, 1918, or contrary to law, and tJ:iat the ardent spirits so received
by me are to be used
~~_____
. }//..L r/1
t £ L'1.
L
_____
_____ _____purposes at my own home, and in con-
by me for _ _ _ _
(State whether for Scientific , Sacraments! , Medicinal
formity with law.
. ~z··
Sworn to ari;
yr
echanical)
/ • lf-J
~ _ ,,t/
\
,,,/
V
/ / ,
(./{.,-/ ,C/-
I L
Consii:nee.
�SOUTHERN EXPRESS COMPANY
FORM 370- VA.
Revised Ju ne , 1918
(I n c orporat e d )
SPECIAL LIQUOR RECORD
May l/19 .._ _
Received at _ _ _~_ _ _ _ _ _ _ _ _ _ _ 0ate_ _ _ _ _ _ __ 1:-.t 1
_i_~_._
Consignee_ __D
f~i~t_z_'"'~e~r~ ,_ _ ____ P. 0. Address_
_ .__s_,_
_{_._D
A
- 2_ _ _ __
Affi davi t No._
C~i~t ...Y~· - - - - _ _~
'-'h'-"-'iwS......,k.y;J----_ _ __ ____ Quantitv----1q..:.,__ _ _ _ Weight
Kind of Ardent Spirits _ ____.W
Wav-llill No. _ 4-8"'---- - - --•ate
Shipper
Frollal t j mo.re....,- ~-ld_• ___
4/30/19 . 191 _
Adv ances t o
Co l lect
To
Roanok e \Vine Co
EXPR ESS CHARGES
PRE P A ID
I
I
P. 0. Address
_ _ lbs.
I
CO LL ECT
r3
WarTax
Collect
02
Add
Unde rc harge
I
RECORD OF NOTICES
To Consignee ________ _ _ _ _ _ _ _ __
To Shipper _ _ _ _ __ __ ____ _ _ _ __
(OVER)
�_J'-----"c:...J"---""'-----'-- ----'' ---,4---'='-"'
-----~
- -~
, being duly sworn , depos e and say
that I am
specif ied on other side of this form, this
day
~~
delive red "to me by the South ern Expre ss
Comp.any, from
•
; th at I am not
a stude nt or minor , anil, if a femal e, I am
the head of a famil y; that the ard ent spirit
s so receiv ed by me
were broug ht into the State on my writte n
order, and that I have not, within the thirty
days previo us
hereto , receiv ed any arden t spirit s of any
kind whats oever , from any perso n or from
any place whatr never, in exces s of the quant ity allowe d by
the provis ions of the Act of the Gener al Assem
bly of Virgi nia,
appro ved March 19, 1918,_or contra ry to law,
and that the arden t spirit s so receiv ed by me
are to be used
by me for
'h·
(State whethe r for Scienti fic , Sacram ental,
Medici nal or Mecha nical)
formi ty with law.
'¾
:r•
.
11 , a.
Sworn to and subsc ribed before me,
lhi,_l i___d ,y of
1.
~
191
~ Agent for Southe rn Expres s Compa ny.
purpo ses at my own home , and in con-
-
Consie-nee.
�FOR M 370- VA .
Revised June , 1018
SOUTHERN EXPRESS COMPANY
(Incorpo rated )
SPECIAL LIQUOR
RECORD
Ma y 1 / l ~Ji'-
Received at _ _ _ _ _ _ _ _ _ _ _ _ _ _ Oate
Shipp er
Weight • l _.,6,.___
l ga J
From l:ia l t i more ~ld
Quanti ty
No._ 6_ 0______0ate _ _~ /_1_3___ 191 _
Advances to
Collect
To
No.__L__
P. 0. Address ___
= ~ - -- - - - -- -Kind of Arde nt Sp irits_ ~r~um
Way-Bill
Affidavit
i~t~y_ ______
Consignee Grl.Dll i ne & 0 t Donn 11
Lamd i n Thom n son liO
P. 0. Ad dress
EXPRESS CHARGES
PRE PAID
I
I
I
RECORD OF NOTICES
To Consignee _ __ __ __ _ _ _ _ _ _ _~
CO LL ECT
To Sh1pper _ _
I
WarTu
Collect
7· 03
lbs.
Add
Unde rcharge
I
t\J
+c/, - ------------
�- -
--- -
·-·--- ---- ---- ---- ---- ---- -------~ ~.
---,
n;
a certain shipment of ard ent spirits, as
this form, this day
t
~~~~~~ ~-_!__- ~
delivered to me by the Southern Express Company , from ~ ~~:"'.:'.!~
by me
received
so
spirits
ardent
the
that
;
family
a
of
head
the
am
I
a student or minor, and, if a female,
within the thirty day s previous
were brought into the State on my written order, and that I have not,
or from any place whatrnperson
any
from
er,
whatsoev
kind
any
of
spirits
hereto, received any ardent
eral Ass embly of• Virginia,
Gen
the
of
ever, in excess of the quantity allowed by the provision s of the Act
by me a re to be u sed
received
so
s
t
spiri
ardent
approved March 19, l ~~~ ~
~- - - , - - - - - - Purposes
-~
- ----vby me for _ _ __ _-'---~- - - - r Mechanica l)
al, l,ledicin
(State whether for Scientific, Sacrament
formity with law.
at my own home, and in con-
�FORM 370 - VA.
Revised June, 1918
SOUTHERN EXPRESS COMPANY
( Incorporate d )
SPECIAL LIQUOR
Received at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0ate
Consignee _
RECORD
1/l 9
fay
W._ __
M. _Heateole,
__
__ __ _ _ _ _ __ __
No._ 7_6_______ Date _ _4~/
-=
3-'-0____ l91 3
Advnn ccs to
Colle c t
.a..Jt
1t1tY
From
3 ga 1
No.__3____
Weight
Baltimore
EXPRESS CHARGES
mmu
Shipper
Affidavit
_ _ P. 0. Address _ __RFD
_ _ _ _ _ _ _ __
r _ _ __ _ _ _ _ Quantity
Kind of Ard en t Spirits _ _ _bee
_ __
Way-llill
i91 _
'""]: :
~:q
75
lbs.
Md
~,
u.,~(.,,.
RECORD OF NOTICES
To Consignee _ __ _ _ ____________
To Shipper _ _ _ __ _ _______ _ _ __
(ona)
�STATE OF VIRGINJA,
)
COUNTY OF.-..- ~-
~ - - - - - , ~ --
a&m , H~~~
!,
being duly sworn, depo se and say tliat I am
the consignee of a certain shipm ent of atdtnt spi rits, as specified on ,other side of thi s form
, this day
. outhern E xpress Company, f rom -1[..-':l_.!
'~
delivered to me by the S
- ;1,: , • - ..,, -; that I am not
• ~/ ~
,L L./
a student or minor, and, if a female, I am the head of a family; that the ard ent spirits so 'received
by me
were brought into the Sta.te on my written order, and that I have not, within th e thirty days
previous
hereto, received any ardent spirits of any kind whatsoever, from any person or froµi any- place
whatrn.ever, in excess of the quantity allowed by the provisions of the Act 'of the General Assembly
Virgini a,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are
to be used
of
,/
by me for
if. dA aL
,
,... .
s....,,'.t'.
.
\#
'
k
(State whether for Scientific, Saeramental, Medicinal or Mechanical)
purposes at my own home, and in con-
formity with law.
Consi 2nee .
Ai:ent for Southern Express CompallJ.
�SOUTHERN EXPRESS COMPANY
FOR M 370- VA .
R evised J un e, 1918
(l ncorpornted)
SPECIAL LIQUOR
Receive d at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Oate
RECORD
Ao ril 2 R/ ~r1_•_
C~i~t~y______
P. 0. Address _ _ _~
H. L . B rtncr ,
Con signee
5
Affidavit No._ _ ____
"
l -.Jy,___________ Quantity---1..q t
Ki nd of Ard ent Spirits__.w...,h.........i ....,s.L..&
Way-Bill No.
101
Date
Advan ces to
Co ll ect
To
Ship per
Frorfumberland Md
191_
4 / 25
J. J. StUIDJ11k Co
P. 0. Ad dress
Weig ht__ 4---lbs.
EXPRESS CHARGES
PREPA I D
I
I
I
I
CO LL ECT
I
I
132
~-'•
•; ct
Add
Unde rcharge
I
R ECORD OF NOTICES
To Consignee_ _ _ _ _ _ _ _ _ _ _ _ _ __
To Shi pper _ _ _ _ __ __________
(O VE R)
�7
~ ~_.__ __ , being p.uly sworn, depo~e and, say that I am
the eopsigne e of a certain shipmen ~ of ardent spirits, as specified
on other sid\) of this form, this day
delivere d to me by the Souther n Express Compan y, fron, ~L
YU~
~ '; · that I am not
a student or minor, and, if a female, I am the head of a family;
that the ardent spirits so received by me
were brought into the State on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from J1DY pjace whatrn ever, in excess of the quantity allowed by the provisio ns of the
Aet of the General Assemb ly of Virginia ,
approve d March 19, 1918, or contrary to law, and that the ardent
spirits so received by me are to be used
I"(
by me for
,(tlt..cf l
1
1 J tl (
(State whether for Scientific, Sacramen tal, Medicinal or Mechanic
al)
purpose s at my own home, and in eon-
formity with law.
Consignee .
�f"ORM 370 - VA .
Revised Ju ne, 1918
SOUTHERN EXPRESS COMPANY
(I nco rporated )
SPECIAL LIQUOR RECORD
Received at ________________ o/
ay
21/l~ •
191 _ . Affidavit No.
/V __
P. 0. Ad dress _ _ _ _i_t_ y_______
: : :.. . , - - - - - - · - - - - - - , - - - , - - - - - - :
_ ~_____ 0ate,_ _ _n ~/--.:::..1--.:::.._~_.--.:::..--.:::..--.:::..--.:::..--.:::.-. -19.1_
Way-Bill No. __2
EXPRESS CHARGES
To___________ _ __ _ __
War T,i
Add
Advance s to
1
_____:._.:_________
Ship per __fi
Colle ct
1
_
-'TEC
P_R_E_J'_A _I D- ~ -C- O_L_L _
I
P. 0. Add ress
Collect
Uud ~rc b11rge
2
RECORD Of" NOTICES
To Consignee
To Shipper _ _ _ _ _ __ __ _ _ _ _ _ _ __
(ovu,
�STATE OF VIRGINIA,
/
COU NTY
OF_~I_---=:___..:._.__--====-=-- ·
_£
~
, ., ,
I,
-(f
, be_ing duly sworn, depo8e and say that I am
the consignee of a certain shipment of ardent spirits, as specified on other side of this form, this day
~
delivered to me by the Southern Express Company, from
;
·l ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent sphits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
✓)/.
Ll .
<
~ - ~ ~ - - - - - - - - - -Purposes at my own home, and in con-
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
j[y
=-.:.___,__::=-.:s=-...,.,c=-=____._._L--=~-
_ ____,t,
.,_
l_) _
formity with law.
Sworn to ~nd subscribed before me,
tbis _ _ _ day of _ {~,1_ _ _ _ , 191_.
Ae;ent tor Southern Exvress Comvany.
�SOUTHERN EXPRESS COMPANY
FORM 370 - VA .
Rev ised June , 1918
(I nco rporate d )
SPECIAL LIQUOR ~ ECORD
6 / 19
Received at __________ _______ Date ________ 191 _
, ~•Consignee_ __ _
3
Affidavit No, _ _ _ _ __
- i i,-,ti,,y+-,,.---- -- - -=A~•~=o=n..ge---____ ______ _ P. 0. Address _ ___,C
gal win t¥eight 15
~fd
Frohialtimore,
W~i~n~ e '---1,----- - - - - - - - Qua ntity_ _~l~
Kind of Ardent Sp irits _ ~
1_3_7_____ Date _ _6~
Way- Bill No._ _
A d vance s to
To
Shipper
_1_6____ 191_
Coll ect
I
Ulman & Sons,
E XPRE SS CHARG E S
PREPAID
I
I
P. 0. Address
I
COLLE CT
145
WarTu
Collect
lbs.
Add
U nd e r charge
.1~3
I
RECORD Or NOTICES
To Co nsi gnee _ __ _ _ _ ___________
To Shipper _ _ _ _ _ _ ___________
(on&)
�STATE OF VIRGINIA,
I, ----"-"'--''-------'"'---'"-'--,_,""--'-'.,_,-.-1,,...__ _ _ _ _ _ , being duly sworn, depose and say that I am
specified on other side of this form, this day
the consignee of
delivered to me ~y the Southern Express Company, from --'"'-1r--",'""""-""'1""'N"'-".,.1J=..As.--- ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place what~oever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
11'.l ~ ,cl,;, " ,c,..J.. CJ, u n..1 . . UJ~•- rpurposes at my own home, and in con-
(State whether for Scientific , Sacramental, Medicina\ or Me; ;;;;cal)
formity with law.
Consi211ee.
Sworn to and subscribed before me,
this
Al?ent for Southern Express Company.
�""'
l;•
FORM 370 - VA ,
ReYised June, 1918
\>~
S~THERN EXPRESS COMPANY
J
"!/;~...__.....,.-·SPECIAL
(In co rporated )
?
LIQUOR RECORD
Received at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0ate _ _._6cc.. /.,. ~1=7
~·-.__ 191 _
Affidavit No. _ _ _,,.__
_ __
Con sign ee _ _
w_.__N_._ _8.-"'P_r_i _k_l_e_____ ____· P, 0. Address·-_ _ _C_i _t~y______
whdiky
Kind of Arden t Spiri ts _ _ _ _
_ _ _ _ _ _ _ _ _ _ Quantity_1qt
_______
_ Weight _ _ _ _ .lbs,
Way-Bill No._ _
1_6_____ Date _ _6~_
1_4_
To
ShippeJ •
_ _
Advan ce s to
Coll ect
Frank Truner,
191_
L'fltUi
PREPAID
I
I
P. 0. Address
ore
d
E XPRESS CHARGES
I
COLLECT
138
""~
Add
Undercharge
C~ ct
I
RECORD OF NOTICES
To Consig nee _ _ _ _ _ __ _ _ _ _ _ _ __
To Shipper _ __ _ __ _ _ _ _ _ _ _ __
(on&)
�- -1----!L- Q..J:,.._~.z,~!"".l.l!!!.'!~~~ V'.!:!'!'"'.{.,,L- -- - , being duly sworn, depose and say that I am
a certain shipment of ardent s i,irits, as specified , on other side of this form, this day
delivered to me by the Southern Express Company, from ~
; ~ I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by m e
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whateoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
�FOR M 370- VA.
~
SOUTHERN E XPRESS COMPANY
( I ncorpornted)
Revised June, 1018
~
5
Oate J unr ~\n ~ 91_ ' Affidavit No.
SPECIAL LIQUOR RECORD
Received at _ __________ ____ _
• _ _ _ __
it ~ _.__ _
Lllrtner ,
Consionee _ _ _ _ _ __ _ _ __ _ _ _ __ -'---~--- P. 0. Address-_ ___Y
w~b.......i,...s~ k~Y-- - - - - - -- Qua ntity-----1-(l,__.,___ _ _ _ _ Weioht--4-_ _ lbs.
Kind of Ardent Spi rits _ _~
6~3~:l~ _ __
Way- Bill No. _ ~
Oate _ _
To
Shippe r
J • ,J . S tump & Co
~fi_,_/~3~ __ 191 _
.Advan ces to
Collect
I
PREPAID
I
I
P. 0. Address
Fro nCu~ ~
EXPRESS CH,J.RGES
COLLECT
\31
...,~
Coll ect
0~
Add
Unde rchar ge
-I
RECORD OF NOTICES
To Consignee _ _______ _____ _ _ __
To Shipper _ _ _ _ __ __ _ _ _ _ _ _ _ __
(OTER)
�S'!ATE
OF
VIRGINIA,
COUNTYOF -,,/
_ ,_TC1,___ _,_,"'=-',......,~~~~-6
~ ~L-+-~- ~-..aH,'- -9'~"---f .4-6- ~;..c~;..... ;~-, being dnly sworn,
depose and say that I au:
shipment of ai-dtnt spirits, as specified on other side of this form, this day
delivered to me by the Southern Express Company, from - --.-~-.-, ,--,-~~--~--~- i that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent
spii·its so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person
or from any place whatEoever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received
by me are to be used
by me fo~
Toe (/,••
u: )
f •, •t (
purposes
(State whether for Scientific, Sacramental , Medicinal or Mechanical)
formity with law.
J~_L
~ ~ /..
at my own home, and in con-
j.
1,,t/J1 C 'Y'
Consienee.
�DELIVERY FORM
eo
•
ADAMS EXPRESS COMPANY
RIIVl IED JUI.Y, 1917
SPECIAL LIQUOR RECORD
an., 24
Received a.___ _ __ _ _ _ __ _ _ Date_____ __191_ Affidavit N..o-,,~ - - ~ity,
auchero
w L
11 -=-- - - - - ~•- - - -- - P, 0. Address _ _ __ . - - - -~ Conalgne •---~
..
Kind of Ardent Splrlta
.
Whisky
Amo1,1nt
1qt
, , .,,.,
Oat____.1._/_ _ _ _ _ _191_ Fro
Way-BIii No. 79 3 '~
To _ _ _ _ _ __ _ __ _ _ _ __
Welaht
» a l tl.l!10 Y' e
7
1
Iha
·:1l" •
r----~--=EXP=i::-:::::::::-CHARG==:::F.s=""---r-----,
Adc:n: to l-=Pc-=RE:;::,:;::PAID;.;:;;=-,,..;..:::OO~LLECT::;:;::;,,.,.,..~ Uad.!:1harp
Shipper _ _ _ _ _ _ __ _ _ __
P.O. Address
RECORD OF NOTICES
To Conal11nee
:ro Shipper _
_ _ _ _ _ _ __ __ _ _
..,
(OVER)
�STATE OF VIRGINIA,
J
,..
\
t
being duly sworn, depose and s-ay
! ,,.
I,
sp
as
;,
spirit
ardent
of
shigment
the consignee of a certain
J; th
delivered to me by the Adams Express Company, f:rom
a student or minor, and, if a female, Lam the head of a family; tha,t the ardent spirits so rec ived byme
were brought into the State on my written ol'-der, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia, approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me
are to be used by me for
•
,
'
-
,,
~
~
/
.r ~,
_,
- ·
·
purposejl.
.
(State whether for Scientific, Sacramental, llledicinal or Mechanical)
7
,,.
(Consignee)
�SOUTH ERN E XPRESS COMPA NY
FORM 370- VA .
Revised June, 1918
(I ncorporated)
SPEC I AL LIQUOR RECOR D
Jan ' 24 / M~
Rece ived at~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Oa te
-~ffidavit No.__1_9___
s_. __•__S_h_a_v_e_r_,,c..._____ ____ p_ 0. Address-_L.c..a_ c~y'---~
Consignee _ _ _
~ f~r~ i =n~ g=s~·- S'
, ____ Weight~ 4c+__ _ lbs,
a..........t~
Kind of Ardent Sp irits_ ~ w~l~i~s~·~I ~k....y,______ ____ Quantity _ _~ , ....
___ __ Dat~
Way-Bill No._ _ _4_3
1 / 23
Advances to.
Col lec t
To
Sh ipper
Frorn h a l timnr e A.. d
191_
Clark e & Son s ,
P. 0. Address
EXP R ESS CHARGES
COLLECT
PREPAID
I
I
I
I
I
132
'.".:.')"·'T...""'
RECORD OF NOTICES
To Consig nee _ _ __ _ _ ____ ____ __
To Shipper _ _ _ __ _ _ _ _ _ _ _ _ __
(on&)
�______
.......____
STATE OF VIRGIN A,
I,
' · " 1.....,,,
, bein~ du1y sworn, depose and say that I am
the consign ee of a certain shipmen t of ardent spirits, as specified
on other side of this form, this day
~1
!(/ { ' { '- .. ,
delivere d to me by the Souther n Express Compan y, from
-{Z
that I am not
a student or minor, and, if a female, I am the head of a family
; that the ardent spirits so received by me
were brought into the State. on my written order, and that I
have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoe ver, from
any person or from any place whatso ever, in excess· of the quantity allowed by the provisio ns of the(Act
of the General Assemb ly of Virginia ,
approve d March 19, 1918, or contrary to law, and that the ardent
spirits so received by me are to be used
--.
by me for
,) /
{
J.__ (
l
L
t L
L-
(State whether for Scientific, Sacramen tal , Medicinal or Mee
formity with law.
Consh:nee .
Sworn to and subscrib ed before me,
this _ _
day of
J ___ , 191 0
.
/,7
/(,? (n _ /
./.
Agent for Southern Exvress Company .
�SOUTHERN EXPRESS COMPANY
FORM 370- VA.
(Incorporntcd )
Revised June, 1918
SPECIAL LIQUOR
RECORD
Rece ived at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Feb,
Consignee
J . J . Weng e r ,
? () /1191_
• _ Affi davit No .__A_____
P. o. Address_~t~ D
~-------
1 at.
Weight _ _
lbs.
d.ltimore
Fro m_ _ _ _ _ _ _ _ _ _ _ _ __
Kind of Ardent Spi rits~ lV- b
~ S~i ~k...,yr -- - - - - -- - - Quantity
Way-B ill No.__3_A
_____
_
Date_ _~_
/_1__/_l _P__ 191_
To
Shipper __R_
Advance s to
Coll ec t
E'r ancione ,
P. 0. Add ress
E X PRES S C HARG ES
PREPAID
I
I
I
I
COLLECT
I
I
WarTax
Coll ect
182.02
Add
Und e rchurge
I
RECORD OF NOTICES
To Consignee _ _ _ _ __ _ _ _ __ _ _ __ _
To Shi pper _ _ _ _ _ _ _ __ ___ _ _ _ __
(OTER)
�I, --"'J.c:.F,~.........,"'---':......"""':...:::.-='.-,:::" - - - - ' = - - - - - - - - -, being duly s worn , d~pose apd say that I am
th!) co;isigne
specified on other side of this form, this day
-✓~V
~_·
delivered to me by the Southern Express Company, from ~fi-~M
~~~z~:~'.)::~l~=M
·
- - - i th at I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within th e thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatrnever, in excess of the quantity allowed by the provisions of the Act 'of the Ge~eral Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
1
by me for
'//UvC<
(State whether for Scientific,
formity with law.
..::? /
Saenmental, Medicinal or Mechanical)
1
purposes at my own hom e, and in con-
Consi&nee.
Sworn to and sub c
t Js_j__day oi
Ae;ent for Southern Express Company.
�FORM 370- VA .
Revised June, 1918
SOUTHERN EXPRESS COMPANY
(I nco rpo rat ed)
·
SPECIAL LIQUOR RECORD
Rece ived at _ _ _ _ _ _ _ _ ____ _ _ _ _ 0ate_ _ _ _ _ ___ 191 _
Affidavit No,.---'-"'·~ - - - -
_ U_s_ e_ _ _ __ _ P. 0. Add ress _ _ _ _ _ _ _ _ _ _ __
_ .__ll_O
Consignee_ _ _ _ _ _ _ _J_. _ A
4 lbs.
Kind of Arde nt Spi rits--Wl:l,-,.s-.-1+·_.,k.,_~.,_r_ _ _ _ _ _ _ _ _ Quan titY- - - ---<--<+--t--- Weight
X
lt
ili
more
i
.La
b
1'
•e
11
111
Fr om
•
.Date
191C?JWay- Bill No.
Adv an ces to
Coll ect
To
Sh ipper
I
Francione
P. 0. Address
EXPRESS CHARGES
PREPAID
I
I
I
I
COLLECT
112
WarTax
Collect
12
Add
Underc h nrge
I
RECORD OF NOTICES
To Consignee
To Ship per_ _ _ _ _ _ ________ ___
{OTER)
�I,
the consignee of
, being duly .sworn, depose and say that I am
as speeified on oj.b.er side of thi s form , this day
;
//
ill
.
delivered , me by the Southern Express Company, from /<:- if"- '/, ·< ",...,_;,., z:.--,',___
; th at I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so
1·eceived by me
were brought into the State on my written order, and that I have not, within th e thirty
days previous
hereto, received any ardent spirits of any kind whatsoever, from any persoi:i or from any
place whatso ever, in excess of the quantity allowed by the provisions of the Act of the Gen eral Assembly
of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me
are to be used
,.
7Ar·
L-'L..
by me for __
..,~.:. _./______
______ __ ______ _ purposes at my own home, and in con(State whether for Scientific, Sacramental, Medicin al or Mechanical)
formity with law.
Sworn to and sub~bef ore me,
this_l_:f_da y of _ ___
.-_ ,
{!_,
191_1
~~'
Agent for Southern Exvress Comva111.
�SS COM PANY
SOUT HER N E XPRE
corporn ted }
FORM 370- VA.
(In
Revise d June, 1918
SPEC IAL LIQU OR RECO RD
Jan , 2,t/ li'J 1._
_o_ n_n_e_l_l __ __ ___ P. 0. Add ress
n_._ _ ~ _._ o_ '_D
Consignee ___ _
1qt
~ i~lt- Y~- --- - - - - Quanti ty
v~h~S
Kind of Ardent Spirits _ _,=
_ __ Date
Received at _ _ __ _ _ _ _ _ _ _ _
_ _ _ _ _ __ 191_
Way• Bill No._ _ _ _ _ _ _ __ Date _ _
Ship per
Ad vances to
Co ll ect
'
To
J . J' . S tun !!
Co
From CUI
I
I
P. 0. Add ress
RECO RD OF NOTIC ES
_ _ _ __
To Consignee _ __ _ _ _ _ _ _ __
Cit;y:
I
I
lbs.
Weight
lJ , rlan d Id
EXPRE SS CHARG ES
COLLE CT
PREPA ID
I
20
Affidavit No.
I
32
WarTu
Collect
02
Add
Und e rc harge
I
_ _ __
To Shi pper _ _ _ _ __ __ _ _ _ _ _
(OYER)
�------ ---- ------ ------ ----aa--- ------- ------ ~-----~-- --COUNTY
o~•
I, ~~\,l_.,.!C..,L ._~~16i~J._:_:2..:~:;,....~~ lllll!!!~the consignee of a certain shipment of ai-dtnt spirits, as
delivered to me by the Southern Express Company, fro~,_..c;.a~..,...~4'~.C.C;..tl:;.t,:::C,;jMi,C\"that I am not
a student or minor, and, if ·a female, I am the head of a family; that the ardent spirits so r ceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place what$oever, in excess of the quantity allowed by the provisions of the Act o{ the General Ass:mbly of Virginia,
approved March 19, 1918, or con rary to law, and that the rdent spirits so received by me are to be used
I
Ai:ent for Southern Express Coml)&IIJ .
�SOUTHERN EXPRESS COMPANY
FORM 370 - VA.
Revised June, 1918
( I ncorpornted)
SPECIAL LIQUOR
._
Con signee _ __ _
RECORD
L
- U !ill._
Received at _ _ _ _ _ _ _ _ _ _ _ _ __ _ _
18
Affid avit No. _ _ _ _ __
J_. _ o_ ' _D_o_n_ n_e_ l_l_l______ P. 0. Address _ _ _~G~i~t"'.ry-i,,______
· k~y,___
......_s.....i...
Kind of Ard ent _Spirits _ ~ \\~[1,
Way-Bill No _ ~ ~ ~- - -- Date
_______ Quantity _ _ __,l q-t
from ~
J an , '>1J/ 1 ~ 1
To
• _J_. _s_
- --'C"--'o"'cc p'--....
.t,.,_U__r.n_,_
Shipper _ _J_
.Ad v•ncc, to
Collect
I
Weight
4
~ d ,
EXPRESS CH.ARGES
! COLLI E CT., -,
PREPI AID
,')
~w"l"
~.•llect
lbs.
id
Add
Unde , cl ba,ge
I
P. 0 . Address _ __ _ _ __ _ _ _ _ __ _
RECORD OF NOTICES
To Consignee _ __ _ _ __ _ ____~ - - --
To Shipper _ _ _ _ __ __ _________
(OTER)
�I, - -"'--"------"------~-~ -,.....---- being dul:t sworn, depose and say that I am
the consignee of a certain shipment of ard~nt spirits, as specified on other side of this form, this day
..,)
/I
delivered 'to me by the Southern Express Company, from.~ - ~ - ~ - - ~ - - - ~ - ~ ; th at I am not
a student or uiinor, and, if a female, I am th"e head of a f;mily; that the ardent spiri ts so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatso ever, in excess of the quantity allowed by the provisions of th e Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for ________________ __________ purposes at my own home, and in eon(State whether for Scientific, Sacramental, Medicinal or Mechanical)
formity with law .
/
Consi Ji?nee ,
.
A Kent for Southern Express Com pan:,.
�FO RM 3 70- VA .
Revised June, 1918
COMP ANY
SOUT HERN E X PRESS
ated)
(Incorpor
SPE:C IAL LIQUO R RECO RD
F eb
Received at ___ ___ ___ ___ ___ __ 0ate
1
-=-----':......cu.:crc.._:t: . :n. : . .e:""'r::....a,'---- ----- - Consig nee _ ___l_.--'.'-----'L
•_
17 /ii91_
Affidav it No,_5_ _ _ _ __
t...,.y,______
·~
· i~
P. o. Address _ _ _ _ _~" ~
_ _ _ Weig ht- 4_ _ lbs.
w~l~J~SL.1,·,._...,k...,y,,___ _ _ _ _ _ _ _ Quantitv_ ~ ._.,_ _ _
Kind of Ardent Spi rits_ ___.
.Date
Way- Bill No.---<...1.. , 1
0
191_
Advan ces to
Co lle ct
To
Shipper ___,!___.__ J
rI l5
• Rt ump 6.·
Co
..i;, om
t
""
~ , . .1
EXPRESS CHARGE S
COL LECT
PRE.PAID
I
I
P. 0. Add"ress
RECOR D OF NOTICE S
To Consignee ___ _ _ _____ _ __ _ _ _ __
I
I
31
"
WarT • x
Collect
Add
Undercha rge
m,
I
To Shipper_·_ _ __ __ ____ ____ ___
(Ol"ER)
�STATE OF
Vm~
COUNTY OF---''--~ ~~
, . ,,.._ /
.
=--- ~ j ( 7'l -~
~'tz(( ll;--t- -1k~
, being duly swom, depose and say that I an:
the consignee of a certain shipment of ardent s pirits, as specified on other side of this J orm, this day
Ifh,~
/i) .• _ ~
a,,-,.f c,; th at lam not
·
delivered to me by the Southern Express Company, from ~
a student or minor , and, if a female, I am the head of a family; that the ard ent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatsoVirginia,
'ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
approved M~ ch 19, 1~18, or contrary to law, and that the ardent spirits so received by me are to be u sed
of
by me for
,,l~
/
,~
1
/,)
~
purposes at my own home, and in con-
(State whether for Scientific, Sacramental, Medicinal or Mechanical)
formity with law.
I
Consienee.
Sworn to and subscribe before me,
tM,2-iil>y o f ~
at.<1,
·
Agent for Southern Express Company.
�SOUTHERN EXPRESS COMPANY
f'0RM 370- VA .
Revised June, 1018
(Iucorporated )
SPECIAL LIQUOR RECORD
I•
.
1 / I ()
J,f
Received at _ _ _ __ __________ __ Date_.u._·_ _• _ _ __._ l gl _- _ Affidavit No._ _ _ _ __
_11.,y
P. 0. Address
i'ut
Quantity
Way-Bill No. _ _ _ _ _ _ __
~ l~n
Date
.Advsnces to
Collec t
To
Shippe r~
191 _
I
,J •
.,, tumn '
ro
P. 0. Add ress
Fro m
<' l
EXPRESS CHARGES
PREPA ID
I
I
I
I
CO Lf,ECT
j ~
I
lbs.
Weight'
('
....1.cl , ' ll
War Tax
Coll ect
Add
Un de r c h arge
- -
-
~
I
RECORD Of' NOT I CES
To Co nsignee _ _ _ __ _ ____________
To Shipper _ __ _ __ _ __ _ _ _ _ _ _ __
(on&)
�---~~ ---- ----------- - ---- ---- ---- - - - ~-- ---~. . . . .
duly sworn, depose and sa-y that I am
I, -r-,,....d ---r-r-<' c--"-T+- ~-L___ _____, ~-=~~ ---, being
on other side of this form,, this day
cified
s~
as
svirits,
the consigne e _of : ,ertain
~.,c---"---'-·-"-'~=~,.__._--=
delivere d to me by the Souther n Express Compan y, from ~l.!~~•
that the ardent spirits so received by me
family;
a
of
head
the
am
I
female,
a
if
and,
minor,
or
a student
not, within the thirty days previous
have
I
that
and
order,
written
my
were brought into the State on
person or from any place whatrnany
from
hereto, received any ardent spirits of any kind whatsoe ver,
General Assemb ly of Virginia ,
the
of
Act·
the
of
ns
provisio
the
by
allowed
ever, in excess of the quantity
received by me are to be used
so
spirits
approve d March 19, 1918, or contrary to law, and that the ardent
by me for
3 itt_c.kA f
\\
l /(
purpose s at my own home, and in con-
al)
(State whether for Scientific , Sac•ramen tal , Medicinal or Mechanic
formity with .law.
J
l/1-1
Sworn to and subscrib ed before me,
this2.!f :-day of__: n..L
.,-,
191+
.
Ai:ent for Southern Express Com'l)A)lif,
/.r1
t. f
Consie:nee .
j
�FORM 370- VA .
Revised June, 1918
SOUTHERN EXPRESS COMPAN Y
( Inco r porate d )
SPECIAL LIQUOR RECORD
Date
Received at _ _ ~ - - - - - - -
'> Q /1 1-s 1_
•
Affidavit No
P. 0. Ad dress
"I
~ l_____ . Date
Way-B il l No.__J
191 _
Adve n ces to
Co ll ect
To
Shipper
()
r.
1nnl· ,-,,
Li n n
I
P. 0. Ad dress
Weigh
.. .I..
From
.; .. n1·
,..
lbs.
11" ':;""f """"t,. '"'
EXPUESS CHAUGES
COLLECT
PREPAID
I
('r,
"'± t;, ,
11
Quantity
11
I
I
I
RECORD OF NOTICES
To Consignee _ _ _ _ _ ____________ _
To Shipper _ _ _ _ __ __ _ __ _ _ _ _ __
(on u)
�STATE OF V ~ I A 1
u~~::::!'~~~;K._~e;&-""_,.,___,
COUNTY OF._J1~
~~
,
j:;:;;;_~
being duly sworn, depose and say that I an:
..
I,
the consign~o of a c e r t a ~ n ~ t spirits, as specified on other side of this form., this day
that I am not
delivered to me by the Southern Express Company, from _ ~
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so 1·eceived by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatrnever, in excess of, the quantity allowed by the provisions ot the Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are to be used
by me for
Tht.44~
purposes at my own home, and in con-
(State whether for Scientific, Sacramental, Medicinal or Mechanical}
formity with law.
,U/t)n 191J (
Sworn to and subscribed before me,
lhi
~
~~
~ dsy
l
I
It
Agent for Southern Express Company.
Consiiinee.
�SOUTHERN EXPRESS COMPANY
FORM 370- VA .
Revised June, 1918
(Inco rporated)
SPECIAL LIQUOR
RECORD
....
.
,;
______________ Date ______ _ _
Recei ved at
1=
i :.:l=---=l_:·=
Consignee _ _ _J____:•_:_•.,\___c
:.: •:___:_:_
l 91_
.
1 ',
Affidav it No .__, _____
':.:"=--c----'n-'-•-1 _ _ _ _ _ _ _ P. 0. Address _ _ _~ i"'----"_.,)c_·~,_ _ _ _ __
1, t
Kind rif Arde nt Spirits._~ :~••.,._
1,'--'s,.'_i,___...,,,:__.:,,r___ _ _ _ _ _ _ _ _ Quantity_ _ __ _ _ _ _ _ _ Weight _ _ _ _ lbs.
Way- Bill No. _ _~1~'1_
____
.A dvanc es to
Co1le c t
To
Shipper -
Date _ _ _ _~_/ _
..-._n___ l 91 _
r'
.,..
" ,..
EXPRESS CHAJlGES
PREPAID
I
"""
I
P. 0. Address
I
COLLECT
11"
W11r T11•
Collect
Add
Undercharge
C ,~
I
RECORD OF NOTICES
To Consig nee ___________________
To Sh ipper _ _ _____ _ _____ ______
(on&)
�STATE OF
I, the consi
-+-'-- ' - - ' ~ ~ - - ~ ~ ~ .,.
, ~eing duly sworn, depose and sa.y that I am
s pirits, as specified on othei· side of this form., this day
~ - - - ~ --
aM
-I;~:t.. ,I
delivered to me by the Southern Express Company, from
J
{ not
a student or minor, and, if a female, I am the head of a family; that the ardent
spirits so received by me
were brought into the State on my written order, and that I have not, within
the thirty days previous
hereto, received any ardent spirits of any kind whatsoeve r, from any person
or from any place whatrnever, in excess of the quantity allowed by the provisions of the Act of the General
Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received
by me are to be used
by me for
~~ ,,. It
' :~
(State whether for Scientific, Sacramental , Medicinal or
formity with law.
echanical)
purposes at my own home, and in conI
It vVU1
I
Sworn to and subscribed before me,
this~
day of::_ _ _ _ , 191_
.
Aeent for Southern Express Compau:,-.
'
Consie:nee.
�FORM 370- VA .
Revised June, 1018
SOUTHER N EXPRESS COMPANY
(In corp o rate d )
SPECIAL LIQUOR RECORD
,..
Received at _ _ _-_._ _ _ _ _ _ _ _ _ _ _ Date_ _ _ _ _ _ __ l91 _
Affidavit N"'o .__, _ _ _ __
i~l~~..y,,___ _____ __ _ _ Quantity _ _1'--'-r•---'t"--____ _ Weigh ' -----''---lbs.
~_l_'_ a._n_ ~ - - -·1l_J_C
_ n_
From _ _u
_ J_f)_____ _Oate_ _1~/~ --()____ l9 1_
Way-Bi ll No. __n
Kind of Ardent Spirits~V~•~l ~
To
Sh ipper
T
.
Ad vance s to
Collec t
.J . Stump
P. 0. Add ress
EXPRESS CHAR GES
COLLECT
I>U.E P A ID
I
I
I
I
. ,,,~
~
I
I
I
1
Add
Und er chnrge
~ Cl
I
RECORD OF NOTICES
To Consignee _ _ _ _ _ ______ __ _ _ __
To Shipper _ _ _ _ __ _____ ______
(onu)
�--
--
~ -
........
-
- -
·-- - ---
'
.... -
being duly swoTll, depose and sa_y that I am
eeified on other side of thi s form , thjs day
Ir. -~
. deliver ed to me by the Southe rn Expres s Compa
ny, frorr(.6Jl~,1,,l.~ ~::.4 ~~W~ c1'!!~U .'.{. ; th at I am
not
a studen t or minor, and, if a female , I am the head
of a family ; that the ardeut spirits so receive d by
me
were brough t into the State on my written order,
and that I have not, within the thirty days previo
us
hereto ,' receive d any ardent spirits of any kind whatso
ever, from any person or from ,any place whatso ever, in excess of the quanti ty allowe d by the provisi
ons of the Act of the Genera l Assem bly of Virgin ia,
approv ed March 19, 1918, or contra ry to law, and
that the ardent spirits so receive d by me are to be
used
I
by me for+--"+-b,q,.'la,',_....~.,._,....,,,.-= --~c..~ ~~~~:- -:----::c
:--:--,-Sta
whether for Scientifi c, Sacrame ntal , Medicin al or
formit y with law.
Sworn to and subscr ibed before me,
,,,
this /..5 day of _ __ _ , 191_'__ .
:(
Agent for Souther n Express Compap J.
---c:-
�COMPA NY
SOUTH ERN EXPRE SS
)
FORM 370- VA .
Revised June, 1018 ·
([n co rpornted
SPECIA L LIQUO R
RECOR D
QuantitY- - - ~- ~ - - - - Weioh ~---+- --lbs .
Kind of Ardent Spirits_ _ _ __ =.,___ _ _ __ _ ___
Way-Bill No,_ _ _ _ _ _ _ __
To
Shipper
. .
Advan ce s to
Co ll ect
Siu,
])
,......t, n~
.-, r,c /-,o
From ____ ____ ____ ___
- - - - - - ~ - -•191_
Go
EXPRESS CHARGES
COLLECT
I
I
I
P. 0. Address
RECORD OF NOTICE S
To Consig nee ____ ____ __ _ __ _ _ _ __
WarTu
Collect
PREPAID
II
I
....
~
. ·" ....
Add
Unde rc harge
I
To Shipper _ _ _ _ __ __ _ _ _ _ _ _ _ __
(O'l'ER)
�STATE OF VIRGINIA,
1
CouNTl OF
/
0---
-//
u
L -.; AJ
,-
1--;r:,e:-i--], '1 l-
rl,'1 -t>/
~?:....:.
.
I, '\ /
62,.,,-, t,,1/1,,7 7..,,.::---- r
, bei~g duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specified on o'.her side of ;9is form, this day
8t (,
,?£,,,.,,::;
}1,7
delivered to me by the Southern Express Company, from
J //
~ a t i am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or ,from any .p lace whatrnever, in excess (?f the quantity allowed by the provisions of the Act of the ·Gen~ra"I Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so 1·eceived by me are to be used
by me for
{)7,7,,t <,(.;,,..,L~2;..v'LCJ_
formity with law.
Sworn to and su~bed before me,
this~1day o f L
-~
-•,
191--5
71 a , ~
purposes at my own home, and in con-
J ✓t{f J it v/,~r
(State whether for Seientific, Saeramental , Medicinal or Mechanical)
Agent for Southern Express Company.
Consienee.
�FORM 370- V A.
Revised Juno, 1018
SOUTHER N EXPRES S COMPANY
( I n co r porat ed)
SPECIAL LIQUOR RECORD
Consignee
L
'l/~9
.1.'eb ,
Received at _____ _____ _____ __ 0ate
•
Affidavit No.__1_____
echert ,
P. 0. Add ress _ _ _ _ _ _~
C~i~t.....,.y_ _ _
Kind of Arde nt Spi rits _ _"~l=
1_i~!k=l~=-.y,_______ ___ Quan tity _ _~1~Q..,.t~,
. ____ Weioht_ _"-f--_ lbs.
Way-Bill No .
L, .
1·
-~ / 7
Date _ _ _ _ _____ w
To
Ship per
Ad vance s to
Coll ec t
H
Francio n
1t ·
PREPAI D
I
I
P. 0. Address
I
RECORD OF NOTICES
To Consig nee _____ ___ _ _ _ _ _ _ __ _
lt!M'
~e~ -~·-••~- - - - - -- - -
EXPRESS CHARGE S
COL L ECT
I
I
8~
I
WarTu
Collect
o-:
Add
Und e rc b a.rge
I
To Sh ipper_ __ _ _ _ _ _____ _____
(on&)
�- -- STATE OF VIRGINIA ,
COUNTY OF
------ - - ------
,
<17~ "C,,-h, '"\, \ d.
c,C:/4 ·/
being duly sworn , depose and say that I am
l;
I,
on other side of this for~ , this day
specified
the consign ee of a certain shipmen t of ardent spirits, as
· t·h at I am not
delivere d to me by the Souther n ·Express Compan y, from
received by me
so
spirits
ardent
the
that
family;
a
of
a student or minor, and, if a female, I am the head
the thirty days previous
within
not,
have
I
that
and
order,
written
my
on
State
the
were brought into
from any person or from any place whatrn hereto, received any ardent spirits of any kind whatsoe ver,
Act of the General Assemb ly of Virginia ,
the
of
ns
provisio
the
by
allowed
quantity
the
ever, in excess of
spirits so received by me are to be used
ardent
the
that
approve d March 19, 1918, or contrary to law, and
\
Con s ignee .
�FORM 370- VA .
R evised J une, 1918
SOUT HERN EXPR ESS COM PANY
( [ n co rpornte d )
SPEC IAL LIQU OR RECO RD
Received at
Consign ee
s
19 1_
P. 0. Address
Ki nd of'Ardent Sp iri ts
Way-lli ll No
Date
h 1 at~
:wh i Sk!
6 409
Quantity
Date
NOT . 4th
To
.Advan ce s to
Collect
J . W. Wald,eek Co
P. 0. Ad dress 10 5
N Hoiv ard
Shipper
City .,
l c1 t
191 _
From
Weight.'i ___ _ Jbs.
al timo re Md
EXPRES S CHARG ES
PREPA ID
COL L ECT
I
I
Affidavit No.
I
132
RECO RD OF NOTIC ES
To Consignee _ _ _ _ _ ___ ___ ___
___
(O l'E R)
To Shipp er _ _ _ _ _ __ _
...~,:..~;··T
.... .
�S'fATE OF VIRGIN !
,
COONffW_r- ~lLh_ ·~~=~ ~~~~
I,
V-)
I
, being duly sworn, depose and say that I an;
the coiisign ee of a certain shipm ent of a rdent s pirits,
as specifie d on other side of th is form, this day
7
deliver ed ,to me by the Southe rn Expres s Comp any, from
~;'.
·
/'_ ; th at I am not
a stud ent or minor, and, if a female, I am the head of
a family; th at the ardent sp irits so rece ived by me
were brough t into the State on my written order, and
that I have not, within th e thirty days previou s
hereto , r eceived any ardent spirits of any kind what soever,
from any perso n or from any place whatso ever, in excess -of th e quantit y allowed by the provisio
ns of th e Act of the Genera l Assemb ly ~f Virgini a ,
approve d March 19, 1918, or contrar y to law, and that
the ardent spirits so rec eived by me are to be u sed
by me fo r
7Y1J:' ,I",
I
[
(S tate w he ther for ~c ientific , Sacrnme ntal , Medicina l
o,: Mechani cal)
formity with law.
purpose s at my own hom e, and in cou/
Sworn to an d subscri bed before me,
~-
Agent for South ern Express Company .
Consigne e.
�FORM 370- VA .
R evised J une, 1918
SOUTHERN EXPRESS COMPANY
( Inc orporat e d )
SPECIAL LIQUOR RECORD
Received at ________ _________ Date_ _ _ _ _ __
Con signee _ _
_ __ _ __ __
_ ._c_. _}.I_c_ K_1_·11
D
191 _
_ ___ P. 0. Address_ _
3
Affidavit No._ _ _ _ __
~ 1=·~t'-'y_, ______
4,____lbs.
" _ _ _ Weig ht~ -----=Kind of Ard ent Spirits_ ~ w~h~s~ j =k=.y,,___ _ ______ Qua nti ty _ _ ____,,,'"ql--"t
Way-llill No.__7_______ Date
Advn.n ccs to
To
Shipper
· Nov.ls :t! i 1_
H
Collect
PREPAID
I
I
I
I
Francione
P. 0. Address
:Wil 8 . _Lal t imore,Ma
EXPRE SS CHAR G E S
-
CO L LEC T
I
12
,
..
~,~ :··r "
"""~
RECORD OF NOTICES
To Consignee _ __ _ __ _ __ _ _ _ _ _ _ __
1-'_··_ _ _ __ _ _ _ _ _ _ _ __
To Shi pper _ ~ ,_
(O'l'E R)
�STATE OF V!RG!Nl A,
.c
I, - ~ ~ ~ - - ~ - - - - - ~~ - - - - - - -- , being duly sworn , depose a,nd say that I arr.
the consignee of a certain shipm en t of ardent s pirit s, as spec ified on other side of this form , thi s day
delivered to me by the Southem Express Company, from /
~ - ~ ~ - - - i that I am n ot
a student or minor, a nd, if a femal e, I am the head of a family; that th e ardeut spirits so rece ived by me
were brought into the State on my wr itten order, and that I have not , within th e thirty day s previ ous
h ereto, r eceived any ardent spirits of an y kind whatsoever, from any p er son or from any place whatrn ever, in excess of the quantity allowed by the provisions of the Act of th e General Assembly of Virginia,
approv ed Ma1·ch 19 , 1918, or contrary to law, and that th e ardent spirits so received by me are to be u sed
J
1
'
'~'
(S tato wheth er for Scientific, Snera mental, Medicinal or Mechanical)
by me for /
purposes at my own home, and in con -
formity with law.
Consi2uee.
�SOUTHERN E XPRESS COMPANY
FORM 370- VA .
Revised June. 1018
(In co rpo rated)
SPECIAL LIQUOR RECORD
_·_,._
Consio nee _ _ _ H_. _ li
_ a_l_l ____ _____
_ c_F
.M
484
To _ _ _
Shipper
TI
Date _ ~t~/_ 6_J _ __ _
..Advan ces to
Collect
F1
an c ione
!ili 8 ~
P. 0. Address
Affidavit No.
~It Solon Va
l qt
Quan tity
~h~ S~ i ~k=.J-Y- - - - -- -- Kind of Arde nt Spirits~ W
J1
Way- Bill N
8
N V
Received at _ _ _ _ _ _ _ _ _ _ _ _ _ __ Date
191 _
From
Weight
COLLECT
I
,..: ;··T. .
"""t
Ma
I
P. 0. Address
lbs.
al timore , Md
EXPRESS CHARGES
PREPAID
4
I
I
:12
RECORD OF NOTICES
To Consignee _ _ _ _ _ ___________
To Shipper _ _ _ _ __ _ _ _ _ _ _ __ _
(OYER)
�I, ,.J.J--L;,L___.,_,,µ,___...,__,__---'--'-----"'= - - - - - - -the consign ee of a certain shipme nt of arcl~nt s pirits,
as
, being duly sworn, depose and say that I am
s eci~ed on other side of thi fo1·m , this day
deliver ed to me by the Southe rn Expres s Compan y,
from
I "
; that I am..not
a student or minor, and, if a female, I am the head of
a family; that the arcle11t spirits so receive d by me
were brough t into th e State on my written order, and
that I h ave not, within the thirty days previou s
h ereto , receive d any ardent spirits of any kind whatso
ever, from any person or from any place whatso ever, in excess of the quantit y allowed by the provisio
ns of th e Act of the Gen e ral Assemb ly of V irgini a ,
approve d March 19, 191 8, or contrar y to law, and that
the ardent spirits so receive d by me are to b e used
I
by me for
1 .
•
(S tate wheth er for Seientifie, Sarrame ntnl, Medicina l
or 1'1echani cal)
purpose s at my own home, and in con-
formity with law.
l
/
Sworn to and subs l'ibed before me,
th ' _ _
' day of _ : / _ ~ , 19 /
t
L1
/
Cons ign ee.
.
r
(
Agent for Southern Ex-press Company ,
�SOUT HERN EXPR ESS COMPAN Y
·F'ORM 370 -VA.
Revleed Jane, 1018
( Incorporated )
S PE C IAL LI QUOR
Dec • 23/l fB.:..._ Affi davit No.__1_4~ - City
P. 0. Add ress
Received at _ _ _ __ _ _ _ _ _ _ _ _ _ Oate
Lren t
Conslonee
/
R E C ORD
Bowman
t
Weio h~.~ - - -lbs.
1.q
Y- - - - ~ - - - - Quanti ty
~h~ s~i=k=-,.
Kind of Ardent Spirits_ W
, Md
ore
Jialtim
1918.
20th,
.
Dec
1 86637
From _ _ _ _ _ _ _ _ _ _ __
_~_ __ Date _ _ _ _ _ _ _ _ l9 1_
·Way-Bill No. _ __
Advances t o
Co ll ect
To
Shipper
R
P. 0. Address
Franc ion
EXPRESS CH AR GES
PR E PA ID
CO LLE CT
I
Bal t:t.more ,.Md.
I
I
I
32
WarTax
Collect
A dd
Und e rcha rge
.02
I
RECO RD OF' NOTIC ES
To Consign ee _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
To Sh ipper _ _ _ _ __ _ _ _ _ _ _ _ __
21
(o n&)
�I, ~ ,M_~~~~~-_!~ ~~=-----=-::______:::_
the consignee of a certain shipment of
Consi2;Dee.
�FORM 370- VA . .
Revised June, 1018
SOUTHE RN EXPRESS COMPAN Y
(Iucorpornted )
RECORD
SPECIAL LIQUOR
21 /i~ 8 • Affidavit No.__l_3____
~ur /!., Va •
P. 0. Address Harris on ·•
Dec
Rece ived at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Oate
C.E.
Car
_ _ __ _ _ _ __ _ __
_ _per,
Consionee _ _ __ _ _
~b-1~S~k.. ,y,,_____ ____ Qua ntitY- ~ 1....c+l~t~- - - - - Weioh t_ ~4Kin d of Ard ent Sp iri ts __\~V
Fr om jjal timore Md
l _2~/_2_0_ _ 191 _
Date _ _ _
Way-Bill No. 186619
0
0
_ i _o_ n_ e_
F~-r:_a~n~c
: ::_-_
::ip-p-er- -~~~-R
~i'_1~l_c~_·_
_d_c_
_ _ _ _ , __A
P. 0. Address _ _ _ __ _ _ __ _ _ _
I
__ lbs.
~
EXPRESS CHARGES
D_ I COLLIEC; 2 ~:r1!:; 2Gndt~I~llrge
I_A_I_
RE_P
P_
,__
I
RECORD OF NOTICES
To Consign ee _ _ _ _ _____ _ __ _ _ __
To Ship per _ _ _ _ __ __ _ _ _ _ _ _ __
(o n&)
�ST ATE OF VIRGI NIA ,
I, ~.,.L.tM'.__('&1..----"'-~~k !f:..J:1~:1!""' - - - -, being duly sworn, depose and say that I an.
s peeified on other side of thi s form, this day
the eonsignee of
deliver ed to me by the Southern Express Company , from _-4~~~ .-!
"l!!d~~.f!oo~~ that I am not
a student or minor, and, if a femal e , I am the head of a famil y; th at the ard ent spirits
so reeeived by me
were brought into the State on my written order, and that I have not, within th e thirty da
ys previou s
hereto, r eeeived any ardent spirits of any kind whatsoever , from any person or from 11ny
plaee whatrn ever , in exeess of the qu antity allowed by the provisions of th e Aet of the General Assembly
of Virginia ,
approved Mareh 19, 1918, or contrary to law, and that the ardent spirits so r eceived by me
are to be used
by me for
.r/' 4~ ~
(State whether f or Scientific, Sacr amental , Med icinal or Mechanical)
formity with law.
Agent for Southern ~
r:ess Company ,
purposes a t my own home , and in con-
�FORM 370- VA.
Revised June, !018
Con sig nee _ __ _ _,...:__-'--''-'---=----=-=--=---=:....:_-=-.:..:....-~-- -Kind of Ard ent Spirits _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
Quantity _ _
~ - ~ - - - - - - 191 _
To
Ad van ces to
Colle ct
P. 0. Address _.--_ _ _ _ _ _ _ _ __ _
~/~c.-----.....,_~\...,>---II.A
From _ _ _ __ __
EX PRES~ ,CHARGE S
PREPAID
COLLECT
Weight __ _f_1bs.
7{
~~- ~-- J-WarTax
Collect
Add
Undercha rge
Shipper _ ~ ~-=- --- - - -- - - - -
P. 0. Address _ _ _ _ _ _ _ __ __ _ __
RECOR D OF NOTICE S
I
To Consigne e_ _ _ _ _ ___ ___ ___ ___ _
(OVER)
To Shipper _ __ _ _ _ _ __ _ _ _ _ _ _ __
�- - - - -- -
-----------
STATE OF VIRGINIA,
)
ll
CouNTY m•--1/_"'=-'---'----=---c::....:=----_:__-,-----'---
-7
I, - - - - - - -- -- - -- - - = - - - - - - -, being duly sworn, depose and say that I am
the consignee of a certain shipmen~ of ai-deut SJJirits, as specified on other side ~ his form, this day
delivered to me by the Southern Express Company, from - - - - ~ - ~ - - - - - - - ; that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, received any ardent spirits of any kind whatsoever, from any person or from any place whatrnever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or contra1·y to law, and that the ardent spirits so received by me are to be used
by me for _______________ _ _ _ _ _ _ _ _ __ _ purposes at my own home, and in con(State whether for Seientific, Saemmental, Medicinal or Mechanical)
formity with law .
,J
Consieuee .
Sworn to and subscribed before me,
r
..,
thig _ __ day of __ - - - -, 191_
.
/
Agent for Southern Express Company,
�F'ORM 370-VA .
Revised June, 1918
.
SOUT HERN EXPR ESS COMP ANY
( Incorporate d)
SPEC IAL LIQUO R RECQ RD
. 17/1 8 .
Received at _ __ ___ _ _ _ _ _ _ _ _ _ DateSep
_ _ _ _ _ _ _ 191 _ . Affidavit No._5__ _ __
Consionee ---=_ _ E
_ ._ _ L_._ D
_e~c.~h~e~r-t--.,~-- -P. 0. Add ress ___
C
_ i ~t...7_, ___ __
Ki.nd of Ard ent Spirits,_\=¥,..
h'-'iL-s.....,k....Y~ - - - - - - - -0uantity
Way-Bill No.
28
9/16
Date
To
Ship per
R
P. 0. Address
Fran cione
Bal t:IJllo re,Md .
191 _ .
Advance• to
Collect:
EXP RESS CHARGES
PREPAID
II
-
I
RECORD OF' NOTICE S
To Consignee
1 ,· t
We i4i _ _ _ _ lbs,
F~ l timo re , .\td
To Shipper
(ona:
COLLECT
I 32
WarTax
Add
Collect
i j ~cbarge
#H~
�STATE OF VIRGJNIA,
COUNTY OF
G-,;;: /4
I
the con; ignee o
t-:;
~;oeC
a
, being duly sworn, depose and say that I am
certain shipment of ard\ nt spirits, as specified on other side of this form, this day
(/s~_/;;a;;
<
j that I am ~ot
Zn
delivered to me by the Southern Express Company' from
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within the thirty days previo.us
hereto , . received any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 19, 1918, or ontrary to law, and that the ardent spirits so received by· me are to be used
by me for --"_r.F-,.L- +-~~~c......:c'--"--'--_-'..___________ _ purposes at my own home, and in con(State whether for Scientific, Sacramental , Medicinal or Mech a nic I)
formity with law .
Sworn to and subscribed before me,
thi s~
~ , f , 191~
/ (. c._r If ( 1 /
day of
c
1 / ./ L c7
Ai:ent for Southern Express
Company.
�SOUTHERN EXPRESS COMPANY
FORM 3 f 0 - VA .
(In co rporated)
Revis ed June, 1~18
SPECIAL LIQUOR RECORD
1\.U t-o- •
Received at. ______ ______ _____ Date -
~n/
°1 91_
4_,__
Affid avit No ,_ _ _
· _e______ _____· P. 0. Address,City
P r_i_c
__.=__
(.. ___
C _
Con sionee. __--=-_
wh'i.sl;:y
Kind of Ardent Spirifil, _ __ _ _ _~ - - - - - - - -
nt
•,
_ _ _ __ _ __
_ _ _ lbs.
Weigh c_4
r _,e.,_______~_ _ _ _,...;....
Way-Bill No._,__ _ _ _ _ _ _ Date _ ~,.,__,..~--~- 1--~ 191 _ .l.,a litn')"'-"'To - -- - - - - - - - - - -- - - - -1
Shipper
P. 0. Address
R
Advance s to
Collect
I
Francino e
117 i .i.; al t
I
i1 orte ,
RECORD Of" NOTICES
To Con signee _ _ _ _ _ ______ ______
To Shipper _ _ _ _ _ _ ______ _____
(O.-ER)
�___L"""'-=...._,._,__,,=~-=--= ----------, being duly sworn, depose and say that I an:;
s pirits, as spec.i ed on other side of this form, this day
delivered to me by the Southern Express Comp any, from -->...<>""---=---==-==~-'------'-----------'-- i that I am not
a student or minor, and, if a femal e , I am the head of a family; that the ardent spirits so rece ived by me
were brought into the State on my written order, and th at I have not, within th e thirty gays previ ous
hereto, received any ardent spirits of any kind whatsoever, from any person or frol)'l any place wh at~o ever, in excess of the quantity allowed by the provisions of th e Act of the General Assembly of Virginia,
approved March 19, 1918, or contrary to law, and that the ard ent spirits so re ceived by me are to be used
c
;)v.. / i...
by me for ____....cc._ __ _ __ _ __ _ __ _ _ _ _ _ _ _ _ _ purposes at my own hom e, and in con (S t ate whether for Sc ie n tifir , Sacramental, Medicinal or 1\Iechan· al)
formity with law.
Con s ignee.
,,
, ,L
Sworn to and subscri-bed before mfe,
day of _ _{__ __ , 191
th i-
/
/[/
1
(.
.
~ ~/
,U r{t;< ( \
l1
Agent for Southern Expres s Company .
�-------
FORM 370- VA.
Revise d June, 1918
EXP RESS COM PAN Y
SOU THE RN (In
corpora ted )
SPE CIAL L I QUO R REC ORD
Date
Received at
Ott o Wis e
Kind of Ardent Spirits :w:h tlii lik,:
OO t
• 22L l $9._
P. 0. Address
Consignee
Way- Bill No.
2(16 ?. 3
Date
.Advnnc es to
Collec t
To
Shi pper
R
P. 0. Address
Fra n c i one ,
317 w ha l to
From
19 1_
RECO RD OF NOTI CES
To Consig nee
E X PRESS CHARG ES
CO LLE CT
I
I
To Shipper
(on&)
lbs.
Weight 4
Lal t imo re '
PREPA ID
I
4
Cit·:,:
1qt
Quantity
1ni'.i7
Affidavit No.
I
32
WarTax
Collect
Add
Un de rc harge
.ot
�STA'rE OF VrnlllN IA,
I, - - - ~ - - - ~ - - - - - - - - - - -- - -, being duly sworn , depose and say that
I am
the consjg nee of a certai n shipm ent of ardtnt
s 1,irits, as specifi ed on other side of this form,
this day
delive red to me by the So{1thern Expre ss Comp
any, from _ ~
- - - ~ ~ ~ - ; that I am not
a studen t or minor , and, if a female , I am the
head of a family ; that the ardent spirits so receiv
ed by me
were broug ht into the State on my writte n order,
and that I have not , within the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind
whatso ever, from any person or from any place
whats oever, in excess of the quanti ty allowe d by the
provis ions of the Act of the Gener al Assem bly
of Virgin ia,
approv ed March 19, 1918, 01· contra ry to Jaw,
and that the ardent spirits so receiv ed by me
are to be used
~
fl
by me for ___
~----- -'-= '--=-'-"= -=-"""-~~e,,o,~c~-~ - - - - - - - PUrpo ses at my own home, and in con(State whethe r for Scientif ic, Saer:un ental, Medicin
al or Mechan ical)
formit y with law.
"'-"
\
•
I
A
Sworn to and subscr ibed before me,
this ___ day of _ _ _ _ , 191_
Agent for Souther n Expres s Compa ny.
Consi gnee.
�SOUTHERN EXPRESS COMPANY
FORM 370 - VA .
Revised June, 1018
(Incorporate d )
SPECIAL LIQUOR RECORD
bc t '
•
Received a~ - - - - - - - - - -- - - - - - ate
H•
Consignee
L . h,, rtner ,
'> 8/1!lt_.__
8
Affi davit No ., _______
P. 0 . Add ress.- '-_
C_i_ t_ y=-----c,_ _ _ _ __
Kind of Arde nt Spirits _~
w~h~ d= m=k=-,y.,___ _ _ _ _ _ _ _ Qua ntity_ ~ l _4~ t ~ - - -Way- Bil l No.
OTer
0ate _ _
Advances to
Collect
To
Ship per
0~/_2_9_ ___ 191_
J . J . S t ump &
ijo
From
I
I
P. 0. Address
RECORD OF NOTICES
To Consignee. _ _ _ _ _ ___ _ _ _ _ _ _ _ __
(on&)
Cum 'terland Md
EXPRESS CHARGES
PREPA ID
I
Weig he,,,,__ _ _ lbs,
COLLECT
13?
WarTax
Collect
Add
Un derc h a r ge
02
I
�!':-'"' "-~
=' -::-,-,=-= - ~ -- - - -- - - -- - - - - -- ~-~
I, __..,J__ JL - + ~.-------!L_L~""=:~(L U;~e .,~~
'- - -, being duly sworn , depose and say that
I an:;
the consig nee of a certai n shipm ent of atdent
s pirits, as specifi ed on other side of thi s form
, this day
delive red to me by the South ern Expre ss Comp
any, from
·"-'--'-•""' i.._,
; ,hat I am not
a studen t or minor , and, if a female , I am the
head of a family ; that the ardent spirits so r eceive
d by me
were broug ht into the State on my writte n order,
and that I have not, within' the thirty days
previo us
hereto , receiv ed any ardent spirits of any kind
whatso ever, from any person or from (tllY place
whatr never, in excess of the quanti ty allowe d by the
provis ions of the Act of the Gener al Assem bly
of Virgin i a ,
approv ed Mar h 19, 1918, or contra ry to law,
and that the ardent spirits so receiv ed by me
are to be used
by me for·_ -L..Ll ±l4l-!~ ~l!!'!'.U ~i.,.,~.,__ _
_ _ _ _ _ _ _ _ _ purpo ses at my own home,
(State whethe r for Scientif i c, Snernm e nt.al,
and in conMedlcina.l or Mechan ical)
formit y with law .
/
Sworn to and subscr ibed
efore me,
--
�SOUTHERN EXPRESS COMPANY
FORM 370- VA .
(Incorporat ed )
Revised June, 1018
SPECIAL LIQUOR
RECORD
Received at_ _ __ __ _ _ _ _ _ _ _ _ _ 0a11O et .
l s/18 191_
E • L • De8hert,
Consigne e
P. 0. Address
3
Affidavit No ,_ _ _ __ _
Ci:ty ,
1
Kind of Ardent Sp irits,__
\\_h-=
i '---'s"---k__.,_
y _ _ _ _ _ _ _ _ _ Quanti ty_ _,,,,
l '""q,_t""._ _ _ _ _ Wei aflt ____ lbs.
Way- Bill No .
27 21
Date
P. 0. Address
191_
Ad vti. nce a to
Co ll ec t
To
Shipper
Sep, 26
Francione
:Daltimore, Md .
R
From
PR E PA ID
I
I
Bal ti more .Md
EXPRESS C H ARGES
I
COLLEC T
132_
RECORD OF NOTICES
To Consignee _ _ _ _ _ __ __ _ _ _ _ _ __
To Shi pp er _ _ _ _ _ _ __
(O .,.ER)
Wa rTu
Collect
!~
A dd
Under c h arge
I
�r--=-=-=-=-=-------------- ----- ------- -----------~----------STATE OF VIRGiNIA,
COUNTY OF
c"---'~'-"=-"""-~-1-...c...Jc,-·_J}v
,-, \l
I, ~--'---?-~-¥.-""e: _z,,._.cC.-_L....i....=_.__.,..,..__ _ _ __ , being duly sworn, depose and sa y t!Jat I am
i,irits, as specified on ot Iler side of this form, this day
delivered to me by the Southern Express Company, from..- v"'-''-"'-'-..,_'---",.,_,,.._,._._--L.1L-L.1.;_...:.._) , tt:S-r am not
a student or minor, and, if a female, I am the head of a famiiy; that the ardent spirits so received by me
we re brought into the State on my written order, and that I have not, within the thirty days previous
hereto, r eceived any ardent spirits of any kind whatsoever, from any person or from any place whatso ever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virgini a ,
approved Marnh 19, 1918, or contrary, to law, and that the ardent spirits so received by me a1·e to be u sed
by me for
1/J
c? I'{,
t
purposes at my own home, and in con-
(State whether for Scientific, Sacramental, Medicinal or :Me rnnicnl)
formity with law.
Con sii;::nee.
Sworn to and subscribed b efore m e ,
thisJ f -day
of£ ~, 191
Agent for Southern Exvress Comvany.
�F'ORM 370-VA .
Revised June, 1918
SOUTHERN EXPRESS COMPANY
(Incorporated)
SPECIAL LIQUOR RECORD
5
2/1 8 .
0 t.
Received at _ _ _ __ ____ _ __ _ _ _ _ Oate _ _ _ _ _ _ _ 191 _ . Affidavit No._ __
9
rry
_ _ _,_ _ _ _ _ _ _ __
__, _ _ _ _ _ _ _ __ P. 0. Address City
__
Consionee _ _ _ _ _ _ _ _ _'e
l nt
~ - - - - - - - - -0uantity
Kind of Ardent Spirits-1f_h_s~ 1~k7
Way-Bill No.
6 27
Date! 0 /1 i
To ______________ __--1
191 _ .
Advances to
Coll ect
E__1_1_a_h_o_n_e_'y------,
Ship per_ J_&_· _ _
P. 0. Address
30S
'"'"'"
RECORD OF' NOTICES
To Consignee
3ifuti il__n_o _r ~ '- -- - - -
EXPRESS C HARGES
Cal ~ rt
To Shipper
(OV111<
Weiaht_4_ _ _ lbs.
omw, 2
1-
"":r;""f"'"'
War Tu
Ad d
�81' ATE
____!..=t.f.L~ ~ ~_l_~~~ ~~'.:!~L_ ____ , being
spirits, as s~
duly sworn, depo~e and say that I am
fie~ onJ th r side of this form, this day
0
delivered to me by th~ Southern Express Company, from ~
that I am not
a student or minor, and, if a female, I am the head of a family; that the ardent spirits so received
by me
were brought into the State on my written order, and that I have not, within the thirty days
previous
hereto, rEceived any ardent spirits of any kind whatsoever, from any person or from any place
whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly
of Virginia,
approved March 19, 1918, or contrary to law, and that the ardent spirits so received by me are
to_be used
by me for
'
f
'
(State whether for Scientific, Sacramental, .Medicinal or Mechanical)
formity with law.
;
purposes at my own home, and in con-
�...
ll'H ltRf,I' EXPRESS COMPANY
;
(Inco rporated )
~ P E,i lAL LIQU d R
RECORD
-~~-~-- ----- Date r:/·
I
Consianee._ _
~
-+-.c1c...+,.->,.+-\--,,.4-~: ...;.-
I
-
19 i'
Received at
- - - - - --
PREPA ID
W1 rT11
Add
Collect
U nde rc h arge
P. 0. Add ress
To Consianee _ __ _____ _________
To Shi pper _ _ _ _ __ __ _____ _ _ __
(OTKR)
�I,
the consignee of a certain sh ipment
- - - - - , being duly sworn, depose and say that I am
spirits, as specified on other side of this form, thi s day
I
J
I
delivered to me by the Southern Express Company, from -4'--->,.- ...,eµ'-"" ..~ ____,.__._~""""- '- ; that I am not
a student or minor, and, if a female, I am the bead of a family; that the ardent spirits so received by me
were brought into the State on my written order, and that I have not, within th e thirty days previou s
hereto, received any ardent spirits of any kind whatsoever; from any person or from any place whatrnever, in excess of the quantity allowed by the provisions of the Act of the General Assembl y of Virginia,
approved March 19, 1918, or contrary to law , and that the ardent spirit s so received by me are to be u sed
~
Sworn to and subscribed before me,
thisllday of _
/
fF·--.,--<,,_-;,,
Cousienee .
�f"0RM 370-VA.
Revised June, 1917
SOUTHERN EXPRESS COMPANY
( I ncorporat ed)
SPECIAL LIQUOR RECORD
lo
Received at 4
Consio
P. 0. Add ress _____________ _ _ ...__ __.__ _ _ _ _ _ _ _ _ _.,__-''---...:...---'
A-ECORD Of" NOTICES
To Consig nee
To Shi pper
(OVE R)
�,.~~
·IA .,,
<l
,!
..,
I, _ ____:::....:__ _ _ ____:,.__ _ _::::::c....__:__::..,.
:..__:Yc......:-''-----"l=
•··c_
...,,...=-, being duly sworn, depose and say that I am
the consignee of a certain shipment of ardent spirits, as specifie~ on other side of this form, this day
(~ t
l --: ,,{"'j f"'', '
delivered to me by the Southern Express Company, from · _ ·: 1-Vl ,n
I,,·
\ ha I am not
a student or minor, and, if a female, I am the head of a family; that the ard ent spirits so··received by me
were brought into the State on my written order, and that I have not, within the thirty days previous
hereto, rrneived any ardent spirits of any kind whatsoever, from any person or from any place whatsoever, in excess of the quantity allowed by the provisions of the Act of the General Assembly of Virginia,
approved March 10, 1916, or contrary to law, and that the ardent spirits so received by me are to be used
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store
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the mont h of Febru ary 1 917. Ten Gallon s of Pur Gr a in Alcoh ol, a nd have
om, hand
this First day of March 1917. Seven Gallon s and Two Pin t s of Pure Grain
Alcoh ol
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rockingham County Prohibition Records: Affidavits for Ardent Spirits
Publisher
An entity responsible for making the resource available
Rockingham County Circuit Courthouse
Description
An account of the resource
Series II of the Prohibition Records collection consists of records (printed affidavits forms) documenting the inventory, sale, and transport of alcohol for medicinal purposes and personal use in Rockingham County. The affidavit was typically filled out by the common carrier in charge of transporting ardent spirits and included information such as to whom the alcohol was shipped, the amount and kind received the date of delivery and the consignee. Items have been arranged by the location in which the liquor was transported to. <br /><br />For more information on the Prohibition collection, visit the "<a href="https://omeka.lib.jmu.edu/erp/findingaids">Finding Aids</a>" tab in the menu above.
Subject
The topic of the resource
Prohibition--History
Prohibition--Government policy--United States
Prohibition--Virginia--History
Rockingham County (Va.)--History
Rockingham County (Va.)--Genealogy
Creator
An entity primarily responsible for making the resource
Rockingham County Circuit Court
Date
A point or period of time associated with an event in the lifecycle of the resource
1916-1919
Identifier
An unambiguous reference to the resource within a given context
Pro002
Relation
A related resource
<a href="https://omeka.lib.jmu.edu/erp/collections/show/7">Prohibition Records: Liquor Inventory</a> <br /><a href="https://omeka.lib.jmu.edu/erp/collections/show/5">Prohibition Records: Criminal Cases</a>
Is Referenced By
A related resource that references, cites, or otherwise points to the described resource.
<a href="https://omeka.lib.jmu.edu/erp/items/show/4524"> Prohibition Records Finding Aid </a>
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Affidavits for Ardent Spirits 16
Subject
The topic of the resource
affidavits
adrent spirits
personal use
Description
An account of the resource
Printed Affidavits forms authorizing the transportation of medicinal alcohol in Rockingham County Virginia for personal use.
Source
A related resource from which the described resource is derived
Rockingham County Circuit Court
Publisher
An entity responsible for making the resource available
JMU Libraries
Date
A point or period of time associated with an event in the lifecycle of the resource
1917
1918
1919
Contributor
An entity responsible for making contributions to the resource
Craig Schaefer, Kayla Heslin, Selena St. Andre
Rights
Information about rights held in and over the resource
<span>This work has been identified as being free of known restrictions under copyright law, including all related and neighboring rights. (</span><a href="https://creativecommons.org/publicdomain/mark/1.0/">https://creativecommons.org/publicdomain/mark/1.0/</a><span>)</span>
Format
The file format, physical medium, or dimensions of the resource
PDF
Identifier
An unambiguous reference to the resource within a given context
RcPr-box11-012
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
Rockingham County