Front:
READ YOUR POLICY.
See Special Regulation No. VI.
OFFICE OF
The Farmers' and Mechanics' Home Mutual Fire Insurance Company
OF SULLIVAN COUNTY.
FORKSVILLE, PA., SEPT. 5, 1898.
a Roger
To.....
100
SIR: Assessment No. 19 of this Company, amounts on
your policy, No5, to $3 You are hereby notified
to pay the same to the Treasurer, A. L. Smith, at Forksville,
within thirty days from this date.
Please present this card to the Treasurer to be receipted.
(Oct
Received Payme
ALSmith
To pay insurance ($266) on T. F. Jordan's barn in Laporte township, burned July
1th, 1898; and on T. J. Forbes' barn ($710) burned August 16 1898, in Colley Twp.
R. D. LANCASTER, Secretary.
......189
Treasurer.
Back:
ONE CENT. 13
ORK SL
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181 S
United States America.
ILL
Mul, Roges
Forhenies fa
