Refund request form, American Locker Co., 1955

Front:
American Locker Co., Inc. 211 Congress Street Boston, Mass. /25/55 Date It was necessary for me to deposit extra coin (s) to check my parcels in Locker No.. 3725 at. BAYBRIDGE TERO at.... STATION Will you please make reimbursement. Name PLEASE PRINT Street City & State (Remarks) JAMES A. GRAY, INC. REFUNDS WILL NOT BE MADE WITHOUT AGENTS SIGNATURE 1st & MISSION STS. SAN FRANCISCNUS PHUNE: GA Agent's Signature.. AMOUNT TO REFUND ANSIT ERMINAL AGENT MUSTAFILL IN AMOUNT A-43 5M-9-52-80220

Back:
ALCA VYT 254 PLY CARD REPI MARTHA TA WASHIN VINGTON AMERICAN LOCKER CO., Inc. 211 CONGRESS STREET BOSTON, MASS. P. O. DEPT. 2¢ REVALUED