Stamp of Issuing Office ._ 



Form 60O1 

 POST OFFICE DEPARTMENT 



gS THIRD ASSISTANT POSTMASTER GENERAL 

 O DIVISION OF MONEY ORDERS 



s 



O O 



63 FEE * 



2 W 



§ ^3 



3 The Postmaster pi 



will insert M 



-* O 



* I 



D here -_ W 



S9 the office drawn on, when the office * 



1 named by the remitter does not trans- 5 



►J act money-order business. 



g Spaces above this line are for the Postmaster's record, to be filled in by him 2 



|Appleation for Domestic Money Order | 



O Spaces below to be filled in by purchaser, or, if necessary, AS 

 S£ by another person for him " 



° Amount — 5 



§ USE FIGURES, -r\ it r~U,~ + ft* 



„ bo not spell — - Dollars Cents ™ 



•f Tobei Peter Henderson & Co. jg 



f.^a paid to/ (Name of person or firm for whom order is intended) 



CO g 



© Whose] __ _ . , _ Z, 



address 35 Cortlcmdi St. at t r* 



2 is ! Street B 



ogf j New York, N.Y. 1 



© State 



PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 



(FOR FEES SEE OTHER SIDE) 



