(Form No. 6001) 
Bust Office Department Ne ote 
THIRD ASSISTANT POSTMASTER GENERAL Stamp of Issuing Office 
DIVISION OF MONEY ORDERS 
dd, jaail, 
: DOLLAR | CENT 
he Postmaster 2 NS 
Svill insert | 
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o 
~~ = 
nD 
= 
a - : poe 
WINE ong Scere cee et Sos Suse eae tee ea 
he office drawn on, when the office hamed by 
he remitter in the body of this application is not 2 Money Order Office. 
Cree 
Spaces above this line are for the Postmaster’s record, to be filled in by him. 
mittance by, 
pplication for Domestic Money Order 
pplication, Take it to your Postmaster and procure 
= ___ Spaces below to be filled in by purchaser, or, if necessary, 
= by another person for him 
Amount : é 
a 3 = 
Pi Ta Sees ok Sees Dol larcr sere... Cents 
g Z 
Be ee WM. HENRY MAULE, INC. eae 
A (Name of person or firm for whom order is intended) 
a 
o - 
then sending us money use thi; & 
= 
re 
Sent Re Ea NL ee oe pact pe Rp PE 5, ee EN 
=] (Name of Sender) 
s = 
B Address = 
of ¥ 
sender ST Oieeseee ns Serna ae ann eR  urh Se et SS Le, Street 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
