(form INO. OUU1) 
Post @ttire Department No... 
Stamp of Issuing Office 
THIRD ASSISTANT POSTMASTER GENERAL 
DIVISION OF MONEY ORDERS 
The Postmaster |_DOLLARS _ |_ CENTS — 
. will insert | 
[So hrenssnoat cece bar oc bnat o REPORCC CLARO OIE EF Oreo Cen onAactt CONE Cee SERS SOLES | ye 
the office drawn on, when the office named by the ae 
remitter in the body of this application is not a Money Order Office. 
Spaces above this line are for the Postmaster’s record, to be filled in by him. 
Application for Domestic Money Order 
ittance by registered mail 
Take it to your Postmaster and procure a 
5 Spaces below to be filled in by purchaser, or, if necessary, 
es by another person for him. 
= Amount 
a 
Se a eee ee Dollanswee ca. Cents 
° 5 
dgbay to | WM. HENRY MAULE; INC., 
$ret Ord er fii yi esr acre ee eRe REO 3c soccscnavs aesepeneees 
Ifo) (Name of person or firm for whom order is intended) 
oe nN tne ee 
&S Whose 
2 Address 
Sa is NA Sees Den Rey res Ds RE ee Be PMU R OER a ae Street 
26 
5 APost } PHILADELPHIA, 
BS OE Ce aera aan armen ane ne te eae nO ESOL, «0s cncdase ices 
() 
os Spare Pennsylvania. 
to 
Ao 
Hot §Sent DY sae et ee ee pe one coset r ener cer ON BITE COOELOITETCCETD= OSE EERREEODESE 
ss (Name of Sender) 
=| 
gi eer ec ee caves es ennnccecennaseneanen nnn eens ances an ans ean aes anne wane naan nw nna e ne ee ane en en sen ennasesasaccanecccessscuscstesccussss= 
E Address } 
Daooaccd posn0ese CSO c0Do-RoUaS co Lost Soca ano santo eecned oct dace SERRCEEOOUOSOOSCOCH UO: COCO OEE Street 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
