Form 6001 
POST OFFICE DEPARTMENT No 
THIRD ASSISTANT POSTMASTER GENERAL 
DIVISION OF MONEY ORDERS Stamp of issuing Offica 
= -- = 
will insert 
= i. a eee 
fAthe office drawn on, when the Office 
named by the remitter does not trans- 
5 act money-order business. 
A MONEY ORDER 
a 
I 
Li} 
A pueg—dqaaddsS wos 
= Spaces above this line are for the Postmaster’s record, te be filled in by him ) 
3 Application for Domestic Money Order? 
#0. 
= Spaces below to be filled in by purchaser, or, if necessary, ; 
e by another person for him < 
2 Amount— g 
E USE FIGURES, = 
i” NOT SPELL -—------ Dollars ________ Cents 2 
= > 
2 Tobe WwW WNSEND SONS. & 
= paid 2} E,. tName of TO' oF whom order is in ed) - a 
ea <= 
(| SST ge Sp ae ee ea ‘a 
| = 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) c16—8301 
