Form No. 6001 
POST OFFICE DEPARTMENT No. ae 
THIRD ASSISTANT POSTMASTER GENERAL Stamp of Issulng Office 
DIVISION OF MONEY ORDERS 
The Postmaster 
will insert 
prs re enone ee 
the office drawn on, when the office named by 
the remitter in the body of this application is not a Money Order 
Spaces above this line are for the Postmaster’s record, to be filled in by him 
Application for Domestic Money Order 
Spaces below to be filled in by purchaser, or, if necessary, 
by another person for him 
Amount 
Feyte..| Henry A. Dreer, Inc. 
a a a a a a a a eo 
Be tee te Wa ac Philadelphia. 
ag i 
Se ae a 
Bt CR AE SE SS ce at yg 22 Be Oe Street 
City 
and 
Pe OR 8 es eee ee Se 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
ceb—T7155 
