No. 



Form. 6001 

 oj POST OFFICE DEPARTMENT 



g THIRD ASSISTANT POSTMASTER GENERAL --_- 



0& DIVISION OF money ORDERS Stamp of Issuing Office q 



° s 



5 FEE w 



z T> 



2 The Postmaster W 



will insert 



here 



I named by the remitter does not trans- 3 



I, act monev-order business. 0- 



gJ . —^ 



2; Spaces above this line are for Postmaster's record, to be rilled in by him 



| Application for Domestic Money Order 3 



2T Spaces below to be filled in by purchaser, or, if necessary, 3 

 5 by another person for him «^ 



z Amount — S 



~ DSE FIGURES, TWI1«,«, r»«« + o 8* 



oo do not spell JJoIIars Uents »i 



§ To bel « 



E~" paid toj (Name of person or firm for whom order is intended) ^ 



(J 2 



O Whose ] > 



. address > m 



S is J Street r 



Z City | » 



^ State I % 



Ud" E 



r- Sent by CL 



K (Name of sender) ft 



O Street < 



z £n 3 



O 

 Q 



PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 



(FOR FEES SEE OTHER SIDE) ol6— 8391 



