Form 6001 



POST OFFICE DEPARTMENT 



NO. 



eg 



S THIRD ASSISTANT POSTMASTER GENERAL „ 



5 DIVISION OF MONEY ORDERS SUmp of Issuing Offlca q 



° P8 



3 FEE W 



Z "0 



2 The Postmaster W 



will insert f-j 



-< r 



fcr here <>) 



m the office drawn on, when the office » 

 i named by the remitter does not trans- 



L act money-order business. "* 



Application for Domestic Money Order § 



<< 



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



S g 



~T Spaces below to be filled in by purchaser, or, if necessary, ■* 

 £> by another person for him ^ 



2 Amount — 2 



"~ OSE FIGURES, Ti^ll„^ rU~+o »" 



to do not spell Dollars Uents t 



I > 



5 To bel g 



^T paid toj (Name of person or firm for whom order is intended) ^ 



X . § 



O Whose } > 



O Whose | 

 . address > 

 3 „.. jsl 



.Street *"* 

 Z City . 



Oand ' 



g State I O 



££ Sent by CU 



** (Name of sender) (D 



H ~ 



O Street J| 



Z City 1 2 



O and { * 



q State ) 



PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 



(FOR FEES SEE OTHER SIDE) oie— 8391 



