(Form No. 6001) 



$nst ©flare 3?pgrtmtt!t 



THIRD ASSISTANT POSTMASTER GENERAL Slams of Issuing Office 



r 2 DIVISION OF MONEY ORDERS 



The Postmaster 

 wifi insert 



thji office drawn on, when the office named by 



the 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 



c v Spaces below io be filled In by purchaser, or, If necessary, 

 by another person for him 



Amount 



. ! Dollars Cents 



P.©. to 1, 



° rder ; ' ' F. - ■■^«B9£S«W^-*'«®9=i 



xftT 



ts i >;o 



State. 



100-9 Bv^ street ftrw. street 



Washington ; 



■&-&T- 



Seo* %f- 



Address'l 



be;ndir J No - Str«et 



'< PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 



