Form No. 6001 



POST OFFICE DEPARTMENT NO. 



THIRD ASSISTANT POSTMASTER GENERAL S tamp of Issuing OHIct 



DIVISION OF MONEY ORDERS 



The Postmaster 

 ■will insert 



nere 



the oifice drawn on, when the office named by ^__ 



the remitter is in Alaska, and does not transact money order business. 



Spaces aboTe this line are for (he 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 peroon for htm 



Amount 



Dollars Cents 



Pay to \ Henry A. Dreer, Inc. 



Order ofj „ ._. 



(Name of poxsoa os 6rxa for whom order ia intended) 



Add°r^l 1305 Sprinq Garden 



l3 JNo n „ street 



Post \ 

 Office/ 



i 



-'hilaaeip! 



iia 







State .. 



Penna. 







Sent by. . . 











No. 





(Kama o£ Bender) 





—Street 



City ] 

 and I 

 State! 











PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 



(FOR FEES SEE OTHER SIDE) oo— 7155 



