Feas for Money Orders Drawa 



€>si Domestic Form 



Payable in the United States, including Hawaii, 

 Pneito Rico, and the United States Virgin Islands, or in 

 Gua.m and Tutuila (Samoa) ; also for orders payable in 

 Antigua, Bahamas, Barbados, Bermuda, British Guiana, 

 British Honduras, British Virgin Islands, Canada, Canal 

 Zone, Cuba, Dominica, Grenada, Jamaica, ilontserrat, 

 Nevis, Newfoundland, Philippine Islands, St. Kitts, 

 St. Lucia, St. Vincent, and Trinidad and Tobago. 



For Orders 



From $0.01 to 

 From $2.51 to 

 From §5.01 to 

 From $10.01 to 

 From S20.01 to 

 From §40.01 to 

 From $60.01 to 



$2.50- 



6 cents. 



8 cents. 



11 cents. 



S5.00 



$10.00 



§20.00 IS cents. 



§40.00 15 cents. 



S60.00 18 cents. 



§80.00 20 cents. 



From §80.01 to §100.00 22 cents. 



Menxoranda of Issuing Postmaster: 



If oi-der is purchased through Rural Carrier, he will fill spaces 

 below: 



Carrier's receipt No. 



Carrier. 



Note. — ^The msxlmuic amount for which a cingle Money Order 

 may be issued is SIOO. When a larger sum is to be sent additional 

 Orders must he obtained. Any number of Orders may be drawn 

 on any Money Order office on any one day. 



Applications must be preserved at the office of issue fer tluee 

 years from date of issue. 

 (Edition JVNZ 1539) eie— 8391 v. a mteummt nnmn anna 



