Form No. 6O01 



POST OFFICE DEPARTMENT No. 



THIRD ASSISTANT POSTMASTER GENERAL Stamp o.' Issuing Office 



DIVISION OF MONEY ORDERS 



The Postmaster 

 will insert 



here 



the office drawn on, when the office named by | 



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



Spaces aboTe thu line are ior (he Postmaster's record, to be filled in by bim 



Application for Domestic Mosey Or^er 



Spaces be!ov7 to lo& filled in by purchaser, or, if necessary, 

 by Einother person for him 



Amount 



Dollars Cents 



o?deV'of}.y.?.nj!y-A'..P.rj.®r.i.i?].?i. 



(Name of person or firm for wtiom order ia intended) 



Whose") " 



Address l_ J.306 .S^jfi „g Qg rdgn 



Is J No. J-e.y-V..:!?JH^I.li.lSl_.V?.?.!-^.^i.L street 



g§U Philadelphia 



State ..P_ei3_0-a._ 



Sent by 



(Name of eender) 



Kg. Street 



City) 

 and > 

 State) 



PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 



(FOR FEES SEE OTHER SIDE) 05—7165 



