Form Ko. 6001 



Post (^f&tt ?9?partm?nt 



Ro. 



dTHIRD ASSISTANT POSTMASTER GENERAL 



Stamp of Issuing Office 



DIVISION OF MONKY ORDSRS 



uTbe Postm&ster 

 ■"Will insert 



"* "/here 



J5 _5the office drawn on, when the office named by the 



" ^mittor in the body of this application is not a Money Order Office. 



aSpaces above this line are for the Postmaster's record, to be filled in by him 



lApplication for Domestic Money Order 



u Spaces below to be filled In by purchaser, or, U necessary, 



^ by anotber person for bliu 



jAmotmt 



S Dollars Cents 



Of } ^^ W. -Bo^na SuCoj. 



(riwBO ot p«rw>o aP^xta for vhom onier w intaol 



—Pay to 

 SOrder 



DtaJSed) 



^Whose I .T^^-^-^ 



l^tHNo„llDX)9 Bystreet N.W. -street 



oPost 

 ^Office 



P 



B 



}- 



-W-ashiiigtaii,- - 



State D.-C«- 



_MSentby.. 

 u 



o_ 



►Address) 

 H of \ 

 - sender I Nc 



»R'. j: 



io Street 



:< PUKCHASEB MUST SEND OKDEB AND COUPON TO PATEB 



