OOlVtfc-ii^TJO, ^-"-^ --^^ (Form No. 6o«s,/ 



Slacap of IssaSng OfV,ct \ 



h 



1 00 



space above this line is for the Postmaster's record, to be iSlled by him. 



Application for Money Order. 



Amount _ Dollars Cent? 



Sent to_ """^ ^' ^^^^^^- 



FLORAL PARK. 

 City or town. ™_™_™™.____ 



Street arid No.. ^__ „ „_____„_^ 



N. Y. 

 State ___________________ 



Sent by.. 



Address of sender : No .^ „ Street;^ 



