Form No. 6001 
POST OFFICE DEPARTMENT NO.- 
THIRD ASSISTANT POSTMASTER GENERAL S tamp of issuing Office 
DIVISION OF MONEY ORDERS 
The Postmaster 
will insert 
here_ 
the office drawn on, when the office named by ___ 
the remitter in the body of this application is not a Money Order Office. 
Spaces above this line are for the 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 person for him 
Amount 
”7- THE STORRSTi’teltTSOrf 
Pay to \ 
Order of/_ 
SEEDSF$ffeN, of TTOKSERYltfgN 
Whose 1 
Address > 
Is JNo. 
Post \ 
Office/_ 
PAINESVILLE, 
OfflO 
State 
Street 
Sent by_ 
(Name of Bender) 
No. ... 
City 1 
and \ 
StateJ 
Street 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
c5—7155 
