form No. 6001 
POST OFFICE DEPARTMENT NO.- 
THIRD ASSISTANT POSTMASTER GENERAL Stamp ol Issuing Offlca 
DIVISION Or MONEY ORDERS 
The Postmaster 
will insert 
here_ 
the office drawn on, when the office named by L.______ 
the remitter is in Alaska, and does not transact money order business. 
Spaces above this line are lor 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 
_Dollars_Cents 
e„.o , F. H. WOODRUFF & SONS 
Order of/_ 
(Name c.f person or firm for whom order is intended) 
Whose ] 
Address > 
Is JNo.. 
Post \ 
Office/. 
State 
_Street 
MILFORD, 
Conn. 
Sent by_ 
(Name of sender) 
No._Street 
C a& 
State) _ 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) o5—7155 
