Form No. 6001 
POST OFFICE DEPARTMENT NO.. 
TH!RD ASSISTANT POSTMASTER GENERAL Stamp of Issuing Offioa 
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 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 
_____Dollars_Cents 
(Name of person or firm for whom order ia intended) 
W hose ] 
Address > 
Is J No___Street 
ggj,}. Newa rk, new J erse y 
State___ 
■ i — rriTnirm i rr i nw n m m in iirrrr mi it i w i - i ni i irn -n-nr-TTiiT-nTTTrr-n- n ■■ 1 1 1 ■ n r m i u ■■ n mu ■■ n rn i n wiii m 
Sent by_ 
(Name of sender) 
No.___Street 
City ) 
and > 
StateJ _ 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) co—7153 
