Form No. 6001 
POST OFFICE DEPARTMENT NO.- 
THIRD ASSISTANT POSTMASTER GENERAL Stamp of issuing Office 
DIVISION OF MONEY ORDERS 
The Postmaster 
Trill insert 
here.-.__ 
the office drawn on, when the office named by 
the remitter is in Alaska, and does not transact money order bu siness. 
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 
Pay to 1 ROBERT BUIST COMPANY, 
Order of J_ 
(Name of person or firm for whom order is intended) 
Whose ] 
Address ]• 
Is JNo. 
Post \ 
Office}_ 
4 and 6 South Front Street, 
Street 
PHILADELPHIA, 
State Fen?syJian|?j 
Sent by 
(Name of Bender) 
No,_Street 
City ) 
and } 
State] _ 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) c5—7155 
