Form No. 6001 
POST OFFICE DEPARTMENT NO.- 
THIRD ASSISTANT POSTMASTER GENERAL Stamp of Issuing Office 
DIVISION OF 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 for the Postmaster’s record, to be filled in by him 
Application for Domestic Money Order 
Spaces belov.’ to be filled in by purchaser, or, if necessary, 
by another person for him 
Amount 
___Dollars_Cents 
Order of}_ ALEXANDER FORBES & CO _ 
(Name of person or firm for whom order ia intended) 
Whose ] 
Address > 
Is )No _Street 
gSiy_ Newark, New Jersey _ 
State 
Sent by_ 
(Name of Bender} 
No._Street 
City ] 
and > 
State) _ 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) o6—7165 
