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Form 6001 
POST OFFICE DEPARTMENT NO. - 
THIRD ASSISTANT POSTMASTER GENERAL stamp 0 f issuing Office 
DIVISION OF MONEY ORDERS 
FEE 
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— 
0 SEW »s P eu} -Dollars-Cents 
To be 1 
paid to / 
(Name of person or firm for whom order is intended) 
Whose ] 
address > 
is J _Street 
City] 
and > 
State)—--- 
Sent by_ 
(Name of sender) 
_._Street 
City] 
and > 
State]--- 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) c5—7155 
