Form No. 6001 
POST OFFICE DEPARTMENT NO.- 
THIRD ASSISTANT POSTMASTER GENERAL Stamp o? Issuing OfliiS 
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 he 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 The Templin - Bradley Co. 
Uame or person cr ftrm lor whom order is in tended) 
W hose 1 
Address > 
Is jNo... 
Post \ 
Office/_ 
5700 Detroit Avenue 
Cleveland, 
State 
Ohio 
...Street 
(Name of Bender) 
No._Street 
City ] 
and > 
State) _ 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) c5—7155 
