~~ 
Form No. 6001 
POST OFFICE DEPARTMENT NO. eR erie: s 
THIRD ASSISTANT POSTMASTER GENERAL “ Stamp of Issuing Office _ 
DIVISION OF MONEY ORDERS i 


The Postmaster 
will insert 
herg\S he eet See ced eta Sa eee | 
the office drawn on, when the office named DY fo erence 
the remitter in the body of this application is not a Money Order Office. 

Spaces above this line are for the Postmasier’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 ancther person for him 
Amount 
Bezte.) HOLMES SEED CO. 

(Name of sender) 
EO a ead Street 
City 
and 
Btate} 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
c5—7155 
