Form 6001 
POST OFFICE DEPARTMENT No. OF GE nb ok 
THIRD ASSISTANT POSTMASTER GENERAL Stamp of Issuing Oifice 
DIVISION OF MONEY ORDERS 
The Postmaster 
wiil insert 
here. St eter Ree aii b ea deere 
the office drawn on, when the office named 
by the remitter is in Alaska, and does not 
transact money-order business. 
Spaces abovet his 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— 
SEALS SERIES (Bd Dollars ean... Cents 
Tobe ROBERT BUIST COMPANY, ¢, 
Geet ae aa Giana s bas wdabbiaid 
eter a oa eas ee a 
oadres| 4 and 6 South Front Street, sircct 
ead} PHILADELPHIA, Pennsylyania, 
See i aC nciokpendesi, ure ah 
cei dep eee eee ceeteis: «ie Par eee Been A eles alata al A eae eS tit Street 
aa | 
and 
State | —---- <n nn nn nn cn ncn en ewe w ann naneneqe sewers enn =e=<-~ 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) e5—7155 
