DO NOT RISK MONEY OR STAMPS IN ORDINARY MAIL—-BUY A MONEY ORDER 
Form 6001 
POST OFFICE DEPARTMENT No 
THIRD ASSISTANT POSTMASTER GENERAL 
PBB cy my. 
The Postmaster 
will insert 
Here) Ses see eee lek Bean eee cot 
the office drawn on, when the office 
named by the remitter does not trans- 
act 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— 
USE FIGURES, 
DO NOT SPELL ----------- Dollars 
Tob ; 
aia o}---- awe LD eds w NT FARM kis 
address 
is 
City 
and 
State. j2=2= 


ee ee we we ee ee we ee we ee ew ee we ee en ee ee 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) 16-8391 
MLV tepsz0 Asuowl ano’ pusg—QqyaAdS wou 
ArvAypap yeroods FVIAI 
