
Form 6001 
POST OFFICE DEPARTMENT No. es See 
THIRD ASSISTANT POSTMASTER GENERAL Stamp of Issuing Office 
DIVISION OF MONEY ORDERS 
Flt Been 
The Postmaster 
will insert 
TOT ee eee cocoa secneern—asas 
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— 
USE FIGURES, 
Boe peut } --—--—--—- Dollars -..------- Cents 
To be | Peter Henderson & Co. 
Street 

Cit | 
an 
State | ana nn — a ma rn ee eT 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) e5—7155 
