Form 6001 
POST OFFICE DEPARTMENT A 
| THIRD ASSISTANT POSTMASTER GENERAL | 2 ea 
5 DIVISION OF MONEY ORDERS Stamp of Issuing Offics 
o 
P5 | 5 Sl et Se a 
az 
= The Postmester 
2 will insert 
5 ln yee 2 eae tA UE Re ees 
FAthe office drawn on, when the office 
| named by the remitter does nct trans- 
J act money-order business. 
A pueg—Gaiads wot 
S Spaces above this line are for the Postmaster’s record, to bo filled in by him 9 
= Application for Domestic Money Order? 
iat 

Spaces below to be filled im by purchaser, or, if necessary, © 
by another person for him: < 
© Amount— $ 
2 Ce Oe ett arrives’ Dolldtarsacun! Cents 3 
> 
tobe BOBBINK & ATKINS g 
FS paid tof""""" (Name of Detson of Sra for whom order is intendoa) ~~ : 
urserymen 
& 1-1 Sea a, ei conics > 
of } us» st 588°Paterson Ave: pala ot oes 
Ci 

PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) 016—8391 
