Form 6001 
POST OFFICE DEPARTMENT Na 
as] THIRD ASSISTANT POSTMASTER GENERAL <0. 1) eS onel 
= DIVISION OF MONEY ORDERS . Stamp of issuing Office 
°o 
Pa FERS ss 
A 
© The Postmaster 
will insert 
5 TIGL O pe eee eer ee eee emer etree etaree eoe 
FAthe office drawn on, when the office 
named by the remitter does not trans- 
= act money-order business. 
A M 
<< 
S Spaces above this line are for the Postmaster’s record, to be filled in by him 
bet 
= Application for Domestic Money Order 
Spaces below to be filled in by purchaser, or, if necessary, 
by ancther person for him 

Amount— 
USE FIGURES, 
DO NOT SPELL ----------- Dollars 
N ORDIN 
Schrldcas Cents 
paid to (Name of person or firm for whom order is intended) 
W UV p10 Aeuowr mod pueg—qaadS OA 
R STAMPS | 
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ar Sa) Set ate PARADISE ss eal z 
= mt | PENNSYLVANIA. a. 
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P= 
a SY sh ed llth leds ll al, Set lied ey SON Rae <A aT a RE Fy 
(Name of sender) = 
& eee aa a a as eas a Eee dae ceen Street & 
™, City “< 
and 
Rad ADC Bo eg it a ee i ee ee ere ee 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) c16—8391 

