Form 6001 
POST OFFICE DEPARTMENT No 
THIRD ASSISTANT POSTMASTER GENERAL ! 
DIVISION OF MONEY ORDERS Stamp ef Issulng Office 
enw eee ew ee - 
FEES SS 
ie 
ry 
'd 
3 
& 
Ey 
A MONEY ORDER 
will insert 
here 32h eS cee een ee nae 
the office drawn on, when the ofiice 

fata} — Tay nghas: Nee ad, {GQ.5-— 
as} 
© 
a named by the remitter does not trans- 
| act money-order business. 
= Spaces above this line are for Postmaster’s record, to be filled in by him 
be 
= Application for Domestic Money Order 
q Spaces below to be filled in by purchaser, or, if necessary, 
2 by another person for him 
© 
Zz Amount— 
SE FIGURES, 
g a DO phed She oe Suee Dollars __.__.__- Cents 
A 
54 

PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) o16—8391 
