Form 6001 
POST OFFICE DEPARTMENT No 


| THIRD ASSISTANT POSTMASTER GENERAL #8 We __-__-___________.. 
3 DIVISION OF MONEY ORDERS Stamp of issulng Office al 
° 2) 
Ps FEE! 51 Gis 7 
a 
S The Postmaster a 
will insert ta 
< eo) 
5 10(:) |: ae Se ee J, 
4 the office drawn on, when the office @ 
named by the remitter does not trans- a 
3 act money-order business. S 
= Spaces above this ie are for the Postmaster’s record, to be filled in by — & 
aA lication for D Money Ord 
pplication fer Domestic Money Urder ; 
Spaces bslow tc be filled in by purchaser, or, if necessary, 
by another person for him < 
> Amount— Q 
Qu 
— USE FIGURES, 
2 DO NOT SPELL ----------- Dollars ________. Cents & 
Ra z “~~ 
2 ts) Awehanan.seed, U0 
Fe paid ae order is 6eG.. 
& Syne) aus ro Memplys: Tenn: oa : 
Me address ; rf 
tJ * 
Areajep peed 

PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) o16—83$1 

