Form. 6001 
POST OFFICE DEPARTMENT 
BY No. 
THIRD ASSISTANT POSTMASTER GENERAL 
& DIVISION OF MONEY ORDERS Stamp of Issulng Office 
0 
Ww 
W 
Ss a") 
S The Postmaster _ 2 
will insert PA 
<— 
MOTO. wan ree oe. Se 
the office drawn on, when the office 5 
Qo 
rs 
| 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 
= Application for Domestic Money Order 3 
St spaced below ane filled in by purchaser, or, if necessary, 5 
y another person for him 
Amount— 
USE FIGURES, ii ara. cle C 
D0 oS LOCK GARDENS 
=] 
9 
(= py 
0 
Rott 
R STAMPS IN ORDINA 
2, 
Qu 
0 
¥ adres | PARADISE 

PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) ol6—8301 
