
Form 60901 
POST OFFICE DEPARTMENT No 
THIRD ASSISTANT POSTMASTER GENERAL s 
DIVISION OF MONEY ORDERS Stamp of Issuing Office 
The Postmaster 
will insert 
MGIOr see nee a ee en ee eee 
the office drawn on, when the office 
named by the remitter does not trans- 
act money-order business 
Spaces above this line are for the Postmaster’s record, to be filled in by him 
Application for Domestic Money Order 
Spaces below to be filled in by purchaser, or, if necessary, 
by another person for him 
Amount— : 
Se ee herc wedane! Dollars ____....- Cents 
Toe ) OROL LEDDEN & SONS 



and 
Oity 
State 

ee www www oo oo oe ee ee a en nn ee ee = + = 
PURCHASER MUST SEND ORDER AND COUPON TO PAYEE 
(FOR FEES SEE OTHER SIDE) 016—8391-2 

