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Days Date) INSTRUCTIONS 1. Purchaser ONLY must complete form in FULL. Print or type clearly. PLEASE READ 2. Fill out one claim card for each money order. 3. A $6.00 non-refundable fee is required for each number to be traced. This non-refundable fee may be changed without notice. This includes tracing, photocopies and refunds. DO NOT SEND CASH. 4. A photocopy will be provided if the money order has been cashed. A refund will be issued if the money order has not been cashed, provided the claim .

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