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Page type: Entry form

Item number (top right of entry form): 317

Image number (corner of image sample itself - leave blank if not visible):

Date of registration stamp:

Date form completed (next to signature): 28 January 1885

Description of work: Drawing of enamelled slate chimney piece marked the "Westminster".
(Copy annexed)

Date of Agreement or Assignment: 4 October 1884

Names of Parties to Agreement or Assignment: W Charles Evans and Evan Reese on behalf of the Dulas Slate Company

Name and Place of Abode of Proprietor of Copyright (use commas): Dulas Slate Company, Machynlleth, North Wales

Name and Place of Abode of Author of Work (use commas): W Charles Evans, 3A Poets Corner, Westminster Abbey, London

Approximate height of image sample (cm):

Approximate width of image sample (cm):