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Page type: Entry form

Item number (top right of entry form): 396

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

Date of registration stamp: 15 March 1885

Date form completed (next to signature): 14 March 1885

Description of work: Drawing of Artistic Design branches of Coffee plant in oblong border – (Copy annexed)

Date of Agreement or Assignment:

Names of Parties to Agreement or Assignment:

Name and Place of Abode of Proprietor of Copyright (use commas): Lewis & Sons, 55 Eastcheap, City, London EC

Name and Place of Abode of Author of Work (use commas): Edward Henry Bott, (in the employ of White & Pike, Moor Street) Birmingham

Approximate height of image sample (cm):

Approximate width of image sample (cm):