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Page type: Image sample

Item number (top right of entry form): 167

Date of registration stamp: Nov. 17, 1983

Date form completed (next to signature):

Description of work: William Cutler's Permanent Gold & Silver Enamels permanent paints for picture frames ( sold in bottles)

Date of Agreement or Assignment:

Names of Parties to Agreement or Assignment:

Name and Place of Abode of Proprietor of Copyright (use commas):

Name and Place of Abode of Author of Work (use commas):

Approximate height of image sample (cm): 6cm

Approximate width of image sample (cm): 8cm