471
Facsimile
Transcription
If this page displays an entry form with no image sample visible, please transcribe all fields except the height and width of the image sample.
If the page displays an image sample only, please enter only the approximate height and width of the image sample in the relevant field below.
If the page displays a full entry form and an image sample, please set the page type to ‘Entry form’ and transcribe all fields including the height and width of the image sample.
Page type: Image sample
Item number (top right of entry form): 256
Date of registration stamp:
Date form completed (next to signature):
Description of work:
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): 17
Approximate width of image sample (cm): 12.5
Notes and Questions
Nobody has written a note for this page yet
Please sign in to write a note for this page