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Page type: Entry form

Item number (top right of entry form): 158

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

Date of registration stamp: 20 March 1886

Date form completed (next to signature): 19 March 1886

Description of work: Drawing of square of "Reckitts" Blue with border and the words "Stamp Reckitts Blue on your memory" (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): Thomas Robinson Ferens, Saxby Stores, Holderness Road, Hull

Name and Place of Abode of Author of Work (use commas): Thomas Robinson Ferens, Saxby House, Holderness Road, Hull

Approximate height of image sample (cm): 4

Approximate width of image sample (cm): 5