| Heading and notes: | No form number. Heading is South Australian Magnetic Telegraph with the Crest in the centre. |
| Message area: | Blank - many details so message area is only about one-third of the form. |
| Reverse side: | Blank. |
| Colours (text & form): | Black on blue. |
| Size of form overall: | 174 × 215 mm. |
Details of use and rarity.
| Form sub-number |
Schedule number | Earliest recorded date | Rarity rating |
| DO-1A | None | 17 November 1857 at Adelaide (?) | RRRR |
| DO-1B | None | 4 November 1862 at Gawler. | RRRR |