| Heading and notes: | No form number can be seen. URGENT TELEGRAM above Post Office Telegraphs, Western Australia (and no reference to Australia). |
| Message area: | 11 rows of three boxes. |
| Reverse side: | Blank. |
| Colours (text & form): | Black on cream. |
| Size of form overall: | 288 × 225 mm. |
| Size of datestamp box: | None. |
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Details of use and rarity.
| Form sub-number |
Schedule number | Earliest recorded date | Rarity rating |
| TU-1 | None | 26 January 1897 at Perth. | RRRRR |