| Heading and notes: | Form number E.T. No. 2. Standard interim heading. |
| Message area: | 32 boxes in 8 rows of four unnumbered boxes. |
| Reverse side: | Blank. |
| Colours (text & form): | Red on cream. |
| Size of form overall: | 165 × 215 mm. |
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VI-TO-1.
Copy made of a used transmission form. Cost: 16s 4d.
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Details of use and rarity.
| Form sub-number |
Schedule number | Earliest recorded date | Rarity rating |
| TO - 1 | None | 15 August 1905. | RRRR |