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[[preprinted form, set up as left- and right-hand sections, filled in by stamped and hand-written information.]]

[[left-hand section]]
Form 2865
Post Office Department, United States of America
Administration des Postes des Etats-Unis d'Amerique

(To be filled in by the office of origin)
(A remplir par le bureau d'origine)

Registered article (-----) (1) (2)
Envoi recommande

Parcel insured for $-----  (3)
Colis avec valeur decleree de 

Mailed at the post office of -----
depose au bureau de poste d
-----
[[stamped over the above wording]]
Grand Central Station
[[?]] Lexington Ave.
New York, New York (17)
[[end stamp]]

on ^[[3/20/50]]---, 19---, under No ^[[369390]]
le                  19     sous le No.

Mailed by M-----
expidie par M

and addressed to M ^[[FMZ [[?]] Mathiesen]]
et adresse a M
at ^[[London W1, Eng.]]
a
_____
1  Indicate in the parenthesis the nature of the article (letter, print, etc.).
Indiquer dans la parenthese la nature de L'envoi (letter, imprime, etc.).
2  Strike out the indications not applicable.
Biffer les indications inutiles.
[[end left-hand section]]

[[begin right-hand section]]
Return Receipt
Avis de reception

C5
Postmark of the office returning the receipt
Timbre du bureau renvoyant l'avis
[[image: indicia. A circle indicia reading as follows]]
REGISTERED
23 MY 50
20
LONDON, W.D.C.
[[END INDICIA]]

(To be filled in by the sender, who will indicate below his complete address)
(A remplir par l'expediteur qui mentionnera ci-dessous son adresse complete)

M ^[[Jacques Seligmann]]
M
^[[5 East 57 st]]
(Street and number) 
(Rue et numero)
a ^[[New York 22 NY]]
(Place of destination, in large characters)
(Lieu de destination, en gros caracteres)

UNITED STATES OF AMERICA
Etats-Unis d'Amerique

POSTAL SERVICE
Service des postes
5--11654