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Consigned to S.R.Keating & Co, 9C Broad Street, New York

[[preprinted]]
Form No.253 - Consular
(Corrected August, 1933)

AMERICAN CONSULAR SERVICE

DECLARATION IN CONNECTION WITH PAINTINGS, ETC., AND SCULPTURES
To be entered under Paragraph 1807 of the Tariff Act of 1930 
(See Consular Regulations, sec.721, note 31, and Circular Instruction of August 2, 1933) 
[[line]] 

^[[Paris, France, May 16 1939]]
(Place and date)

I* ^[[ [[signed]]Durand-Ruel[[/signed]] 37 ave Friedlnd,Paris]] do hereby declare that I am the [[strikethrough]]painter or producer[[/strikethrough]] ^[[shipper]] of certain works of art, viz: 

^[[37 original oil paintings, 1 original pastel, (framed) 
( see description attached )]]

covered by consular invoice No. [[stamped]]9720[[/stamped]], certified by the American Consul at ^[[Paris, France]] on the [[blank]] day of ^[[May]] 19 ^[[39]]; that the said paintings, pastels, drawings, and sketches are originals; that the said sculptures or statuary are originals or the first or second replicas; and that the said etchings, engravings, or woodcuts were printed by hand from hand-etched or hand-engraved plates or blocks and are artists' proofs ^[[The artists whose works are being shipped, with the exception of Matisse and Picasso, who are out of town for the moment, have been unable to sign this declaration for the following reason : they are dead]] 

^[[signed]]Durand-Ruel[[/signed]]
(Signature of [[strikethrough]]artist or[[/strikethrough]] shipper) 

[[stamped]] CONSULATE GENERAL OF UNITED STATES OF AMERICA
CITY OF PARIS, REPUBLIC OF FRANCE[[/stamped]] } SS: 
[[line]] 

I, [[stamped]]JONES R. TROWBRIDGE
Vice Consul of the United States
of America at Paris, France[[/stamped]] Consul of the United States of America at, [[blank]] do hereby certify that the above declaration was subscribed and sworn to (or affirmed) before me by [[blank]] on this [[blank]] day of ^[[May 16]] 19 ^[[39]], and that the statements therein contained are true to the best of my knowledge and belief. 

^[[stamped image of the American Consulate in France]] 
^[[stamped]] JONES R. TROWBRIDGE
Vice Consul of the United States
of America at Paris, France[[/stamped]]
Consul of the United States of America

No fee when issued with a consular invoice. 
[[line]]
* If declared to by the foreign shipper the form should be changed to conform thereto, and a statement embodied therein showing why it is impracticable to obtain the declaration of the artist. 

1-1086
U.S. GOVERNMENT PRINTING OFFICE 
[[/preprinted]]