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[[pre-printed]] Form No. 253 FOREIGN SERVICE (Amended March 1944) FOREIGN SERVICE OF THE UNITED STATES OF AMERICA [[line]] DECLARATION IN CONNECTION WITH PAINTINGS, ETC., AND SCULPTURES To be entered under Paragraph 1807 of the Tariff Act of 1930 [[line]] ^[[19 Aout 1949]] (Place and date) I,* ^[[Rene Lefebvre]] do hereby declare that I am the [[strikethrough]]painter or producer[[/strikethrough]] ^[[agent]] of certain works of art, viz: ^[[TOULOUSE LAUTREC Femme dessin Prudhon Impératrice Josephine dessin " " [[ditto for TOULOUSE LAUTREC]] Yvette Guilbert " [[ditto for dessin]] GAUGUIN Ictus painting Prudhon le bain " [[ditto for dessin]] ]] covered by consular invoice No. ^[[9514]] , certified by the American Consul at ^[[Paris]] on the ^[[19]] day of [[stamped]]AUG 22 1949[[/stamped]] ^[[Aout]], 19 ^[[49]]; that the said paintings, [[strikethrough]]pastels,[[/strikethrough]] drawings, [[strikethrough]]and sketches[[/strikethrough]] are originals; [[strikethrough]]that the said sculptures or statuary are originalsor 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 [[/strikethrough]] MM TOULOUSE LAUTREC - PRUDHON - GAUGUIN sont decedes [[signed]] Lefebvre[[/signed]] Signature of [[strikethrough]]artist[[/strikethrough]] or shipper) [[stamped]] REPUBLIC OF FRANCE} DEPARTMENT OF SEINE} CITY OF PARIS} EMBASSY OF THE UNITED STATES OF AMERICA} } SS [[/stamped]] } SS: I, ^[[Jean V. Smith Vice Consul of the United States]], Consul of the United States of America at ^[[Paris]], do hereby certify that the above declaration was subscribed and sworn to (or affirmed) before me by ^[[Rene Lefebvre]] on this ^[[19]] day of ^[[Aout]], 19 ^[[49]], and that the statements therein contained are true to the best of my knowledge and belief. [[signed]]Jean V Smith[[/signed]] ^[[Jean V. Smith]] Consul of the United States of America. [[image: seal]] 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 was impracticable to obtain the declaration of the artist. U. S. GOVERNMENT PRINTING OFFICE 16-10608-2[[/pre-printed]]