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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]]