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[[preprinted form]]
INVOICE OF PURCHASED MERCHANDISE (Amended Nov. 1924)

AVIS IMPORTANT.- Employer cette formule pour des expeditions de marchand ses achetees ou faisant l'objet d'un contrat d'achat. Pour toutes marchandises non achetees (en consignation) employer la fomule blanche (139-140).

Si la facture ne peut tenir ci-dessous, la faire soit sur des entetes de la maison, soit sure des feuilles libres ordinaires en [[italics]] n'ecrivant que d'un seul cote. [[/italics]] - Le papier employe doit etre ferme et durable. Fixer les feuilles le long du pointille en sorte la formule consulaire forme la derniere page.

(Villa)  (Pays)  (Date) ^[[Paris, France, February eleventh]]19^[[33]]

Invoice of (Genre de marchandise) ^[[WORKS OF ART]] purchased or agreed to be purchased by (Ecrire ci-dessus le nom de l'acheteur) ^[[Mr. WILLIAM RANDOLPH HEARST]], (Ecrire ci-dessus l'adresse de l'acheteur) of ^[[c/o Hudson Forwarding & Shipping Company]]
from (Ecrire ci-dessus le nom du vendeur) ^[[JACQUES SELIGMANN & FILS]], of (Ecrire ci-dessus l'adresse du vendeur) ^[[underline]][[17 State St. New-York]][[/underline]]^[[57 rue St. Dominique, PARIS]]
as per order accepted (Ecrire ci-dessus la date de venta) ^[[on the ninth of July 1931]]
to be shipped per (Ecrire ci-dessus le nom de paquebot) ^[[SS LAFAYETTE leaving Le Havre February fourteenth 1933]]

[[double line]]
STATE WHETHER PRICES IN THIS INVOICE ARE IN GOLD< SILVER, OR PAPER CURRENCY
[[/double line]]

[[table of four columns]]
MARKS, NUMBERS, AND QUANTITIES | MANUFACTURER'S NOS. (See Note 1 below) | FULL DESCRIPTION OF GOODS N.B. - Always state the cost of packing, and all other costs, charges and expenses. [[italics]] (Il est indispensable [[/italics]] de faire figurer dans la facture. ou a sa suite, la valeur complete des emballages, et tous autres frais). | PURCHASE PRICE PER UNIT. (PRIX AR UNITED | TOTAL INVOICE PRICE (MONTANT TOTAL) | CONSULAR CORRECTIONS OR REMARKS

^[[SD 6823/28 | 4161 (13270) | A large mantle in ancient faience.German work produced before 1829. Purchased iron Francois Flameng,Paris,Sept. 9th. 1911........ | Frs 42,000.--]]

^[[SD 6829/42 | 8602 (13269) | A carved stone mantle.French work produced before 1829. Purchased from Mr.Roger, of Moricq s/Mer (Vendée) France. June 3rd. 1921... | " 70,000.--]]

[[total]]^[[Frs 113,000.--]]
^[[  |  | Case & packing...... |1,500.--]]
^[[  |  | Consular invoice...... | 64.25]]
[[total]] ^[[heavy underline]][[Frs 113,564.25]][[/underline]]
[[/table]]
^[[NO TAXES ARE PAID [[underline]]FREIGHT & CHARGES INCLUDED.]][[/underline]]

[[preprinted vertically along side of form]]
Donner un resume des differents genres de merchandises avec leur valeur et es quantites demandees [[/preprinted vertically along side of form]]

NOTE 1. - "Manufacturer's Numbers." This column must include manufacturer's grade, quality, marks, numbers, or symbols.
NOTE 1, - If any taxes to which the merchandise is subject are not included in the unit prices given in the column headed "Purchase Pri per Unit" such taxes must be set forth separately and clearly at the foot of the invoice.
NOTE 3. - Items of commissions in the invoice must specify nature of commission, as, "buying," "selling" commission, etc.

[[italics]] Signature of seller or shipper or agent of either signing in the name of his principal.) [[/italics]]

[[italics]]
Signature of Seller of Shipper [[/italics]] ^[[stamped]] JACQUES SELIGMANN & FILS[[/stamped]]

[[italics]]
By (authorized agent) [[/italics]]
^[[stamped]] ARTHUR PECK [[/stamped]]

[[/preprinted form]]