| Heading and notes: | Form number T.G. 41A. URGENT TELEGRAM in two lines in central box. | 
| Message area: | 25 boxes in 5 lines. | 
| Reverse side: | Blank. | 
| Colours (text & form): | Black on salmon-pink. | 
| Size of form overall: | 104 × 190 mm. | 
Details of use and rarity.
| Form sub-number | Schedule number | Earliest recorded date | Rarity rating | 
| TU-12A | Sch. C. 6361-8/50. | 26 June 1953 at Melbourne. | NC | 
| TU-12B | Sch. C. 6621- 10/51. | NC |