| Heading and notes: | No form number. ELECTRIC TELEGRAPH WESTERN AUSTRALIA spans the central crest. | 
| Message area: | 8 lines of 5 boxes. | 
| Reverse side: | Regulations and Charges (3A) or blank (3B). | 
| Colours (text & form): | Black on cream. | 
| Size of form overall: | 171 × 216 mm. | 
Also see the rare posted form elsewhere.
   
|  | WC-TO-3A. Albany to Melbourne 2 December 1889. Characteristics: 
 | 
|  | In reference to the note below, see Regulation # 3. As reference to the Press is not contained in that regulatsianon, it might be inferred that this form was printed after April 1884. 
 | 
| The West Australian of 15 April 1884 noted that: 
 | |
|  | WC-TO-3B. Cue to Adelaide Characteristics: 
 
 See elsewhere for the very rare form with this format posted from Perth to Guilford on 14 September 1898. | 
Details of use and rarity.
| Form sub-number | Schedule number | Earliest recorded date | Rarity rating | 
| TO-3A | None | 2 December 1889 at Albany. | NC | 
| TO-3B | None. | 21 March 1892 at Perth. | NC |