| Heading and notes: | Form number E.T. No. 2. Standard interim heading. Has row for "Stamps to be affixed ...". |
| Message area: | 6 rows of 5 boxes. |
| Reverse side: | Blank. |
| Colours (text & form): | Black on cream. |
| Size of form overall: | 183 × 222 mm. |
| Size of datestamp box: | No box but "Stamps" row is 24 mm high. |
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SI-TO-1
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SI-TO-1.
Top part of form only. |
Details of use and rarity.
| Form sub-number |
Schedule number | Earliest recorded date | Rarity rating |
| TO-1 | None | RRRR |