Name and town which appears on the dial (and country if not UK)

Maker of the Movement if different to above.

Type of movement 8 Day Longcase Clock 30 Hour Longcase Clock French Clock Lantern Clock Bird cage movement Wrist Watch Pocket Watch Other please specify in next box

Other information on the Movement

Strike Chime or Timepiece Striking Chiming Repeating Timepiece

Type of Dial Brass dial with silvered chapter ring Brass dial with non silvered chapter ring Brass one piece dial Painted dial Vitrious Enamel Gold or Silver Other please specify in next box

Other information Dial

Type of Hands Brass plain hands Brass chased hands Hands are not original Steel hands Other

Other information on the Hands

Type of Escapement Verge Lever Cylinder Recoil Deadbeat Other please specify in next box

Other information on escapement

Weight Driven Spring Driven Both

Type of Case Brass Wood Oak Metal Silver Gold Other please specify in next box

Other information on case

Approximate Date of item

Have you any information on the maker

If you have found information on a clockmaker, or the family of one, from other sources (i.e. grave stones or church records etc )please enter in the next box. Please supply references and dates of records

Notes

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Name Address Phone Number Web Site

Please E-mail a photograph of the Item, Grave stone, House where maker lived or any relevant subject if possible.

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