<printed form letter>

PARLIAMENTARY AGENCY OFFICE,
PALACE-YARD, WESTMINSTER,

JANUARY 29, 1833.

SIR,

I TRUST you will excuse the liberty I take in requesting your kindness in filling up and returning me, at your earliest convenience, the accompanying form, to enable me to submit to the House of Commons, and the public in general, the most correct information of the result of the late Election.

I have the honour to be,
Sir,
Your most obedient humble Servant,

CHARLES MOSSE

To
<manuscript> W. H. F Talbot Esq <printed> M. P

W. H. F. Talbot Esq M P
&c &c &c

31 Sackville S^{t <1>}

---

Notes:

1. Added in another hand.