One leaf with preprinted staff lines handwritten in pencil on the front and handwritten in carbon on the reverse. The document is in good physical condition. The document was removed from a bound volume. There is moderate fraying along the right edge of the document. The document was laminated. There is a parenthetical "5" at the top right corner. There is a check mark at the lower right corner. The document is located on the reverse side of "The Wife of Usher's Well," Sheet Music 5, Copy.