Partly-printed document, signed “Henry Cowell” twice on each side, 2 pages [back to back], 4to [10-15/16 in. x 8-7/16 in.], [New York City], undated. ASCAP-ACA Survey Form, completely filled in by Cowell in ink, registering his composition “Amiable Conversation,” composed in “1918?” with pertinent information about copyrights, publishers, running time, etc. On verso, he registers another composition, “The Voice of Sir,” composed in “1920,” supplying similar information about the composition. His signature appears in the body and at the end of both pages. Paperclip stain on one side, otherwise in very good condition.