STÁTNÍ TAJEMNÍK U ŘÍŠSKÉHO PROTEKTORA V ČECHÁCH A NA MORAVĚ, PRAHA, inv. 2768, sig. 109-16/3 Page 174 · 174 of 209

STATE SECRETARY FOR THE RUSSIAN PROTECTOR IN THINGS AND IN MORAVA, PRAGUE, inv. 2768, sig. 109-16/3

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Page 174

English Translation

2501 19 (Authority) Notification 1. Name and surname: 2. Date of birth and =place: 3. Occupation: 4. Place of residence: 5. Nationality: 6. Jude: 7. Drt and time of suicide or attempted suicide*: S 8. Type of execution: 9. Reason for suicide or attempted suicide*): To the State Criminal Police Din A 5 (148×210mm) Criminal Police Office 1 page form in- RKP.41 *) Invalid criminal science and practice publishing house — Verlag der "Kriminalistik" Berlin N 54 supplement 1941.