STÁTNÍ TAJEMNÍK U ŘÍŠSKÉHO PROTEKTORA V ČECHÁCH A NA MORAVĚ, PRAHA, inv. 1815, sig. 109-5/43 Page 26 · 26 of 97

STATE SECRETARY TO THE RUSSIAN PROTECTOR IN THINGS AND IN MORAVA, PRAGUE, inv. 1815, sig. 109-5/43

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English Translation

NXV VI. Has anyone asserted against you any claims for damages, etc. (name, race, address and legal ground) VII. Do you have any other obligations or liabilities? Have you granted someone the power of representation (enforcement)? (Name, race and address.) I declare that I have given the above information on official requests to the best of my knowledge and conscience and have not concealed anything from my property. I am aware that false or incomplete information is being punished. 62716 am (signature) 10 141