English Translation

47 Model A. the office Place B.Nr. Police permission. The Jew - The Jew (first name, name underscore) (Zuname, in the case of women also maiden name) (occupation) in resident in .... (municipality) (Straße, Platz Nr.) becomes here- (nationality) (official photo ID) with the police permission to leave his - their residential community once and again ...... ........... about ............. according to ..................... - and back - on ..... from until ..... (date) (time) .. . . .. this permission is entitled to use (means of transport) unless a use of this -r- mode of transport -S is excluded or restricted by the modes of transport or their supervisory authorities. This permit is only valid in conjunction with an official photo ID. Service stamp (signature) Strike out what does not apply.