English Translation

k. u. k. öst. ung. army (time, troop part, last rank) : a) before 1914 b) 1914-1918 Legions and legionaries (time and type, last grade): former Czech-slow. army after 1918 (time; troop section, last grades) : 21. member of a Masonic lodge from until in leading position as resigned due to 22. Member of political parties (name, time, function) : NS since function: 23. Member of sports clubs and similar organizations: Sokol from up to function Orel from up until function 24. Other information: Place and date of exhibition. Seal of office and signature. 13176 Printing house of the Ministertam es Innere. 40-777.