LEAGUE OF NATIONS - United Nations Treaty Collection
LEAGUE OF NATIONS - United Nations Treaty Collection LEAGUE OF NATIONS - United Nations Treaty Collection
312 Socijte' des Nations - Recueil des Traites. 1931 MODELUL Nr. 2 WZ6R Nr'. 2 LA ARTICOLUL 4 AL CONVENTIUNEI do artykulu 4 Konwencji TRAFICUL DE FRONTIERA LOCAL ROMANO-POLON POLSKO-RUMU14SKI RUCH POGRANICZNY Certificat de trecere permanent. ... >....... Nr ............. Przepustka stala ............ Nr .......... N um ele 5i pronum ele .................................................................. Nazwisko i imiC O cupatiunea ........................................................................... Zawdd Proprietar (posesor, arenda§, etc.) autorizat sd munceascd pdm-ntul in comuna ................. Wta~ciciel (posiadacz, dzierawca i. t. d.) uprawniony do Wuytkowania gruntdw w gminie A ngaj at la ............................................................................ Zatrudniony u Locul na~terei ............................... data na~terei ............................. Miejsce urodzenia data urodzenia N ationalitatea ......................................................................... Obywatelstwo. D om iciliat in com una .................................................................. Miejsce zamieszkania Punctul de trecere peste frontierd ....................................................... Miejsce przekraczania granicy V alabil 6 luni (un an) ................................................................... Wa~na 6 miesigcy (jeden rok) RECTO Verte No 2752
1931 League Of Nations - Treaty Series. 313 Locul fotografiei. Mieisce na fotogra/i. Sem ndtura titularului .............................................................. Wtasnorczny podpis posiadacza VERSO Numele persoanelor minore, mai mici de 15 ani, care insotesc pe titularul permisului .... Wymienienie osdb maloletnich, w wieku poniiej lat 15, towarzyszqcych posiadaczowi przepustki Localitatea in care a fost liberat certificatul ........................................... Miejsce wystawienia przepustki D ata . ..... ..... ..... .... .... ..... .... ..... ...... .......... ........ ........ .......... . Data A utoritatea ............................................... Urzqd Sem ndtura . .......................................... Podpis No. 2752 Stampila oficiald. PieczC urz~dowa.
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1931 League Of <strong>Nations</strong> - <strong>Treaty</strong> Series. 313<br />
Locul fotografiei.<br />
Mieisce na fotogra/i.<br />
Sem ndtura titularului ..............................................................<br />
Wtasnorczny podpis posiadacza<br />
VERSO<br />
Numele persoanelor minore, mai mici de 15 ani, care insotesc pe titularul permisului ....<br />
Wymienienie osdb maloletnich, w wieku poniiej lat 15, towarzyszqcych posiadaczowi przepustki<br />
Localitatea in care a fost liberat certificatul ...........................................<br />
Miejsce wystawienia przepustki<br />
D ata . ..... ..... ..... .... .... ..... .... ..... ...... .......... ........ ........ .......... .<br />
Data<br />
A utoritatea ...............................................<br />
Urzqd<br />
Sem ndtura . ..........................................<br />
Podpis<br />
No. 2752<br />
Stampila oficiald.<br />
PieczC urz~dowa.
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