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Front: Tan form with printed information in a list on the lefthand side (eight bullet points) and information written in blue ink in printed boxes on the righthand side. A blue oval stamp with the Star of David on the lefthand side.
Back: Printed information in a list on the lefthand side (bullet points 9-12) and information written in blue ink on the top box. Purple stamp in middle. These pre-printed forms were used for determining an individual's work in the Lwow Ghetto.
Information Provided by Michael D. Bulmash:
Pre-printed form, double-sided, used for determining individual's work, each with blue LWOW Ghetto marking.
5 3/4 x 8 1/4"
Star of David, Stamp, LWOW, Ghetto, Prisoner 55829
"Form Issued to Prisoner 55829 in Lwow Ghetto" (1943). Bulmash Family Holocaust Collection. 2015.2.52.