-Page No.5-

The form is filled by a person issuing the passport.

STUB

number 449 is issued by the city administrator of Sevastopol in 1920, January the 19^th
to Maria Anatolievna fon Rizenkampf.

Place for a stamp about going overseas.

This stub is torn out by the border customhouse when the passport is presented.

STUB

number 449 is issued by the city administrator of Sevastopol in 1920, January the 19^th
to Maria Anatolievna fon Rizenkampf.

Place for a stamp

about going overseas.         about coming back from overseas.

This stub is torn out by the border customhouse when the passport is presented.