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SEAL: free for the term no longer than one year 

1. Denomination: Jewish 
2. Date of birth or age: 33 years old 
3. Occupation: a tailor 
4. Marital status: married 
5. Number of dependents: N/A 
6. How related to military service: low rank in a reserve 
7. Signature: illiterate 

in case of illiteracy of the holder, print his signs:
Height: middle
Hair: dark white
Special: N/A

Holder of this document, inhabitant of VOLHYNIA Gubernia, ZASLAVL Uezd, town of Labunia, Ghershko, son of Leyba, BARINSHTEIN has been released (allowed to go) to the different towns and villages of The Russian Empire from the date listed below to April 10, 1902. Issued and sealed: April 10, 1901 

Deputy of the chairman of Labunia community 
(signature unreadable) 
SEAL of the Labunia city government 
Postponement: the document is postponed for three months e.g. until 189...year

Seal: Free
Personal seal: unreadable