Top, left: Manager of the PYAFP
......... the ......... 192...

Topics:
Acts:

REPORT

Signature

Chief Secretariat
Warsaw, Leszno 2, Tel. 308-90

File: ................. (theatre, troupe)

REPORT No.

for the time from ............ to ............

Columns: 1. Day; 2. Date; 3. City; 4. Theatre; 5. Play;
6. Gross Income; 7. Union Fee; 8. Do Not Fill In.