Спб. Общество Взаимного Вспоможения на случай смерти
Machine translation from the original · Show original
Honorary Chairman, Collegiate Advisor, Nikolai Nikitich Mikhailov 2.
Vice-Chairman, General – Major, Alexander Bogdanovich Ganike 3.
Member of the Board - Secretary, Midwife Evdokia Ignatievna Vasilyeva.
Headquarters - Captain, Alexander Grigorievich Arkhipov.
St. Petersburg merchant, Eduard Eduardovich Burkhard.
State Councilor, Vitold Fedorovich Voevodsky.
Pharmacist, Vasily Mironovich Ganzen.
Captain, Nikolai Aleksandrovich Efimov.
St. Petersburg merchant, Parfeny Mikhailovich Kosovsky.
Titular Advisor, Eduard Vasilievich Koch.
St. Petersburg merchant, Ivan Aleksandrovich Kashnikov.
Collegiate Advisor, Vasily Vasilievich Semenov.
To the Board of St. Petersburg. Mutual Aid Societies in Case of Death.
(They are asked to write) Title or rank, first name, patronymic and last name.
In accordance with § 2, 3 and 9 of the Charter, I declare that I am of age, and
my wife (enter her name, patronymic and how old she is). I have the honor to ask
The Board will accept me as a member of the Society in a group with a fee of r.
I live in the St. Petersburg unit, school,
street in house No. 189
day with my signature (according to § 2 of the Charter),
I certify that the applicant and his wife are healthy.
Based on § 22 of the Company’s Charter, I have the honor to declare to the Board that
in the event of my death, the benefit follows in accordance with § 3, paragraph 3 of the Charter, from the cash register
Society, must be issued to (enter to whom) or one of us spouses
Survivors of the day 189.
The board humbly asks you to write everything down in detail and clearly, to whom exactly the benefits will be given, etc., and to sign your name and surname under the applications.
The applicant's signature, rank or rank, first name, patronymic and last name.
Printed applications for those wishing to enroll as members of the Society
are issued by the Board free of charge.
Persons wishing to receive detailed information or enroll as Members of the Society are pleased to contact the Board of the Society (Pushkinskaya, house No. 10, apt. 46), daily from 4½ to 7, except holidays and time days, to the Member of the Board - Secretary Evdokia Ivanovna Vasilyeva, from whom you can receive all the desired information related to the Society.
The founder is the initiator of the Society.