Measures 144 x 210 mm (approx. 5 ¾ " x 8 ¼ "). The document shows an ink stamp of the Pechorskiy District Military Commissariat in the city of Kiev and is hand-signed by the commissariat's chief Col. Boltnov.

Very good to excellent condition, free of significant wear. As with nearly all large certificates of its type, it has been folded in four, but unlike most, it has not developed any separations along the fold lines and remains perfectly sound. There are some very mild water stains in the upper part, which are not too distracting. The handwritten entries are slightly smudged, apparently from when the document was filled in, but they remain fully legible. The ink stamp is pristine.