Beskrivning: Stämpel med droppformat handgrepp och svarvat träskaft. Skaftet är försett med ordet "KLIMAX" på en metallplatta. Tvärställd stämpel, rektangulär av gummi med text i upphöjd relief. Text: "MELLANSKILLNADSKVITTO LÄMNAT DEN / 19...".
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