Material: papyrus
<gap/>.. ζ καὶ ϛ  τῶν [κυ]ρίων ἡμῶν 
[Διο]κλητιανοῦ καὶ Μαξιμιανοῦ Σεβαστῶν 
<gap/> 
<gap/>..... ἀννωνῶ 
<gap/>υτων τῆς αὐτῆς Παιης καὶ ἄλλω 
<gap/> σ ο...........  χειλίας δια
[κοσία]ς   Ασ ......
<gap/><gap/>.... ἀννωνῶ[ν ]<gap/>ς ἐξ ημ...<gap/>
<gap/> ζ  καὶ ϛ  τῶν κυριω ἡμῶν 
[Διοκ]λητιανοῦ καὶ Μαξιμιανοῦ 
[Σεβασ]τῶν Ἐπεὶφ ιγ διεπαισα κὶ 
<gap/> 
<gap/>υρου . τι οἴνου καὶ ἐλαίου 𐅷 καὶ 
<gap/> ἐπὶ λόγ δραχμὰς διακοσί
[ας  ]...  ..αυτο.μιζω... 
<gap/>.ακυρ θ διεν ἡ αὐτὴ ...... 
<gap/>........ καὶ τι οἴνου καὶ 
<gap/>.... γ  ἑκατὸν ἑβδομήκοντα ἕξ 
 ροϛ.