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[[Obverse Text]]
伍 / 0000000 / 青島地方銀行 / 0000000 / 伍 / 樣本 / 伍圓 / 伍圓 / 伍 / MANAGER. / 憑票即付中國國幣伍圓 / PRESIDENT. / 伍 / 中華民國十三年 / 財政部印刷局製 / 71.348.1264

[[Reverse Text]]
5 / TSINGTAO CITY BANK / 5 / PROMISES TO PAY THE BEARER ON DEMAND AT ITS OFFICE HERE LOCAL CURRENCY VALUE RECEIVED / 此票係樣本不能兌現收到 / 樣本 諸君務即出具收據 / 為荷 財政部印刷局敬啟 / 5 / 伍圓 / 5 / FIVE YUAN / 樣本 / 5 / APR 15TH 1924 / 5 / BUREAU OF ENGRAVING AND PRINTING PEKING CHINA