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Eg. — Thebes — H.G.E. White, Monastery of Epiphanius II (1926) 145, no. 690
| 1 | [Κ(ύρι)ε, βοήθησ]ο̣ν τὸν δοῦλόν σου |
| [καὶ ἐλάχ]ισ(τον) Μιχαίας καὶ παντὸς | |
| [ἐν οἴκῳ αὐτ]ὸν(!) ἐν εἰρήνη ἀμήν. | |
| [ἐγράφη Πα]χὼν ιαʹ, ἰνδ(ικτιῶνος) ηʹ. |