In Staszów on this day, 2 December 1946, at 12.00 p.m., I, platoon sergeant Artemiusz Stelmach from the Citizens’ Militia Station in Staszów, acting on the basis of Article 20 of the provisions introducing the Code of Criminal Procedure, and complying with the formal requirements set out in Article 259 of the Code of Criminal Procedure, with the participation of a reporter, officer Feliks Kaźmierski from the aforementioned station, have heard the person named below as a witness, determining as follows:
| Name and surname | Jan Góra |
| Parents’ names | Józef and Marianna, née Raczyk |
| Date and place of birth | 24 June 1920 in Staszów |
| Religious affiliation | Roman Catholic |
| Marital status | unmarried |
| Occupation | baker |
| Place of residence | Staszów, Opatowska Street 37, Sandomierz district |
| Criminal record | none |
The aforementioned testified as follows: I know that in November 1942, during the German occupation, the Germans shot approx. 400 Jews of both sexes at the Jewish cemetery in Staszów. The victims were buried in two graves.
I have testified everything that I know in the case. At this point the report was concluded and read out to me, whereupon I signed it. I confirm that this is my testimony.