The image is a photograph of a piece of paper with Japanese text written on it. The text is written in black ink and appears to be a document or a document of some kind. The paper is white and the text is in both English and Japanese. The title of the document is "2016年9月9日" which translates to "New Year's Eve" in English. Below the title, there is a blank space for the user to enter their name and address. 

The paper is resting on a wooden surface and there are two other papers visible in the background, one on the left side of the image and the other on the right side. The papers appear to be old and worn, suggesting that they have been used for a long time.