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Form DA—Revised 7-44 33149—TIIE AUGUSTINE CO. GRAND ISLAND. NEBR. � <br />CERTIFICATE OF AWARD No. � <br />I QldAeAssstanceType of Aid................... ...g----,............. <br />I <br />Name of Payee............B.oroff......Richard....._.............................Age..66.......------------....Number...........�:0.-211..mA:................................. <br />i <br />Address-Doniphan ,. Nebraska..............................:_.....---.................................---------...........County................--------.11all............................................. <br />Original Grant$.......... X.....0.0..--.._......................................-----....----.............._.------...---.....-----D..........-8-1- 6 <br />...................................................................... ......................................19............ <br />NAME OF CHILDREN FOR WHOM ASSISTANCE IS GRANTED <br />BIRTH DATE <br />RELATIONSHIP TO PAYEE <br />(Will be filled in only if used as certificate for children securing aid for dependent <br />children.) <br />i <br />i <br />Lots 15, 16, & 17, N. W., Doniphan <br />Village Co. Sub. of Part S- of Sec. 5, <br />Twp. 9, Range 9, Hall County, Nebr. <br />i <br />i <br />Richard L. Boroff Neil C. Vandemoer <br />Signature of Payee <br />Director of Assistance and Child Welfare <br />Filed for record this 18 day of October, 1947, at 8:00 o'clock A.M. <br />ii - - �✓✓ <br />5 Register of Deed <br />