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X Orm 1jA-2LCV16Ca 'f -ZZ 33140–TIIC AUGUSTINE CO. GRAND ISLAND. N EDR. <br />I <br />CERTIFICATE OF AWARD No. <br />Type of Aid ......P ... A, .e---.Ass3.stance_....................... <br />Name of Payee........'r�..eerleyI....Harriett V.---------------.....Age.........0...............Number.......1!:�.-182�.-A1 <br />Address ............ 61.7..... Y.91h. Grand... T.sl andz.... Nebr.........................................._.County.........Hall.............................................................. <br />Original Grant$---.1,80.S2............................--....-----......................................---.................................------Date.......a-1-42 <br />...........................................19............ <br />NATfE OF CHILDREN FOR WHOM ASSISTANCE IS GRANTED BIRTH DATE RELATIONSHIP TO PAYEE <br />(Will be filled in only if used as certificate for children securing aid for dependent <br />children.) <br />Lot 4, Block 9 H. G. Clark Addition, <br />City of Grand island, Hall County, Nebr. <br />Neil C. Vandemoer <br />Signature of Payee Director of Assistance and Child, Welfare <br />Filed for record this 18 day of October, 19473 at 8:00 o'clock A. <br />50 Register of Deeds <br />