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NEBRASHA <br />DA -7A 4W <br />BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND C'MD WELFARE <br />CERTIFICATE OF AWARD <br />OLD AGE ASSISTANCE OR BLIND ASSISTANCE <br />Typeof Aid ------------- .................. <br />Name .............. QW -Ws, -BM= ----------------------------------- Age ------ ff ..... HH No..4"M?AR." <br />Addressv --------- ad-jRj,nr*..VvbMdK..................... County --------- an ........ <br />OriginalPayment --- # — - -------------------------------------- Date .........::..fit!! ... . --------------------------- <br />Old Age Assistance: Legal description of I real estate owned by recipient: <br />Late 4 wd 119 Mak 199 OrI91=1 tMM Of <br />voca River <br />...... ;, ............ DI <br />Sienature o[ Payeo :. (J <br />303 <br />Hanota-Carey <br />To <br />State of Nebraska <br />A7r OF <br />(z Y oz <br />c:rij,,), oi3t this wnent VV= <br />nterA, til, <br />,;,.imerical b Vd d ft <br />er. r,-., . --x <br />r,-e(.I*C. .Al)thL,. - 4 <br />ril 19.LL3 at— —10.1.30 <br />crsv L- <br />X_A &j_ aqjpadod in bwk <br />s <br />2 of Ctf, of at swze–� <br />Register of Deeds <br />N-- CbffP <br />