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DA -7A NEBRASKA <br />9-5-1 DIVISION OF PUBLIC WELFARE c 0 1 ri T: C,T7 O 1 <br />Certif icate of Award <br />Old Age Assistance or Blind Assistance <br />Type of Aid .......... Old Acle..Assistance..................... <br />Name ............. -SIIck�_fxtt^L--------------------------------------Age.---.7-3------- III -I No....►:Q_-6TO-Al. <br />Address 11�F� . _ 1r _^^an -rs as--�4'�,County----------iiAU---------------------------- <br />Original Payment.......... 55.:! 0 ......... --------------------- Date -------------- 124T -a ----------------------- <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Pa -,t of HW, of sTt of Section 31, Township 11, <br />T?r0 9. <br />if <br />J <br />.................................. _ '.... .. .. .... ...............h <br />r <br />Signature of Payee State Director <br />.,State of Mebrasl:a <br />ss <br />Cour'y of Hal: <br />Entered on Nu—nerical index and filed <br />for ;ecard in Cr. :ce cf Reuister of <br />Ueerls on the __ — ----- day of <br />December,• ts.5.4_ at _4:.CQ- <br />o'clocl; and ..__-_ __ Mir-tes-_P.M. <br />2 <br />ar.d reccru::c z:• c -o.. _ ______-- <br />_ of <br />Ctf. . of A ards <br />i <br />Re€ ister G Deeds <br />By__---------- <br />Deputy <br />Fees $--Np _ Q.b,arge <br />