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DA -7A, NEBRASKA <br />P-st DIVISION OF PUBLIC WELFARE <br />Certificate of 'Aivard <br />Old Age Assistance or Blirid Assistance <br />Type of Aid ............. 0W--_1 f?m--Aaa1ztanco---...----------- <br />Name-------- Sta4as ='a" pt .................................. Arre.... 6-----I-IH No.J,,) 361—:ti-- <br />Address.---.23L. Y:Q...!. tQ.. T1tP&C-rW1..T61=1_.County.---------full------------------------------ <br />OriginalPayment..... -t2%. W ..................................... Date .............. L'—I.- r ----------- -------•----- <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot 29 ^lock 18, Packnr P4 arr's Send Ad.tition <br />to -ram! Itall County, i'e:.'raska. <br />(Joie., title with con) <br />. ........... <br />Signature o[ Pnycc <br />Efate of Nebraska <br />rr........ ------ <br />Sh1tc rector <br />County of Hall f M <br />Lntered on P:u:terical Index and filed <br />for record in GH-ce of Register of <br />Leeds on thee?'! ....... day of <br />o'clock and __is, minutes .e.,PYA. <br />end recorded in Book . of <br />r� ���uEetec�(o at page_.ze?_., <br />Register of Deeds <br />By-- —------ <br />Deputy <br />_���---- <br />Feta $—�% <br />