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DA-7J� NEBRASKA <br />DMSION OF PUBLIC WELFARE <br />Certificate of Award <br />Old Abe Assistance or Blind Assistance <br />Type of Aid .......O.LT,*...-".(L ....................... ASS ..GL <br />....................................... <br />Name ----,S ....... �f . . .............................................................. Age ....... HH No .... !09n2910 ... A.2 <br />Address.... 2.Q3..I O.Q.....Girrknd .... laltmd, ... C o u n I y ...... .............................................. <br />Original Payment ................... i;58.&EO ........................................... Date ....... S!! 1.n5.T ........................................... <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot 10, Block 28, Pacfer a- Harr 2nd Addition, Grand Island <br />V Z-2 <br />............. <br />.................. .............................. . ................................ .................. ....................... 15 ..... . ............ <br />Signature of Payee State Director <br />.`.tate of Nebraska <br />C4unity of Hail <br />, rtered on Numerical Index and Mftd <br />for record in Office ojL' Register of <br />ezds c"n' ' the .-.--3* &Y -,f' <br />June ---- 19-3i- at <br />O'Clock and .-_5Q -- rrrinrrtc- <br />ai4 " ecorded in Book of <br />C'tf,."Qf. Award, <br />of page <br />RegL-tcr or 1jeecUr. <br />BY-------------------- <br />Fees De;;ety <br />