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DA- NEBRASKA <br />DIVISION OF rumc *V]ErXARF, <br />Certificate of Award <br />Old'e <br />A" Assistance or Blind Assistance <br />'iy U-' '-'-G <br />Type of Aid... QW.-A&K :�UR -t"* ' '* .:...........•-...•-•--...---••--•......... <br />Name...... ........................................................... Age ..... i9 ........ HH No.4.0.�-HLLAI ........... <br />Address... 18111x'd ...... County.—H-411 ................................................ <br />Original Payment ... ........ 4.C, <br />.... ... ... Date .... 7!!!I�U .............................................. <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot G, block 9,' Sosrrff.!e Addition to leat TR, <br />A, <br />Signature of FAYce S,t,a,te Director <br />Grate of Nebraska <br />as <br />Cr,Unty of <br />on ln&,x w2d,filed <br />for CCCIAIU.) in Rcgit�turpf <br />L C (I tltL <br />UC. <br />al <br />......... .. <br />Register of I)eecls <br />By--------------------- <br />Fees ep U tv <br />