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DA -7A NEBRASKA <br />6-56 DIVISION OF PUBLIC WELFARE <br />Certificate of Award <br />Old Age -Assistance-- or Blind Assistance <br />. ................................. <br />Type of. Aid ....... 1.4� ... ARF1 ... <br />Name............................................. : .......... Age ..... 4.0 ........ HH No....19:40,"k.Al ......... <br />Address.108..)�.a...i.tkL.-c-t-:.,....Grand..Ialand,...Nabr.Qoun11 ..............hal.................................... <br />OriginalPayment ............ OZ.20 ................................................. Date ................ Znl*-ZE? ................................... <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot 60 Blook 19, Griginul Toym of Grand Jsl%nd, Bull Coontyq Nebre <br />__4.k......... <br />.. <br />. ..D..I. Arec. <br />t <br />or.. ture ofia e; 11 <br />Stale of Nebraska <br />CcU--.',y of i.ali <br />on i,:umcrical Index and filed <br />fc-; record is (,ff' ce of Regioter of <br />I- ced-z on the ------ day -of <br />X_ at <br />o'clocl, an._, rn!nuies <br />mid recoyded ;n Dook ___-_2 -------- of <br />I�Y71`1_7 i piad <br />Register of Deeds <br />By-------------------- — — — — — <br />Fees $2-Z-4-- Deputy <br />meq! W-7. <br />