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DA=,M NEBRASKA <br />6-56' DIVISION OF PUBLIC WELFARE ' XENii.YAL <br />Certificate of Award <br />Old -Age Assistance or Blind Assistance <br />Type of Aid........... .. QLT)...8-0F ... ............................. <br />Name .... BrItt%iri., .... Uor.anaa .............................................. Age ....... 1.0 Hit No....An-!n7!M..AZ .......... <br />Address Mal ... <br />nO .... ... County .. ........................................... <br />.... .. ....L!M .. <br />Original Payment ............................................................ Date ......... 2mInE.8 ........................................ <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot 8# Block 2. Gideonle ;iddltion to roniphan, hall, ftbraska <br />/x <br />Signature of Payee <br />