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DA -7A NEBRASKA <br />11-57 DIVISION OF PUBLIC WELFARE <br />Certificate, of 'Atvard <br />Old ,Age' Assistance -or -Blind 'Assistance z— <br />Type of Aid...... .... nT' ;w%s :q� ............ f'. A;5f:* -Ti <br />Address.......... 2-w .. ..... —...1 ...... ........... ;Y ................................ <br />................................ <br />Original Payment ....... Wza .......... ........................................... Date ............ .. <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />0rjLCjnal joy,,j of Grand Inlaiyllj, <br />Lot 6t Block Igo <br />Coun-Ity of 1411.9 Nebraska <br />� � <br />............... ....... <br />4 AF.- ...................... <br />Snn ure of PnYce State Director <br />si <br />State of Nebraska Gs <br />County of Hall <br />Entered on r1unnerical Index and Ned <br />for record in office of Regioler of <br />Deeds' en <br />day cf <br />at <br />olejosh ana.--Z:-57 <br />ant', of <br />---------- <br />X,C9.z;tC.,- of Deeds <br />By-------------------------------- <br />Deputy <br />Fees40- 4- <br />