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DA -7A_ NEBRASKA <br />11-rI7 DIVISION OF PUBLIC WELFARE <br />Certificate of Award <br />Old'—Age-Assistance --or Blind, Assistance <br />Type of Aid............. ... �seistance <br />U.— Creanon. knna A. A.o. 15 Ri4Z <br />Original Payment .................................. �om9y .............................. Date ............ P1TA!!?7 ...................................... <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot 3# Block 3. Ideon Ad-,itiont 0omwiphanp Nebras':a. <br />Wr...... .......... . - � . ....... <br />Signature of Payee t le Director <br />Statc of NclaratIm <br />Coun:y of all SS <br />Index and fi.ed <br />Regisier of <br />---------------- da -Y of <br />C- <br />- -cc co cuic <br />---- Of <br />-- --- - ---- - ---- <br />illc,ui- of Deca'a <br />By------------------------.•----_ <br />Fees $-A 12 <br />L--611 . Deputy <br />0 <br />