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002-373
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Last modified
7/8/2017 6:53:01 PM
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7/3/2017 12:14:44 PM
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002-373
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T <br />DA -7A =RASTUL <br />DIVISION OF PUBI tO WELFARE <br />Certificate of Atvard <br />Old Age Assistance or Blind Assistance <br />'Tipe of 'Aid ................................................ <br />Name I'lisha Re ........ Age ... 7.9 .......... HH No.h9!4D;�,.1:nA)k .......... <br />........................... . ............................................................. <br />_Tz, i. -n -b ........ ........... .......................... <br />Address.. do ... Nt, r County ... Hall <br />Original Payment.......... .................................................... Date ......... :1:41: .............................................. <br />............ <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />(A) —Zast 2/3 of lots h ;, 5o Block 33o' P!icker 74 Barr 2nd Addition to <br />Grand Island. (B) Part or Tots 2 !: 3., Block 33, Packor aro 13arr <br />2nd Addition to Grand Island. (0) E-ist 1/2 of lots 6 c� 7o Block 33, <br />Packer and Barr 2nd Addition to Grand Island* <br />77 <br />Cv/ Lam; <br />............ <br />............................................ ................... ...... ............ . ................................................... <br />Signature of Pa State Director <br />statn cif !''hra.-I:a <br />
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