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DA -7A NEBRASKA <br />1t-57 DMSION OF YUBL;.O WELFARE <br />Certificate of Ataard <br />~' Old -Age- Assistance or Blind Assistance <br />tType of Aid OAd f <br />Name... .T'A1L�rts. IfIry�y Age �i0 HH No O�;E iQ.-r11 <br />Address ...;istA.'...ftivnT'a... 4;??xa•nka........:..... county !!tin.. .............................._ <br />........... ... ...... <br />OriginalPayment.... -700 Q..........................................................Date......1}-1.-60........................................... <br />Old Age Assistance: legal description of real estate owned by recipient: <br />Lot 4, Block 109 Original Torn of Mood River., liebraska <br />�- <br />� �%' �" <br />....!... <br />... <br />St�nq <br />a aYce <br />. <br />..................................................... <br />State <br />Director >I/ <br />b�4 <br />)} ss <br />C':un-,y o: 1 a2? <br />f::::e n and filed <br />fa 1:7 off Oi �nrs:YGS Of <br />i r, is --- -l'---------da <br />_°f <br />a <br />o'ctoc'z and------ Ln't_.utes __1gJ-Pil. <br />arc; <br />reccrded :.. • 7�— • <br />_ anGgg2-- 3 -- <br />- Rcal sfa: of Deeds <br />----� .. <br />BY---------------e-u---- <br />Fees $--'- <br />