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NEBRASKA <br />DEPARTMENT OF PUBLIC WELFARE <br />Certilicate.of Award <br />-Old Age Assistance or. Blind Assistance— <br />QAA- <br />TV0e of Aid ..... . ......................... <br />................ <br />........................................... :Age ...... <br />OriginalPayment ...... Z:Lb&W ...................................................... vaTO ..... ......................................... <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />tate5 and 6, Mock 3v 3rd AddlMOD tO QdM* "MM TOMMUPs <br />flau Countys Nebmkae <br />.... U.,.a <br />z ................................................... <br />........... . ............... ........... <br />Signature of Payee State Director <br />State of Nebraska <br />County of Hall ssI <br />Entered on Nimerical Index and filed <br />for record in Office of Register of <br />Deeds on the --- f�th -------- day of <br />June------------- 19-§4-- at -- <br />and minutes <br />and recorded in Book 2____--- <br />9---- Of <br />Ct:C.__Qf ds <br />apage <br />legister _Xee;_dd_; ------ <br />By-----------D- ep------uty------------ <br />Fees $ <br />