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DA 177N ..NEBRASKA rar fr= mki <br />DEPARTMENT OF, PUBLIC I'VE <br />' Certi f icate o f •-Award <br />Old•A& Assistance:or Blind -Assistance <br />lYPe of Aid <br />Name :.. ALRE� .ii�tc'ea.. A ....... Age .... .....HH No .!!0�-t136--... <br />.... ' <br />....... <br />Address..1112....10.14nd1#No1?.gCounty.Hail10.14nd1#NP1?.qCounty..1f4U .................................... <br />Original Payment."M.*.?Q............................................................ Dale ..... k!i-!0-............................................... <br />Old Age Assistance: Legal description of real estate owned by recipient: <br />Lot 22# Block 2# Soth=n Sub Diva# liall County# Nebrl "WL <br />....................... <br />z <br />........................... <br />Signature of Payee - tntc Director <br />State of Nebraska j <br />County of Hall <br />j ss <br />Entered on N-umerical Index and filed <br />for record in C:ffice of Register of <br />Deedon toe nU------ day of <br />January • • <br />19 - at --- 3 <br />and 30 m'-nutes-P.._-M. <br />and recorded in Book --_ __ of <br />Ctf. _of Awa - --_ g --- ----- --- <br />----- - --- ----------- <br />Re 's of Deeds <br />By------------ ------------------ <br />Fees $_po_ eharg Deputy <br />E, <br />� om <br />g:. o <br />,Q <br />co <br />w <br />42 <br />�. t <br />