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DA -7A NEBRASKA <br />Rev. 7-66 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to thc*Aged, Blind or Disabled <br />HH NoWw4669wA2 ............................... <br />Name.......... J;M-111IL17 ..................................................... ................................... Age..eo <br />Address.---...211................................................................................................... ................................. <br />City ............. f;rand -.162A349 ... Nebr"Ia .............................. SS No ... 505.4 .......................... <br />County ........ Ma3l ...................................................Original Payment S ....... We ..Date .... 5P...;t---6 <br />...... 5 ............... <br />Legal description of real estate owned by recipient: <br />A. Lot 60 U -1k, 6, PUssant -HUIL Add, rjlrziIsland, <br />I <br />Po Lots 4 ' .0 Si biko 6# Pleasant HM Add,& Grand inlanct <br />................... .............. <br />Signature of Payee State Director <br />State of Nebraska <br />es <br />Csun-'Y of 1-1all <br />Entered on 1� umerical Ind . ex and filed <br />for record in tffict of Register of <br />Deeds on the -- 213th day of <br />ICT Z8 OL October.. 19 65 at .2_ <br />o'clock and —94. . m,nutes -Fe <br />ALL W and Jl� record Boo of <br />C p ge- <br />OSSE <br />It of .Do*ds Regie <br />. ......... ..... <br />Regiz of Deeds <br />By------------ <br />Fees $±*--'--g-- ePI7.'-Y <br />