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DA4A NEBRASKA <br />Rev. 7-1,6 DEPARTMENT OF PUBLIC WEIX)IRE <br />Certificate of Award <br />Aid to the Aged, Blind or Disabled <br />HH No.....�U-291C•..�2.................. p.. <br />Name.................... t?.: �. . Chtzrlesli................................................ ................ Age.....:...... <br />0 �i. 1> lclo.......................................---........................................................................... <br />Address .................. ...3.......... - . <br />Grand Iisland.....11ebr•.. ....SS yo ...................:............ <br />City ........................................................ 5�• Harp <br />Trrl l n.:..:.,�1 D --f C � 9'� ��-------------- <br />Legal description of real estate owned by recipient: <br />A. Packer & Laarr ?.nd .Add. Lot 10j, Ink M <br />19 .. ...........------- // tate <br />SiRnaturc o[ Payee <br />0038'83 <br />State of Nebraska ) <br />County of all <br />r. ss <br />Entered on Numerical Index and filed <br />for record in Cffce of, Register of <br />CC Leeds on the ?8th -- day of <br />OCT 28 2 o5 �� X05 ---October 19 65_ at -- --- -- <br />OP N!8 o'clock and .05. minutes ..E• ht <br />M 88 and recorded in Book _ _ 3 -- • . of. <br />RC ANN JA 1✓t-Slt?__ Sa pa _-- 3�-•--• <br />ofCa�ds NJ ------ <br />Register Deeds <br />N��.. -Deputy----------- <br />Fees $- �- <br />I <br />