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DA -7A NEBRASKA <br />..Rev. 7-r5 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Aged, BMW or Disabled <br />NN No...... ...a5...3. -t,1 <br />............................ <br />Name ..... _................ <br />............. rJ?t2Cflix....ilia8beth...................................................................................Age ......M. <br />?, C+9 i;. 7th <br />Address. ..................................................................................................................................................................... <br />City........................Grand zsl t...2iobr•............................ SS 110....................:.................................... <br />Count..................................................... <br />County flrii�........................................Original Payment S....OT....... Dafe.._.?M1!§!�................ <br />Legal description of real estate owned by recipient: <br />Lot 3, Blk 5, Original Town of Grand Isl!►nd <br />Ci"Aw <br />r <br />...ign...a.t.ure.......of.......... i..r............................. rr.........................................................,�....... <br />SI'uyI � 3ltllC Director <br />00386 <br />State of Nebraska <br />Ccunty of Hall 8` <br />Entered on i%u►nerical Index and filed <br />for record is t.Jf:ce of Register of <br />,D'-eds a `!8` ? -- day of <br />OCT ZO G 05 ''j �5 �ctberl9 at _2... -_ <br />STAT 0/ NEER ) o'clozk and 05. minutes P.. V1. <br />cot) ��and recorded in Book _,.�_ .. of <br />Gtf,__ <br />RC <br />6,� - <br />- ANH a CO 3EN; ,� _ Axax at age 5�, ___..�_✓. <br />Of ytC� <br />,e <br />Fgisteof lleeds <br />By---------- ------------------ <br />Fees ;_�- chg,- <br />