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7/8/2017 6:54:24 PM
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v <br />0038'8 <br />DA -7A NEBRASKA <br />Rev. 7-65 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Lid to the Aged, Blind or Disabled <br />HH No.--lrQ-Fh750-1............................ <br />Name .......... 1:Is}n*ie ........................... Age....-?�"- <br />Address....... X13 �a ...; �.........---••---•----.-...---•---••...............................................•-•--•--•-••----.............-................... <br />City............... :.rand ... x+t'j.:►f-'d......................................................... SS No ..... .SCr6 26oW&.:..............0..... <br />County ....... Mall ...................................................Original Payment S ..... 5....0 .... Date.!,! -4-65 .................. <br />Legal description of real estate owned by recipient: <br />of Lot 3, "Ake 37, OriCizdL town of <br />mould Island <br />el <br />Signature of Payee I State Director <br />m► 1 <br />State of Nebraska l <br />County of 1�:a1t j ss <br />Entered on Bumerical Index and filed <br />for record in t–ffice of Register of <br />I CT Z6 2 05 PH 65 <br />L-eeds on tiie 28th__ __ day of <br />October 1965. <br />1T9TR' NSBR Al.SiU <br />_ at ------- __ <br />o'clock unit -b5 minutes -A.M. <br />CO TY Q HA L. ) <br />^--- <br />ur. recorded in .P,00.� of <br />CtX.:_4_ Awards <br />CSE A�lN L. EN <br />ae. of l74wia (% <br />at ge_-- --• <br />mss/�j <br />—/ ------- _- ter o f e?_----- <br />�/� Register of�eeds <br />BY------------ ------------------- <br />Deputy <br />Fees $ _ no - chgt <br />DA -7A NEBRASKA <br />Rev. 7-65 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Lid to the Aged, Blind or Disabled <br />HH No.--lrQ-Fh750-1............................ <br />Name .......... 1:Is}n*ie ........................... Age....-?�"- <br />Address....... X13 �a ...; �.........---••---•----.-...---•---••...............................................•-•--•--•-••----.............-................... <br />City............... :.rand ... x+t'j.:►f-'d......................................................... SS No ..... .SCr6 26oW&.:..............0..... <br />County ....... Mall ...................................................Original Payment S ..... 5....0 .... Date.!,! -4-65 .................. <br />Legal description of real estate owned by recipient: <br />of Lot 3, "Ake 37, OriCizdL town of <br />mould Island <br />el <br />Signature of Payee I State Director <br />m► 1 <br />
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