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DA-4ANEBRASKA <br />Rev. 7-65 --'DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Aged, Blind or Disab7cd <br />HHNo.h * 0 *TUX ? . .............................. <br />Name---........ail . .................................................... ... .......... ..... ... . ... . I .............. Age .... 75 <br />Address.......-IJM"'In, ................................................................................................................ <br />City .............. !^&zmd ... ............................. SS No ....... 5.06 -5Z. -M8 ...................... <br />County .......... U411..................................................Original Payment 5....-.-.32. W.Date ... 9.-As65 ............... <br />Legal description of real estate owned by recipient: <br />L -M. 220 1351k, 22, �!:,!ottvuzi Sub -division,, Cfty oE <br />Grz)nd lo]ArAdjp 161 Co., 11(.0braske <br />­-�, ................................. ----- State Directo� J <br />Signature of 'Yee <br />0 0 3 8' 9 1 <br />State of Nebraika <br />County of I -WI <br />Entered on Numerical Index and filed <br />for record in Office of Register of <br />OCT ZO 2 o5 PM '65 Deeds on the . 28tll. - day Of <br />----.Dc.tober-.. 1-%5 at .2... -- <br />NIB <br />NIB O'clock and --05 m,nutes Y. <br />ri.01 . L <br />F NIB <br />and recorded -vt Book --3-. of <br />*CSIE: ANN JA IN: a <br />Fe. $_M- chg. * Deputy, <br />