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DA -7A NEBRASKA <br />Rev. 7-65 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Aged, Blind or Disabled <br />HH No.410.611,3-14.............................. <br />Name... S;:��.^R�...;..................................................................._...................................Age..... <br />..---------fix-sem . axo � r ,. r 9ti... <br />City.....--- %M.W..-a.................... .:........................................ SS No. ---...................... <br />County.... r-!,.% ........................................................Original Payment $... Uendior... Date... ....... ............... <br />Legal description of real estate owned by recipient: <br />a)t 700 :floc], 1s Knicl:-ohm 5ttt Addlitioq to c1t,1* n i.rC'n(i :l3,idnt� <br />s:a13- Gou-a;*�'Ie:raaiet�� . <br />............................................................ <br />Signature of Payee <br />0�3gg4 <br />............................. <br />State Director <br />State of Nebraska <br />County of Hall ss <br />Entered on !Numerical Index and filed <br />for record in wff.ce of Register of <br />Deeds on the 28th_- -- dly of <br />OCT 28 2 06 PM 65 , October 1 �5 at ------- -_ <br />$TA t of 14E � SS o'clock and ..--.96 minutes P!-. I'vl. <br />L <br />and recorded in Book _ 3_ ., of <br />SHN: Ct A a mat ag ! — ------- <br />r4 JA <br />1ceiof Duo" 14Sc � - - = <br />Register o eeds <br />By----------- ------------------ <br />$- n°- �r-'� <br />Deputy <br />Fees <br />