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DA -7A NEBRASKA <br />Rev. .7-65 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Aged, Whid or Disabled <br />HH No ...... 4Q!7.55� !nna <br />........................... <br />Name................... <br />....................................................................................................... Age <br />Address ............... <br />City..................... ................................ SS No ? . ........................ <br />County ................ 1--i'M ........................................... Original Payment S ...... IVO ........... Date .... 9!4!tS ................ <br />Legal description of real estate owned by recipient: <br />A. Lot Pip Dik 62 Bonnie Brae Mdn.,, :.rai,ld Ir land <br />Signature of Payee <br />State Director <br />0 0 3 8'9 <br />State of Nebraska <br />County of Hall as <br />Entered on �,umerical Index and filed <br />for record in c-ffice of Register of <br />OCT ZO 2" 06 PH 'G5 Veeds on the 28 day of <br />October Ila -----P -- <br />InAMMYKA) o'clock and Mmutes --- M. <br />ALL/. and recorded in Book - --.. of <br />LROSE fA0M0"J11AVZ 6081N, Gtf � -of -A-s page <br />- <br />R& O <br />Riegistie Deeds <br />BY------------ ------------------ <br />Fees Deputy ' <br />