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DA -7A - NEBRASKA <br />Rev. 7-65. DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Agcd, Blind or Disabled <br />HH No.hC44UC-me-IQ .............................. <br />Name........... M'02. �MAt.. f :,!a = a a.. ................................................ Age .... 7.0 ... <br />Address...................................................................................................................................................................... . <br />City. r ^S1nka ........................................ SS No ... 50.6. -IC -3337 ......................... <br />County ......... t i cin ..................................................Original Payment S ...... n. * 2D .... Date ....°-2-gay............... <br />Legal description of real estate owned by recipient: <br />LOt 2# 131k+ 3# Vijja <br />Or rnjjjph:jn,, 11! 11 coLr <br />3 tyq <br />....................... Signature of Payee State Directoe' <br />Q0390I <br />State of Nebraska <br />County of Hall as <br />Entered on Numerical Index and filed <br />for record in Cff;ce of Register of <br />OCT 18 2 os PM '65 Deeds on the Oc28th-- __:day of <br />tobe:n 19 65 at .2..... -- <br />ST <br />.......STATA OF NEORM to88 o'clock and m"nutes P.- M. <br />/PE an <br />U V�HALL d recorded in Book 3 Of <br />0 OSE <br />SAMN JACO• ------- <br />RW of Doe& <br />Register�f Deeds <br />By------------- ----------------- <br />Fees $--=-Chg. Deputy <br />