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DA -7A NEBRASKA <br />Rev. 7-65 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Ted, BMW or Disabled <br />HH.............................. <br />Name...... I.? ':;_? `A!;..I117......................................................................................................................Age... 3... <br />Address...?............................................................................ <br />Cit " .- ' '� .............SS No. trig .fm ... <br />county ..... i ! ........................................................Original Payment S......`.^;.lnt.0ate...... .-1-6.5.............. <br />Legal description of real estate owned by recipient: <br />tone• <br />...ignature .......-r*e- ...of...Ih�yi.......e................. <br />S <br />State Director <br />State of Nebrasl:a t ss <br />County of Hall s <br />Wintered eII Itumesical Inde;: and filed <br />for record in Cff-ce of register of <br />Deeda cn t'.:e -. 29th -- day of <br />October 19.65.. at --- I ---._- <br />OCT Z9 1 49 PM '65 o'cloc.s and 49.- ._. nl:rutes: <br />and Iecordcd in ?cc;': ___-3 ------ of <br />fOSE <br />YI� NRBR 9K Ct. -- Awars at gig ]------•Y NI 1A -- Nttt JCC N; i:egi'sI/eY eff cess -- <br />' � Noneeeds <br />By --------�,�-�u;y------------ <br />Fees None----- <br />