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DA -7A NEBRASKA <br />Rev. 7-55 DEPARTMENT OF PUBLIC WELFARE <br />Certificate. of Award <br />Aid to the Arced, Blitid or Disabled <br />HH No.......ho-19lo-:11..................: . <br />Name ............ `t :::?tsT,Li'.�� IciUL' ee V. ,... <br />...........................................................................................................Age..... _57 <br />Address .......... _..... . <br />..........,_...... ............................. <br />Ci 1•oo,... i7ivor�,.�ebr: ............................... ,�a�;� .�... ...................... <br />.............SS Noy..............:'.1.....3' 3:.......... ....... <br />Co un ty.......... <br />.....................................................Original Payment S.....66+tgq... Date ..... ................. <br />Legal description of real estate owned by recipient: <br />'orth Stet of iot 7 s. Ir a Lot C, Dike )t•. <br />jot > l. !;9 t:• Lot 10� ,11k )1,9 Brett f': Johntson's <br />Add. to '.'Ood itiver,, lia11 Co.., Nebr. <br />........................................................ �`,':.................. ^...... <br />...L. .................... <br />:Signature of Payee /f/ Slate Director <br />000950 <br />State of Nebraska <br />County of Hall <br />ss <br />Entered on t.umerical Index and filed <br />for record in C:ffce of Register of <br />Deeds cn t a lst _ day of <br />Ploy 1 s 52 6M '65 _ - November_ 19.6 _ at _------- <br />o'c!ac!; an,-! 5?. A.m. <br />4TOF N H SS and rcco.:icd in 13cot- __ 3________ of <br />Ctr..o_ -s- ::t ag-?�---- <br />RASE AVN JAq SEN: ���� - <br />.g of W.ds%f% <br />Regisof Deeds <br />Y-----------�epaty------ <br />Fees $ no charge <br />