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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 h0 -2200—A2 <br />......................................... . <br />Name....................................................................................................................................................... Age . .......... <br />Address .......ttielir. . ....................... <br />.. ........................................................... ... <br />City, .............. .................................................................... .......... SS N <br />�1-00 ........:. ..... .............. <br />County ........................................................................ Original Payment $ .......... -Ute........... <br />........... Date ....... . .......................... <br />Legal description of real estate owned by recipient: <br />cul <br />Tl of -"41 of ofs oac 2O, Tlvp. 11, lige 12, 11111 COss <br />i <br />'Te <br />t br. <br />6 <br />.......................................................... . ............. <br />Signature of Payee State <br />7[ <br />003960 <br />State of Nebraska ss <br />County of Hall <br />Entered on Eurnerical Index and filed <br />for record in Gffice of Register of <br />NOV 8 52 AP 15 Deeds on the day of <br />-----A b <br />kmad er - . 19 65-- at _.8---..__ <br />B <br />.8------- <br />9 or NEE AESS o'clock an -1 minutes -At.M. <br />CU. "co <br />F H LL and recordpage of <br />0 -- CU. ()fcc� <br />!�AC US <br />ROSE AN SEN; ------ <br />of G#WS <br />By-----------D-- --- — — ------------ <br />Fees $,,no charge pty <br />