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DA -7A <br />Rev. 7-65 NEBRASKA <br />DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Aged, Blind or Disabled <br />1111 No <br />Name ......... .................................................. <br />LP <br />. ...... e ...................................................................................................................................... Age ............ <br />Address ...... 2.3,1 .... ' I Ru 1,y <br />.......... <br />City ... ..... ...... SS No .......................... 10 <br />................. <br />S .... e:2:..Y,9 .... Date...-. <br />counfL—.---, <br />Legal description of real estate owned by recipient: <br />;j — 1. -1—L $ 0 r , -3rid <br />- - 7,(" 2., '.Z')j, RrIcker f- Rsri- 2nd Add . Ci.y of Or., <br />T jEi,-jd r, <br />T!all Co,j, Nobr. <br />Y <br />....................................................................................... ................ I <br />............................................................... A <br />Signature of Payee State Director <br />0 0 4 <br />State of Ncb I <br />rasira <br />ccunty of <br />Entcrcj cn f',um-1cal index and file -1 <br />fur record ii-; - Aff,,ce of of <br />Nov 15 D-2ea'3 on th- day of <br />9 ij, T1 'S 5 November <br />_j --------------•---.. 1 t...... <br />STATE F NIEBRA .13— __A_-'--T:.� <br />%111KA) 'I <br />couttxSrV LL SS <br />9F H' Lt SS arra Tecorckd in 2001- ------ of <br />Ct <br />pa- ?- <br />RPSE ANN j <br />13SEN; <br />Rats. Of De <br />.,(n. 157 <br />Fees $-22L-CharReD,2putty <br />