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DA 7a NEBiiABHA' <br />Rev. 7-65 DEPARTMENT OF.,PUBLIC WELFARE <br />Certificate. of. Award. <br />Aid to the Aged, Blind or Disabled <br />HH No )6040]6--MTY-- a ....... <br />Name ....... VAOAH..RATti@iM-..P.......................................................................................Age...61.. <br />Address 13QQ..Vft& -5th.3.t&. ...:_ ...................................................... <br />.CityS aQ..I `atgtd, Tsaln�asko ........... SS No 5.^i .......... 20 ........ R.O.C... .. <br />County ..... nA ......... <br />----............ ....:.......Original Payment $.%sx�.... Date.....-_rt����i9-.�A.-. <br />Legal description'of real estate owned by recipient: <br />Lot 29 Clock 6' Bonnie arae Add. a:�and 'L91and, <br />.............•.......-........-•-•-..-.................----•--.............................................. ................... <br />Signature ,o . Payee State Director <br />GloantOrState of Nebraska <br />as <br />L}Tentee County of I1a11 <br />I� erieal� Entered on Numerical Index and filed <br />for record in Office of Register of <br />1)0't a c:n t:>e __,•lith ------ dae of <br />M ��9 Augast. <br />.. ? 9..69 _ at <br />AUG ti � i 19 Q o'eiock an;! _ ..�-9... _ minute:. —ALs jvL <br />an Ir. of <br />STATE of NEBRASKA) SS Ctf • of Awards_ n.t page- 1 Z7-_`• <br />COUMy of HALL ) ------ - - <br />Rose Ann Jacobsen <br />Roses �•acoE3sfiN: ---ter of Doe&v <br />Rut- of 00"S <br />Deputyno charge <br />Fees �,---____ <br />