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4 <br />This is a True Copy of <br />Certificate Originaly Issued <br />Ne it C . Vandemoer NEBRASKA N2 <br />`------------------------ Diretor of Assistan <br />cce...-----.....----....... BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />1 <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />Iq Jn Old Age Assistance <br />❑ Blind Assistance <br />Cit <br />_..........._Central y <br />- - -Ju1x -�'- <br />City or Village <br />Merrick -46°-164 - - <br />------------------------------.......-------------------------------------------------------------------- ------................. <br />County Application Number <br />In compliance with State Assistance Statutle:s in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described <br />real estate as all of the real estate owned in whole or in part by myself and/or my spouse.' <br />t1. Legal description of real estate used by me as place of my residence: <br />�. <br />2. Legal description of all real estate not used by me as place of my residence: <br />1/5 interest in Lot 5 Block 2 Original Town, Central City <br />Delilah Woods Estate <br />Lots 29-2�1-30 Hest Lawn, Grand Island, Hall County <br />Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, <br />1941, authorizing the Register of Deeds to release the Old Age Assistance liens of record, I hereby release the within lien this <br />......... day of ....................... 1941. ................... ..................... <br />...... <br />Register of Deeds <br />.-.-.-- .Jessie...._Sinsel. .................................... Signed ........... .... ..................... ...-..-Cha8 _E.Woods - ........................ <br />Witness Applicant for Assistance <br />VERIFICATION <br />Hall County lots verified by Register of Deeds, Grand Island <br />I he" investigated 60 Iferriek ...--.....County records and hereby certify the above description(s) <br />to be correct to the best of sny knowledge. <br />----- ----------- -- - -----------Je a 8 0-8_in-ael. - - --------------------- <br />County Assistance Director et+iSb wr <br />