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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No.. g.-1,1'.�.................... <br />............................... HAI.. ..................... County, Nebraska <br />Name ........ AUVAI .Moll ................................... ............... <br />. ........................................................... <br />Age ... Address......' ..E•...9�h Bt....Grsnd Isleind,ATebr......... <br />Amount $..17 . q0 ............... Modified Amount $ ............................. $ ................................ <br />Apr 1113 x193Date.... .......................... <br />This is a true copy of Certificate originally <br />issued. <br />Neil C . Vandemoer <br />. <br />Director of Assistance SL <br />�.S <br />D h d rl Toien.r.... <br />....... <br />Dtsector of Assistanos <br />.................................................................................. <br />Signature of Applicant, Next Friend or Guardian <br />