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This is a True Copy of <br />Certificate Originaly Issued l� l� p 9 <br />Neil I C . Va_ n_ demoe_ r NEBRASKA <br />Director of Assistance BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />3 Old Age Assistance <br />❑ Blind Assistance <br />Grand Island November 10 Iq 9__ <br />...... -.............. _------------------.....-------------------------------------- ------ ......------------------------------...-..---._...-------- .......................................... <br />City or Village <br />Hall <br />County <br />Application Number <br />In compliance with State Assistance Statutes 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 />1. Legal description of real estate used by me as place of my residence: <br />Lot 10, Block 15, Packer & Barr Addition. <br />(Recorded in -name of Lucy P.Haney,spouse.) <br />2. Legal description of all real estate not used by me as place of my residence: <br />Lots 8 & 9, Block 15, Packer & Barr Addition. <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 y release the wit ' lien this <br />o _ , <br />`/'... day of ..... il_�- 1941. Register of Deeds <br />-----......... -Anthony...- .............................. ........---...... Signed---------------............A1I1ia»n.._Haney-----------------........... ...... .................... <br />Witness Applicant for Assistance <br />Husband of Lucy P.Haney <br />have investigated the ---- <br />to be correct to the best of my knowledge. <br />To: State Assistance Director, <br />1008 State Capitol, <br />Lincoln, Nebraska <br />VERIFICATION <br />records and hereby certify the above description(s) <br />.................................................... <br />Muriel Anthon.......................... <br />- ---------..._.........-_.....---... ...... <br />County AssisaaaKe-Oiwolso-ep Visitor <br />- - -Hall - _.....County <br />November 18, <br />- - -- -- - -- ----------------------19.-.3 9. <br />Received for record Certificate of Award for Application No.._8-1 5 2--------------------------------- (Old Age Assistance), (Blind Assist- <br />ance) at ---------- _..9. ................ o'clock and ....-------- ---- ....minutes ......AM. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. <br />Book 1, Page 9. Signed .................................. (.. f D ---- ......................... <br />�-----:---------- _ <br />Register of Deed -s <br />