Laserfiche WebLink
DUPLIOATZ <br />OLD AGE ASSISTANCE CERTIFICATE <br />OF <br />No.......... On 0.3 ............ <br />.............................. Rial ...................... County, Nebraska <br />Name........ ........................................................................................................... <br />Age .... 67 .......... Address .............. 1322 ... lu.6th ... st....varand ... isi and.................. <br />Amount $... i.4.00 .............. Modified Amount $................................$................................ <br />Date...... May ...16-t .......................... 19-36.. <br />This is a true copy of Certificate originally <br />• <br />issued. <br />................... <br />Director of Assistance <br />JL <br />...............COUW.... W .. P...TQ.I.OA ......... <br />Dirsoor of Assistance <br />.................................................................................. <br />Signature of Applicant, Next Friend or Guardian <br />