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DUPLIOATZ <br />OLD AGE ASSISTANCE CERTIFICATE No . .......... ............ <br />............................ 9411 ........................ County, Nebraska <br />Name...... JJ%JRG.B..-.Q2=GY ............................................................................................................. <br />Age......2......... Address ............ ...... GxaxAJm1&nd&XAbz . ........................ <br />Amount $....&.00 ................ Modified Amount $...............................$................................ <br />Date......... . x4y ..5.a .........................19....36 <br />This in a true copy of Certificate originally ................. U1.2.0101AU ...... <br />Dimator of Awastanee <br />issued. <br />................ AjaVlandmma ................. .................................................................................. <br />Director of Assistance Signature of Applicank Next Friend at Guardian <br />