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This is a True Copy of Certificate originaly Issued 1! 0 14 NEBRASKA 1� .................................. BOARD OF CONTROL Director of Assistance DEPARTMENT OF ASSISTANCE AND CHILD WELFARE DECLARATION OF OWNERSHIP OF REAL ESTATE ® Old Age Assistance ❑ Blind Assistance ................. -................... 1lrand..._I.sland. ....... -•----... ........................ -love mber...1Q-................. .... __._.....19....#3-_ City or Village ............................ ............_Hall........... - ................................. County - - ......................... - .8. 4(ra -- -- -- ---------------•-.............._...._.—..._.................. Application Number In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described real estate as all of the real estate owned in whole or in part by myself and/or my spouse. 1. Legal description .of real estate used by me as place of my residence: N* of Lot 1,Blook 34,0riginal Town, ( Recorded in name of Maude E. 8onebruok. ) 2. Legal description of all real estate not used by me as place of my residence: Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, 1941, authorizing the Register of Deeds to release the Old Age Assistance liens of record hereby release th within lien this .''. !. 1941..U....of Deed ..... ...day of....... Registers _...................._..----- 1k=.G.1 Anthony ................. - ...................... Witness Signed -.-... .......... jam .061..._L....�t1b1-&...._....-------------------...----------- ant for nce husband of ;[laud Y Loucks�formly Maud VERIFICATION . E• $OIIebruok have investigated the ............................. ----------- _.H_1.................... ................ County records and hereby certify the above description(s) to be correct to the best of my knowledge. ------------------------------------------ - -INT..i..01.....Axatbiony............... --- .................. .... County Visitor To: State Assistance Director, ........... .......... .................... ............. County 1008 State Capitol, ember 1�, Lincoln, Nebraska --Oe------ ------------------ - ------------19 -} - Received for record Certificate of Award for Application No________________0"'---------- --------- (Old Age Assistance), (Blind Assist- ance) at ................... ............... o'clock and ................. -._.....minutes _.......... M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. Bpok 1,Page 14 Signed ............. -.................. C? �, - - Register of Deeds