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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE <br />No . ........... 6:7151 ........... <br />............................. W.1 ........................ County, Nebraska <br />Name -A9.4 .. MhQrk ........................................................................................................................ <br />Age..6.6........... 6.6 ........... Address ....... S&.. ........ <br />Amount $..14.90 ............... Modified Amount $................................$ ................................ <br />Date....... . ARX-11...5:......................19. <br />This is a true copy of Certificate originally ................ In ... Aplam ........ <br />Director of Assistance <br />issued. <br />....... N.ei.1 O...Tand.ew..q.; .................... ................................................................................... <br />Director of Assistance Signature of Applicant, Next Friend or Guardian <br />8.L <br />