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This is a True Copy of <br />Certificate Originaly Issued <br />Director of Assistance <br />NEBRASKA <br />BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />N2 21 <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />[I Old Age Assistance <br />❑ Blind Assistance <br />----------------------.Grand lisl.axet1.......----------------- ---......... .............................................-No-vember -15--1.- ........ _..... 19.34._. - <br />City or Village <br />_............................. �1-- - --............. - - ................... ----- -------- ---------8--`--1-50 - ------------------------------------------------------- ---­--------­--­- <br />County 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 S,Blook 7,Zvan'a Addition <br />2. Legal description of all real estate not used by me as place of my residence: <br />Lot 7 ,Blo ok 7 , man ' 8 Addition <br />Pursuant to the Enaetnwmt ai L IL Sk 1* tir "tk cession of the Legislature of the State of Nebraska and approved May 12, <br />1941, authorizing the Register of Deeds to release the Ofd Age Assistance liens of record, eby release the�wijhin lien this <br />p UJ/ <br />.... , i941. .. L�ifi�?�........ . <br />?! .. day of .......'�" Register of Deed <br />- - -- - -0 BelkuBlp........__... - - - .............._........... Signed-_.. - - -Stephen J. Lay ---------- ------------------------ ------ <br />... <br />Witness Applicant for Assistance <br />VERIFICATION <br />have investigated the ........------------------- _..----------- Hal- ................................ County records and hereby certify the above description(s) <br />to be correct to the best of my knowledge. <br />......... ------------ Wr .el.....An tho ny-- _---_------ _----_---_----_ <br />County Visitor <br />To: State Assistance Director, .............. ......................_N d.! .......... -.... _.......... County <br />1008 State Capitol, <br />Lincoln, Nebraska - --------------- --------------------------N4Y....24---------19-39 <br />Received for record Certificate of Award for Application No ................... g..1§0----------------- (Old Age Assistance), (Blind Assist- <br />ance) at -...-...._..a- ......... - ...... .o'clock and-.--.......3Q......-minutes .....AW. 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 21 <br />Signed---------- -- '�------------ _.... -........... <br />Register of Deeds <br />