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This is a True Copy of - Certificate Originaly Issued ........................................................ Director of Assistance NEBRASKA BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE N2 24 DECLARATION OF OWNERSHIP OF REAL ESTATE Z] Old Age Assistance ❑ Blind Assistance (Isla, .. I ----------.-.....19 .....---..------------------------__..----------------------... .....3 .. _.. City or Village ..................... Hell....----- .........................------ ---. -- . -------------------- Kn 9......-----......------ ---------....-- ----.................--------......----._.............. County 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: Lot 14, Block 6,Evan's Addition. 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, I h/ y release the. wifltiq lien this `Y... day of ...... . ,flu ..... , 1941. ................. Register of Deeds ldurial ...Anthony...............__............--- ----------- Signed---George-William..._Gre----- ld----- Witness Applicant for Assistance VERIFICATION have investigated the ------------ ....._-------------- ..._Hall..----------- ..___..___...--------- _.....County records and hereby certify the above description(s) to be correct to the best of my knowledge. To: State Assistance Director, 1008 State Capitol, Lincoln, Nebraska _Mori el.....Anthony.........._.....--_-------------...._.__..... County Visitor ....................... ...... 281.1. .... ............................ County ...-------------- ----------------------19 3 - Received for record Certificate of Award for Application No.......___________._9-7-9---- -------------- (Old Age Assistance), (Blind Assist- ance) at..... -----0....-..._-.._ ....... O'clock and ......JO ........... minutes ..A#..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. Book 1,Page 24 Signed... ........... -............ ------_------------ -------------------------------•--------.".`..'`��'�1-.------------•---•- Register of Deeds