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L.. <br />Name .............. <br />.........L...Johneo............... <br />... a ................................ ......................... No ...:........................... <br />Address.....150 ..West ...4th...St Gra },albuntsof...........Hal.l. <br />......................... ..' ..... .......... <br />Changesof Address................................................................................................................. <br />.................................................................................................................................................................. <br />Original Grant $ .............19 A.............. Date.... Apri1...1................... 19..'3.0 <br />................................................................................................ <br />Signature of Payee <br />Neil C.Vandemoer <br />...................... ; ........................................................... . ........ <br />Director of Assistance and Child Welfare 15 <br />