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This is a True Copy of Certificate Originaly Issued NEBRASKA NO. 28 ................ Director.of.Assistance........................ BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE DECLARATION OF OWNERSHIP OF REAL ESTATE [I Old Age Assistance ❑ Blind Assistance - d GranI.ssl. .and - ..................- 19 - -------------d .... ....n ._..... --.......... ... City or Village Hall......_ -Q --------------------------------------------- - 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: East 30 Peet of Lot 6 & West 6 feet of Lot 7, Block 9, Original town. 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!NgbX release Z.tthew tl�--�l en this ...day of....... ..L✓!k«..... 194L ................... U� ........... Register of Deeds Muriel Anthony Carrie Gunnarson - Signed--------------------------------- -................................................- Witness Applicant for Assistance VERIFICATION I have investigated the ------------------------Hall ........... County records and hereby certify the above descriptions) to be correct to the best of my knowledge. Muriel Anthony -------------------- -------------------------- --- -------------------------------------------------- ........... ....................... -.... -..... County 4pis V w Visitor To: State Assistance Director,Hall _...........County ---------------------------------..................... 1008 State Capitol, Nov. 2i} Lincoln, Nebraska __--19_14.._. Received $ved for record Certificate of Award for Application No..._.. --._-.__$30-2-..-------._._.-_ (Old Age Assistance), (Blind Assist- - ance) at.._....._ .............. ........... o'clock and ...... . ._........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. d Book 1 Page 29 Signed ....... ......... .......... .... - ;............._.... �. - Register of Deeds