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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No . ..... 4.7.311 ................. <br />............................... Hall ..................... Courity, Nebraska <br />General S.Hiddleson <br />Name......................................................................... ............................................................................ <br />Age..73 ............ - Address...... q6 ... E,q <br />..t4p ... qpand ... 1.q1and..Ne.b.r ....................... <br />Amount $.......15, ©0 ........... Modified Amount $ ................................ $................................ <br />Date.... M ..4.1................................19....36 <br />................................19....36 <br />This is a true copy, of Certificate originally <br />issued. <br />..N.e.i.1 ..... C.....VanA�m.Qer ................ <br />Mr0awr of Assistance SL' <br />(Signed) Irl D.Tolen <br />.................................................................................. <br />Direct= of Assistance <br />.................................................................................. <br />Signature of Applicant, Next Friend or Guardian <br />