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Last modified
7/8/2017 6:44:14 PM
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7/3/2017 5:44:48 PM
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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE <br />No...... -410 ................. <br />..........................Hall ........................... County, Nebraska <br />NameWilhelm ...Sehl.ichting.......................................................................................................................... <br />Age...7.5 ............ Address. 5?3. East...Tenthr...Grand. Island.Rebr.l............ <br />Amount $. Re,j eC ted....... Modified Amount $.....16.•.00 in $....................... <br />........ ......... <br />Datkm?7..-3.6........ .-6-3.7........ 19........ <br />(Signed) Irl D.Tolen <br />Thisis a true copy of Certificate originally.................................................................................. <br />Director of Assistance <br />issued. <br />.....Re 11 C.! Vandemo®r <br />Director of Assistlyp Signature of Applicant, Next Friend or Guardian <br />
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