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This is a True Copy of Certificate Originaly Issued NO NEBRASKA 1� - ........................Director of Assistance........................ BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE DECLARATION OF OWNERSHIP OF REAL ESTATE --------.._Gran ---1131.and---------------- --------------- --- City or Village . -- -- --- He,11------------------------_.._........... County 35 ® Old Age Assistance Blind Assistance A%vemb er _21 ........_.....19.._3..9-._ .......................................... - - -806 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: Lots 4 & 5,Block 11,$heridan place. 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 byrelease the�"' lien this ...day of...... ,(/l!/!!�...... 1941. ..... Register of Deeds - -- - .fur Muriel An George W.. B al com ------------------------------------------ ............................. --_............. .................... Witness Applicant for Assistance Husband of Maryann Balcom VERIFICATION have investigated the ...............................Hal_ -__...........................-..--_._......County records and hereby certify the above descriptions) to be correct to the best of my knowledge. - -................. -........ ------------Mu>� el. ---Anthony..- ---- ---------..._.... -- County Visitor To: State Assistance Director, Ha11 ......... .-County 1008 State Capitol, Lincoln, Nebraska ----- -------------------Dec -------- 6 --------------------------- 19 -- Received for record Certificate of Award for Application No07 _9__�_____________________________ (Old Age Assistance), (Blind Assist- ance) at ---------- _..1....................o'clock and.........................._minutes 2.....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 35 �.J✓ Signed........................ -------------------------------------..... Register of Deeds