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OLD AGE ASSISTANCE CERTIFICATE No . ..... 6-3P . ................... <br />.......................... Hal.1 ........................... County, Nebraska <br />.......... <br />Name......... JU11Ua..R=smm ....................................................................................................... <br />Age..6.5 ........... Address .......412..1.14thtgxand...I:itland.o.Nebr . . .................... <br />Amount $ ....... 15AQ .......... modified Amount $ ................................ $................................ <br />Date .............. APF4 ... 11 ................ 19 .... 36 <br />..... (Ift <br />This is a true copy of Certificate originally A..t.TQ1.qM .................... <br />Director of Assistance <br />issued. <br />................. O:r ......... .................................................................................. <br />....... .. ... ... <br />Director of AssistanceSiquature of Applicant, Nazi Yriend or Guardian <br />8L <br />