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OLD AGE ASSISTANCE CERTIFICATE No........ 1-:13 ................. <br />....................... #&Q1 ............................. County, Nebraska <br />Name ... XXv.,.XMtjy..A0QA ...nn rlfflA <br />..... <br />Age ..... P ......... Address .. .... 1121 ...... W -3rd St.. -Grand IelandsNebr. <br />................................................................................................. <br />Amount $-.10.*00 ............. Modified Amount $................................$ ................................ <br />Date ................ *AX -23--i-1936 .... 19 ........ <br />This is a true copy of Certificate originally ..... ......(Aign.irl D.Tolen <br />.. .......................................... <br />issued. Director of Assistance <br />..............ate l .... C.UnA.M.O.or ............ .................................................................................. <br />, Director of Assistance SL Signature of Applicant, Next Friend or Guardian <br />