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Last modified
7/8/2017 6:44:54 PM
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7/3/2017 5:44:50 PM
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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No........... .......... <br />.......................... Hall ........................... Courity, Nebraska <br />Name .......... ....E....ush <br />..... V. I .... B....................................................... . .................................................................. <br />85 ........ . 'Address ............ Alda, Nebr. <br />Age...... ...... .................................................................................................. <br />Amount $ ..... 18 129 ............. Modified Amount $ ................................ $ ................................ <br />Date.......a...1 ........................ 19..36 <br />t.PA&n.�d) Irl D.Tolen <br />This is a true copy of Certilioats, originally . .................................................................. <br />Director of Assistance <br />issued. <br />Nell C.Vandemoer <br />........................................... .................................... SL ......................................... I ........................................ <br />Director of Assistance Signature of Applicant, Next Friend or Guardian <br />
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