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001-053
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Last modified
7/8/2017 6:45:00 PM
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7/3/2017 5:44:50 PM
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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No.......... .'17 <br />.......Hall ...County, Nebraska <br />.................. ... ......................... <br />NameRasmus ...Mortensen.......en. <br />sen <br />Age17............ Address ........ food.,River....Nebr...................................................... <br />Amount $ l&M ................. Modified Amount $ ................................ $ ................................ <br />D ate... M a re h... ?7.x .......................19-36- <br />............. <br />9.3.6 . <br />(3igned) Irl D.Tolen <br />This is a true Dopy of Certificate originally ............... <br />Director of Ass tstance <br />issued. <br />Nell C.Vandemoer <br />................................................................................................................................................................... <br />Director of Asdstance ►7L Signature of Applicant, Next Friend or Guardian <br />
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