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This is a True Copy of <br />Certificate Originaly Issued <br />NEBRASKA lr �T <br />0 54 <br />-------------------------.•---irecttoo..-r•- of Assist . ...... <br />Dance ......................... BOARD OF CONTROL <br />D <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />I Old Age Assistance <br />❑ Blind Assistance <br />Grand Is -1-d --December---6'------------------------........------.....------19 <br />------------ -- --- -- ... . - <br />City or Village <br />Hall <br />County <br />8-1 <br />............................. ..- - <br />Application Number <br />In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described <br />real estate as all of the real estate owned in whole or in part by myself and/or my spouse. <br />1. Legal description of real estate used by me as place of my residence: <br />Lot 1, Block 15, Boggs and Hill Addition. <br />2. Legal description of all real estate not used by me as place of my residence: <br />Lots 2,3,& I#; Block 15; Boggs and Hill Addition. <br />Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, <br />1941, authorizing the Register of Deeds to release the Old Age Assistance liens of record, I by release the wjiliirt lien this <br />... day of........ .64!V?..C....., 1941. <br />day of ........ i.d1�:�� <br />Register of Deeds <br />-Muriel..._Anthony Signed------------......... Rhoda Belle Reynolds <br />-----.... ------------------- --------------- <br />Witness Applicant for Assistance <br />VERIFICATION <br />have investigated the.................................. Hal l ............... County records and hereby certify the above description(s) <br />-- - ------------------------- <br />to be correct to the best of my knowledge. <br />Muriel Anthony <br />------------------------------------------------------------------------------............... ---...................... ------...... <br />County *szistanR9ifectin or Visitor <br />To: State Assistance Director, <br />- .......... ----Hall.. .....County <br />1008 State Capitol, <br />Lincoln, Nebraska <br />---------------De-�- 1 ..............- 19-.39. <br />Received for record Certificate of Award for Application No 87.1 _-1._ ------------------------- (Old Age Assistance), (Blind Assist- <br />ance) at ........... 10.._.............o'clock and............ minutes .....A. - <br />M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. <br />Signed.............................. -2 t✓✓ ........ .............. ............... <br />Register of Deeds <br />1 Page 4 <br />� 5 <br />