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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No,.......,8.-95................ <br />............Hall ......................County, Nebraska <br />Name.......Henri..Stan e............................................................................................................ <br />Age ... 77........... Address ............. ......... <br />Amount $..1.5.-.00.. ............. Modified Amount $ ................................ $ ................................ <br />Date....APr ...Via.........................19..36. <br />This is a true copy of Certificate originally ... s.lmkd)...,�x�� . D Tsa1f�II...................... <br />' Director of Assistance <br />issued. <br />Neil C.Vandemoer <br />.............................................................................................................................................................. <br />. Director of Assistance SL Signature of Applicant, Newt Friend or Guardian <br />