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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE <br />No...... ..-15 �................ <br />............................. Hall ........................ County, Nebraska <br />Name....... Samu.e1...E V iseman................................................................ .......................... <br />Age ...... 6 ........ Address.... 1724 N.LaPayette, Grand Island.Nebr._ <br />Amount $.1g it 00 ................ Modified Amount $ ................................ $ ................................ <br />Date. Apr il...5.p ... .936 .............19........ <br />This is a true copy of Certificate originally <br />issued. <br />....... eil,,. C_,Vandemnoer..............SL <br />Director of Assistance <br />(signed) Irl D.Tolen <br />.................................................................................. <br />Director of Assistance <br />.................................................................................. <br />Signature of Applicant, Nest Friend or Guardian <br />