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Last modified
7/8/2017 6:45:15 PM
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7/3/2017 5:44:50 PM
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G <br />DUPLIOATZ <br />OLD AGE ASSISTANCE CERTIFICATE No . ..... &n5.5 ..................... <br />.......................... Mal .......................... County, Nebraska <br />Name...... 1X46 ... GrA f f in ................................................................................................................ <br />Age..7.7 ............ Address....... 1121... .. .................... <br />Amount $.17---0Q ................ Modified Amount $................................$................................ <br />Date...... AP. -.U... ... Ix ......................19.29 <br />This is a true copy of Certificate originally <br />issued. <br />................. <br />Director -of Assistance <br />. SL <br />..... (.$*z <br />.................... <br />Director of Assistance <br />.............. ................................................................... <br />Signature of Applicant, Next Friend or Guardian <br />
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