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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No... $.-211 ................... <br />........................ Hal. ... <br />l ......................County, Nebraska <br />... <br />Name.... !i11iam. H.Wieae...................................................................................................... <br />Age .... 67.......... Address....... R.#1.0...�airo., ....N.ebr.. <br />................................................... ....... ........... <br />Amount $...9.00 .................. Modified Amount $.................:...........:.. $ ................................ <br />Date.-- Na .... ..12 ..................................10 6.. <br />This is a true copy of Certificate originally <br />issued. <br />Nall .... C.. lanaemQer...................... y <br />Director of Assistance BE <br />(Signed Irl D. Tolen <br />"Director of Assistance <br />................................................................................... <br />Signature of Applicant, Nezi Friend or Guardian <br />