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001-067
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Last modified
7/8/2017 6:45:25 PM
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7/3/2017 5:44:50 PM
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-7 <br />'DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No........9421 ......... ...... <br />i Bli <br />.......... . ......a........................................ County, Nebraska <br />Name ........ Rjqhard Owan Dy.e.r .......................................................................................... <br />...................... <br />Age.6 ............. Address .......... qairo., .... Nebr. <br />........ ................................................................................. <br />Amount $.1-47!5 . ................ Modified Amount $................................$................................ <br />Date............ 2-1- 3.9 .......................19........ <br />.... <br />Nell C.Vandemoer <br />.. ...... .... ........ <br />This is a hue copy of Certificate originally ............................................... Di..retor-lof-Ass-fat.........-SL <br />issued. <br />..........................................irec......to................................... ..................... I ........................................................... <br />� Dr of Assistance Signature of Applicant, Next Friend or Guardian <br />
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