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DUPLICATZ <br />OLD AGE ASSISTANCE CERTIFICATE <br />No . ........ j�t6? ................ <br />............................. IfAll ....................... County, Nebraska <br />Name....... ....................................................................................................... <br />Age...fiig ........... Address...... ...WroL.Jahr . ........................................................ I ........ <br />Amount$..18-00 ............... Modified Amount $................................$................................ <br />Date..... W-22,,1936 ...............19........ <br />This is a true copy of Certificate originally <br />issued. <br />.......... A011 .... a.vandemo-er ............... <br />Director of Assiatanc* <br />SL <br />...... (01911k§d.) ... U.1 ... 1D.&T01.4A ................... <br />Director of Assistance <br />................................................................................. <br />Signature of Applicant, Next Friend or Guardian <br />