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f / \ This is a True Copy of Certificate Originaly Issued �T NEBRASKA 1v 2 Director of Assistance ... BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE DECLARATION OF OWNERSHIP OF REAL ESTATE ............................. _.wro.-....---------------------- ....................... ----------........ City or Village Hall County 72 M Old Age Assistance ❑ Blind Assistance ------------------------------------------ December 5 .......... -.......... _..... 19...39_ _ -x-59------------ .................... ----- ............................ -........... Application Number In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described real estate as all of the real estate owned in whole or in part by myself and/or my spouse. 1. Legal description of real estate used by me as place of my residence: North 13.6 feet of Lot 10 & all of Lot 11,Block 2,5th Addition to Cairo. 2. Legal description of all real estate not used by me as place of my residence: Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, 1941, authorizing the Register of Deeds to release the ,Old Age Assistance liens of record hereby release th ' hin lien this ....%/ ...day of , 1941. .I. .......... �> " Register Deeds' of Deeds --------------------------------.... j4X1.01..-_AV hoAY----------------- -------------------------- Signed Armenia My Corms ok _... - ...............................-- Witness Applicant for Assistance Wife of L.W.MoCormick VERIFICATION have investigated the --------------- .-------------------- Hall ............................. ............ County records and hereby certify the above descriptions) to be correct to the best of my knowledge. - -W=1.e .._MQ00rm -ck ................. County or Visitor To: State Assistance Director,_......_Hall............................County 1008 State Capitol, Lincoln, Nebraska----Deo--.--14 ------------- --- ---- --------193-9 Received for record Certificate of Award for Application No --- ----- ---_---..-_-8 59 -------- __-__ (Old Age Assistance), (Blind Assist- ) .......o'clock and...........................minutes ..A...M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended Assist- ance) at-----------1•-•-----•------ by L. B. 389, 53rd Session Nebraska Legislature, or 68413 Com. St. Supp., 1939. — J-!.� ....... ....... - ----------- Book 1 Page 72 Signed -----------------------------_i../�- Register of Deeds