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This is a True Copy of <br />Certificate Originaly Issued <br />NEBRASKA <br />-.-----toor - r --- of ---- A-- - ssistance------ --------------------------- BOARD OF CONTROL <br />Direc <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />N° <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />77 <br />® Old Age Assistance <br />❑ Blind Assistance <br />-Grndl-1andDecember 11 <br />a--------------------------------------------------------------...------------------------ ------....--------19 <br />City or <br />Village <br />........................ Hal................................................................. .......... -- -..._$--757------------- ----------....------ <br />County Application Number <br />In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described <br />real estate as all of the real estate owned in whole or in part by myself and/or my spouse. <br />1. Legal description of real estate used by me as place of my residence: <br />Lot 5, Block 29, Packer & Barr's 2nd Addition. <br />(Recorded in name of Melissa Fallis, mother). <br />2. Legal description of all real estate not used by me as place of my residence: <br />Lots 3, 4, 6, & 7; Block 29, <br />Packer & Barr's 2nd Addition. <br />(Recorded in name of Melissa <br />Fallis, mother). <br />Ej of NEJ of Section 22, Township 11, Range 10. <br />(Recorded in name of Melissa <br />Fallis, mother). <br />Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, <br />1941, authorizing the Register of Deeds to release the <br />Old Age Assistance liens of record, I releaselien this <br />day of ......��ii!� ..., 1941. <br />vRegister <br />of Deeds <br />................ Joe ...��.*...Lutgen..--...........--.......---------........-...------- <br />— <br />.-...... Signed-------.........................al_sy -F4111s - -.......... <br />N. <br />Witness <br />Applicant for Assistance <br />VERIFICATION <br />have investigated the .......... Hall <br />County records and hereby certify the above description(s) <br />to be correct to the best of my knowledge. <br />Muriel Anthony <br />----------------------------------------- ....... ...................... ..... - ............... _...................... _.......------------------------...-. <br />County Visitor <br />To: State Assistance Director, <br />1008 State Capitol, <br />Lincoln, Nebraska <br />Hall County <br />--------- -- --------------------------------------------------------------------Coun <br />._December. --21 -- ... 19--3-5 <br />Received for record Certificate of Award for Application No ---------- Z -s--'--- -- -- <br />- (Old Age Assistance), (Blind Assist <br />- <br />ante) at._._...._..._I.... . ............ o'clock and....._....'..'. -._....minutes ..._P_tM. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. <br />Signed. ........ -.................... - ............ �`` ............ <br />Book 1 al <br />Pe 77. Register of Deeds <br />