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OLD AGE ASSISTANCE CERTIFICATE No . ..... a:7?.4;R ................. <br />............................ Heal ........................ County, Nebraska <br />Name............ ALLAIR.-A-FRX-MOX ................................................................................................. <br />Age.A7 ........... Address .......... 110 ...&-M...3 tt-AKOA... .......... <br />6-7-36 <br />Amount $.....REJZCTZD.... Modified Amount $...14 oA.............. $................................ <br />Date ..... Augus.t ... 3.1 ..................... 19.36 <br />This is a true copy of Certificate originally <br />issued. <br />.............. Nail...O.Yandemaer ............ <br />Director of Assistance <br />S. L. <br />..(.8.jgAq4) .... M..P.,.Tq1.......qn <br />........................... <br />Director of Assistance <br />.......................................................... ....................... <br />Signature of Applicant, Next Friend or Guardian <br />