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OLD AGE ASSISTANCE CERTIFICATE <br />No.....t-636 ................. <br />........................... Real .......................County, Nebraska <br />Name....... =12 ... WrAU-0A ....................................................................................................... <br />Age... 7.3............ Address .... 113... <br />Amount............... Modified Amount $................................$................................ <br />Date........... U=--16 ........................19..E 7 <br />This is a true copy of Certificate originally <br />issued. <br />....... Nail .... 0.*7"Clomex ................... <br />Director of Assistance <br />S.L. <br />................... <br />Director of Assistance <br />................................................................................ <br />Signature of Applicant, Next Friend or Guardian <br />