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00�W� <br />OLD AGE ASSISTANCE CERTIFICATE <br />No...A=32-d .................. <br />...........................H19 1 ......................... Count3r, Nebraska <br />Name........ ........................................................................................................ <br />Age .... 7.9 .......... Address ........ 123 ---Z ... 181—St—P.G.rand ... joland.xMalar........... <br />Amount $......9 x-09 .............. Modified Amount $................................$................................ <br />Date .............. Ma .... elo.1.936 ...... 19 ........ <br />....... 091SAIW P.T.TqIA:R .................. <br />This is a true oopy of Certificate Originally Director of Assistance <br />issued. <br />............ .............. .................................................................................. <br />Director of AssistanceSignature of Applicant Next Friend or Guardian <br />S.L. <br />