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001-087
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Last modified
7/8/2017 6:45:58 PM
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7/3/2017 5:44:52 PM
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4,44,?A!C� <br />OLD AGE ASSISTANCE CERTIFICATE No. ........ $" 241 .............. <br />.......................... ..........................County, Nebraska <br />Name....... L1M8r... E...1' fa ; M0X....................................................................................................... <br />Age ...... 71. ..... ... Address ....... UP ... 1t.M...$ AKMp ... IAIA?d.1.9ebr............. <br />6-7-36 <br />Amount $..R j.eG.t....... Modified Amount $...1:...00 .............. $ ................................ <br />Date ........ August ... It ..................19..'1.6 <br />This is a true copy of Certificate originally <br />issued. <br />Neil Q. Va ddma.®r .......... <br />............................................ .......... <br />Director of Assistance <br />S.L. <br />... pjgned) Irl D..Tolen <br />..... ............................. <br />Director of Assistance <br />.................................................................................. <br />Signature of Applicant, Most Friend or Guardian <br />
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