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Last modified
7/8/2017 6:46:03 PM
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7/3/2017 5:44:52 PM
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OLD AGE ASSISTANCE CERTIFICATE No . ..... 6-295 ................. <br />.......................... Rfal ........................... County; Nebraska <br />Name......... MOX.Y ... V...Galia ............................................................................................................. <br />Age ... 71 ............ Address ...... X;fd .. #1 .... Caizn.jXe.b;r . . .................................................... <br />Amount $....14..QO ............. Modified Amount $................................$ ................................. <br />Date....... MaY....5-i ............................ 19-36. <br />This is a true copy of Certificate originally <br />issued. <br />............. ............. <br />Director of Assistance <br />S.L. <br />sign .... 1.91 .. A,791 -n .................... <br />Director of Assistance <br />.................................................................................. <br />Signature of Applicant, K*zt Friend or Guardian <br />
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