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This is a True Copy of <br />Certificate Originaly Issued N2 <br />NEBRASKA l� <br />Director of Assistance BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />----- - ---- -............... Dr.and .Island ................................ <br />City or Village <br />............... .......... -H.B.a.l.....-----------------------------..._.._------------- <br />County <br />92 <br />;[j Old Age Assistance <br />❑ Blind Assistance <br />------------------------------------.D.ecembr----�........... ..... I9..3.9..__ <br />_........-- ---- ...._.._--- ----------8. 5.57. --------------- - - .---------- ......................... <br />Application Number <br />In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described <br />real estate as all of the real estate owned in whole or in part by myself and/or my spouse. <br />I. Legal description of real estate used by me as place of my residence: <br />North 39 ft.of Lot 1,Block 4,Hann's 2nd Addition. <br />2. Legal description of all real estate not used by me as place of my residence: <br />Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, <br />1941, authorizing the Register of Deeds to release the Old Age Assistance liens of record, reby rrele�as'e�[he (Wilt lie <br />n this <br />�!.. day of ........ .-Gf!%'t-`..... , 1941.� "— U.�. <br />Register of -Deeds <br />--------------------------------HarrelWthony------...... ----------- ------ ---- Signed._._. ---------------------- B_._W-NQ—rlk--------- ---------- ---------------------------------------------- ------------- <br />Witness Applicant for Assistance <br />Husband of Carline Monk. <br />VERIFICATION <br />have investigated the ------------------------- Hall ............ .......................... .............. County records and hereby certify the above description(s) <br />to be correct to the best of my knowledge. <br />----................... -............................. <br />Muri_el..._Ant ho ny-------------------------- -------......... <br />County Visitor <br />To: State Assistance Director, ...................... 1......_.._.........._...........County <br />1008 State Capitol, <br />Lincoln, Nebraska-----------`raIlUary....�-----------------------19----40... <br />Received for record Certificate of Award for Application No..............$.`:756........................... (Old Age Assistance), (Blind Assist- <br />ance) at ........... ..... 20 ............ o'clock and ...... ......__minutes ....A..M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. and L. B. 2 ,J nary 1940 <br />Book1 , P 8g IC 92 Signed---------------------------- ------------- ----------- - --- -- ----------- ------�t`�-------------- -- <br />Register of Deeds <br />