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Last modified
7/8/2017 6:46:24 PM
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7/3/2017 5:44:53 PM
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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No. ....... &.x.5.9 ............... <br />...................Hall.......... . ......................County, Nebraska <br />......... <br />Name..... Rater ... T,.atel.s.on........................................................................................................ <br />Age ..... d4......... Address......lotrar�d.. 3,iuex',...I5teb..................................:....................... <br />Amount $.13..00 ................. Modified Amount $ ................................ $................................ <br />Date .... NQv KAher...2.3................19.3..6. <br />This is a true copy of Certificate originally (.51Faed.).... Irl ... ..Tod am .......................... <br />issued. <br />Director of Assistance <br />.................... Kell .... ii.....Yaxllafwzll(?.er...... .................................................................................. <br />Director of Assistance'' L Signature of Applicant, Next Friend or Guardian <br />
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