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This is a True Copy of Certificate Originaly Issued NEBRASKA N2 105 Director of Assistance BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE DECLARATION OF OWNERSHIP OF REAL ESTATE X] Old Age Assistance ❑ Blind Assistance _a O.S . --R. t er------------------------------------------------------------------- ..-------_------- Januar.-y 2-3 ----------------------------------•---------- City or Village Ha -ll ---_---------------------------...._ ------------- __--------- ----------------- - - ----------- County Application Number In compliance with State Assistance Statutes in Section 68 Comp. St. Supp. 1937, 1 hereby declare the following described real estate as all of the real estate owned in whole or in part by myself and/or my spouse. 1. Legal description of real estate used by me as place of my residence: SEJ, Section 1, Township 10, Range 12. 2. Legal description of all real estate not used by me as place of my residence: W NEI., Section 35, Township 11, Range 12. Recorded in name of Lillie M.Root, spouse. Pursuant to the Enactment of L. B. 89, by the 55th Session of the Legislature of the State of Nebraska and approved May 12, 1941, authorizing the Register of Deeds to release the Old Age Assistance liens of record, ereby release thejhin lien this .. day of..... �..... , 1941. rel .... Register of Deeds ------ ---------------fur -e1-An_tl qqy ---------------------- Si Witness have investigated the ...................... Hal to be correct to the best of my knowledge. To: State Assistance Director, 1008 State Capitol, Lincoln, Nebraska VERIFICATION Frank- A.Root ------------------------------ Applicant for Assistance records and hereby certify the above description(s) ------------------------------------Muriel Anthony..------ --------------------------- County Assistance 44sesU& or Visitor _-------------- Rall -------------- --------------------------------County ----------..lebr..uar..y 21. ................... 19-40------ Received for record Certificate of Award for Application No-Afn5.74.................................. (Old Age Assistance), (Blind Assist- ance) at ------------ 10 ----------------- o'clock and --------------------- ----- minutes ..... ...... M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended by 1K. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939and L. B. 2 Ja7-f—'e y 1940 -----•-----•------•-----•----r.C..._.._....-•-? ------------_-- Signed Book. 1, Page 105 Register of Deeds