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This is a True Copy of <br />Certificate Originaly Issued <br />NEBRASKA jr �T <br />2 110 <br />-' ' " Director of Assistance......................... <br />"""'..."'.. BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />X] Old Age Assistance <br />❑ Blind Assistance <br />--------------------- Grand _.._I.s1.a.nc1--.......................... ......-----...------....Januar-y 27--- ............................. ............... _..... I9.14D _ <br />City or Village <br />............Ha i------------------------------------------------------------------------............. -------------------- <br />County 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 />1. Legal description of real estate used by me as place of my residence: <br />E 1/3 of Lot 7, W 1/3 of Lot 8, Block 28, Original toT,?n of <br />Grand Island <br />Recorded in the name of Lola E.Ross, spouse. <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 reccI hereby release/ within lien this <br />�/ i '�.. <br />Register V� ........ . <br />1941. <br />day of ...... ��' of Deeds <br />Z U — ---- <br />.......... Muri-el Antho.ny-------- --- ----------- -- ----------- Signed ................... Mar..shat.l..._R._R...Q.S.s.................... --.................. <br />- <br />Witness Applicant for Assistance <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 />............ ---------------------------------14uni-e1.._.Anthany.............................. <br />County Assistance Bier Visitor <br />To: State Assistance Director, .............. ---------- Ha.11..- .................. .......... ............ County <br />1008 State Capitol, <br />Lincoln, Nebraska ------------------ --F_ebr-uar-y----2__-...-_--19---40------- <br />Received for record Certificate of Award for Application No ........... 8_-_7_q__q-------------------------- (Old Age Assistance), (Blind Assist- <br />ance) at.....10...................... _..o'clock and ................. ......... minutes �._....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.�annd L. B: 2 January 19+0 <br />Book 1, Page 110 Signed.............................Vl.-�--... ..... -- .............. -........... <br />Register of Deeds <br />