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This is a True Copy of Certificate Originaly Issued Director of Assistance NEBRASKA BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE N° 115 DECLARATION OF OWNERSHIP OF REAL ESTATE ® Old Age Assistance ❑ Blind Assistance _Doniphan - - - - - January. ---26--------------- .......... 19.._40_.._ ------------- City or Village Hall 8-523 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: Lots 14,15,& 16; Block 5;Scudder's Addition. 2. Legal description of all real estate not used by me as place of my residence: 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 reby release the 1941. �n lien this Z ... day of ...... '�. Register of Deeds ............... ......................... -.... Mur.iel- Antho_ny.---------------------------------- Signed .......... ._----------- Blmer E...Msx'.s_h.................................................. -........... Witness Applicant for Assistance VERIFICATION have investigated the..................................HaI3--------------------------------- --_County records and hereby certify the above description(s) to be correct to the best of my knowledge. -------------------�duriel...Anthony_....._......-----....._................ - County Assistance Direeter-er Visitor To: State Assistance Director, ................... ___............... H811 ...................... -...... County 1008 State Capitol, Lincoln, Nebraska _..___ February 2 --- --------- 1940._._ Received for record Certificate of Award for Application No...............6'.-52.3---------------------- (Old Age Assistance), (Blind Assist- ) ....o'clock and ...... .-..-............ minutes ....A..M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended Assist- ance) at-----•---.._�..Q--•-------- -- by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. and •L. B.2 January 1940 Book 1,Page 115 Signed ..................... .01?-�-� -.......... ............. ..... ..... _._. Register of Deeds