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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE <br />No...&.,..Ig ....................... <br />...................... .............................. County, Nebraska <br />Name...... Th.Q.W—P .... T.,.FAQ.e .......................................................................................................... <br />Age ...... 71 ......... Address.......... 213 ... E..8.th..4r.and..-1s1and,-Xebr . .................... <br />Amount $ .... 18..00 ............. Modified Amount $................................$ ................................ <br />Date ....... Apr.L]..-i . ....................... 19.36. <br />This is a true copy of Certificate originally <br />issued. <br />...... He -n. -..G Vazidemozr ............... <br />, Director of Assistance 8L <br />(.9ignad) .... Irl ... D-Tol . . ......................... <br />Director of Assistance <br />.................................................................................. <br />Signature of Applicant, Nort Friend or Guardian <br />