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This is a True Copy of Certificate Originaly Issued N2 124 NEBRASKA f Director.of Assistance BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE Open DECLARATION OF OWNERSHIP OF REAL ESTATE n Old Age Assistance ❑ Blind Assistance ....................Drax ci Island January2 -------5- ....-------....----- 19.... .._ City or Village Hall-------------------- ---27. .....--------- --------------------.....----------------- ------------------------------------------------------------------ ------------------------------ 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: Lot 6,Block 128,Koenig and Wiebe's Addition. 2. Legal description of all real estate not used by me as place of my residence: West j of Lot 7,Block 128,Koenig and Wiebe's Addition. 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, I heyeHX relea�ith' J{inn this ..... .. day of ...... ..., 1941. Register of Deeds - ................ .............. ...-....... >lllurie.1. Anthonx- - - Signed --Louise --�I. Hann----------------- ---------- ------------ Witness Applicant for Assistance VERIFICATION have investigated the .._._._---------------_-- Hall. .._.............................................. County records and hereby certify the above description(s) to be correct to the best of my knowledge. ---_Muriel---Anthony...-.......................................... ........ - County Assistance 41irwMrw Visitor To: State Assistance Director, ------ ---------- _Hall County 1008 State Capitol, Lincoln, Nebraska ................... 19-._w..... Received for record Certificate of Award for Application No ............ 8..` ?.74 ....................... (Old Age Assistance), (Blind Assist- ance) at.......... ---9 ................ o'clock and !!n=!n Jhs..M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 asmended by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. And L. B. 2 January 1940 Book 1 pa a 124 ��G g Signed. ...... -- Register of D ----- - - -----eeds ------- ----- -------------- . st