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This is a True Copy of Certificate Driginaly Issued N2 n 7 NEBRASKA �V �( . Director.of Assistance .... BOARD OF CONTROL DEPARTMENT OF ASSISTANCE AND CHILD WELFARE DECLARATION OF OWNERSHIP OF REAL ESTATE ® Old Age Assistance ❑ Blind Assistance ..... - ...... ...... Grand... I.alando.Rebr.............. ---------------------------- i4nuarY 17 -------------- -------- ----- 19.- 4 - City or Village Hall------------------------------------ ........ ........ --------------- 289"19.9 ................................................ ---. ----------------------...----- 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: 2. Legal description of all real estate not used by me as place of my residence: Lots 103,104, & 105;Belmont Addition to Grand Island. Pursuant to the f]nactment 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, eby release the (wt 1} , lien this .; 1941. ��tic...U.�.-' %/ ...day of ....... �.1/l!!'�'• • . ............... Register of Deeds ................ .-•---._.....-...... .u.r'i.e1.....Anthany ....................... ......__._.--..._.. Witness VERIFICATION IFer Minnie X henry Mark Applicant for Assistance Wit: Muriel Anthony Wit: Minnie Mapes have investigated the ............ .......... ................Hall ....................................... County records and hereby certify the above description(s) to be correct to the best of my knowledge. To: State Assistance Director, 1008 State Capitol, I inrAn. No-kracka ----------------------------------- Muriel Anthony --............................. County Assistance Director or Visitor Hall ..------------•----.......... County Mch 1 1940 Received for record Certificate of Award for Application No._____..2_g.-199.__------ .--- .__ (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------- - ••-•---•--._. ---- . by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 :Com. St. Supp., 1939. and L. B.2 January 1940 Book 1 Page 12 �_, 7 Signtd........._... .-� _-... .......... Register of Deeds