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This is a True copy of <br />Certificate Originaly Issued N2 <br />NEBRASKA <br />�V......................... --- Director ---------- of Assisa-a tnce <br />ssis <br />A-. •-•-.........••--••......•-- BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />----------------------------Grana-Iela..xn .............................. <br />City or Village <br />- --•------- ................ x81 '---...................................................... <br />County <br />133 <br />® Old Age Assistance <br />❑ Blind Assistance <br />------------ ----------_----- ----------- -February-- �7---------------------.19....44.... <br />............... .-----4.0 .5.9.7 nl---------------- ............. -- -......................... ................ <br />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 />Life interest in Lot 5,Block 11,Bonnie Brae Addition. <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 record, ereby release the lien this <br />% . day of ....... 1941. ............ ................ <br />Register of Deed <br />---------------- JAur .el... ---- Anthony ----------------------- Signed----- ........................... ... Rebecca -Schroeder ....................... <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 />To: State Assistance Director, <br />1008 State Capitol, <br />Lincoln, Nebraska <br />Muriel Anthony <br />-------------------------------------- ---- ------...._.....--------.._-------------- <br />_ <br />County Assistance e:& -.. Visitor <br />---------------------------------..HaU................. - County <br />-----------------------mch 1-5----------------------19-40----- <br />Received for record Certificate of Award for Application No ....... 4-59.7. .- . (Old Age Assistance), (Blind Assist. <br />ance) at..... ------------ 9................o'clock and........ minutes .&....M. in compliance with Sec. 68-258 Com . St. Supp., 1937 as -amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. <br />and L . B.91 January 1940 <br />Book 1, Page 133 Signed -qf_­f�tie8 ............. .... .... -------------------- <br />Register of Dee <br />