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DUPLICATE <br />OLD AGE ASSISTANCE CERTIFICATE No....4o.,i.72"j ....... <br />................................ J14al .................... Countyt Nebraska <br />Name ....... Kargan..B.12ravia <br />Age ....... 71 ........ Address..... 5n..&.5.tjL <br />.-Iit.-.,Orand..Ialand,lieb.r&Bka .... <br />Amount $ ..... J.&DO .. . ........ Modified Amount $ ................................ $ <br />Date ......... APr.11 ... 13�rl-936 ...... 19 ........ <br />This is a true COPY Of Certificate originally <br />issued. <br />........ Ren .... Q.!t.Y4Ad4w0j . ................... <br />Director of Assistance <br />SL <br />(Signad) ... Ir1..D..T.o3-qn <br />Director of Assistance <br />.......................................I................ <br />.... <br />Signature of Applicant, Next Friend or Gnardiaa <br />