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This is a True Copy of <br />Certificate Originaly Issued <br />NEBRASKA <br />N° 175 <br />ij',.....''�"--.-....-•-'---------"'............." BOARD OF CONTROL Received Jan 13 1941 <br />Director of Assistance <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />[N Old Age Assistance <br />❑ Blind Assistance <br />-----------------------•--WOOd River ...................................... ----------------- - _J. Anugf-'y 1Q_ ..... -........ _.....- <br />City or Village <br />-------------------------------Hal-Z- ------- .------- - \.. - ---••- •... - ------------ 4C? - -2...... - -- ..... - - -- - - <br />County 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 />2. Legal description of all real estate not used by me as place of my residence: <br />Lots 16 and 19,Foster 9ubdivision,Wood River,Hall County,Nebralska. <br />(Recorded in the name of my wiferMay Powers.) <br />Pursuant to the Enactment of L. B. 89, by the iiiith Session of the Legislature of the State of Nebraska and apikoved May 12, <br />1941, authorising the Register of Deeds to release the Old Age Assistance liens of reeord(--7 I e �OiLJtin lien this <br />... day of ......� / ?�.., 1941. . ... <br />Register of Deeds <br />............... ........ .............. M.uri.el_.._Anthony ......... -----. - .._-.._...... Signed................................... Harry ...Powers --- -...---------------------------------........ <br />Witness Applicant for Assistance <br />VERIFICATION <br />have investigated the .....:..................__ -al..................... - ............................ .County records and hitiby 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 />-----------------------KUr...el...,h.l t -my--------------------- - - --......... <br />County Assistance-bireeisr-erVisitor <br />...................... -----•----�-jj........................ County <br />----------------- ------ Jm-16---------------------------19 411 <br />Received for record Certificate of Award for Application No.....4Q-776-1------------------- (Old Age Assistance), (Blind Assist- <br />ance) at..._..-._.. ---- ------------- o'clock and......, .-e.....minutes ._2..M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68-413 Com. St. Supp., 1939. L. S. Z <br />Book 1 Page 275 <br />Signed - L.. --------- ----------- - - -- -- - <br />Register of Deeds <br />