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This is a True Copy of <br />Certificate Originaly Issued <br />.Ne iC V�ndemo e r <br />Director of Assistance <br />DEPARTMENT <br />NEBRASKA <br />BOARD OF CONTROL <br />OF ASSISTANCE AND CHILD WELFARE <br />N° 4 <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />City or Village <br />............ ............ Jeff _8Z.san............. _................................ <br />County <br />® Old Age Assistance <br />❑ Blind Assistance <br />..... -.... -..................... -...... ,T. u1Y.....210.,1939----- --------- -..... 19 <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 />None <br />2. Legal description of all real estate not used by me as place of my residence: <br />Lot 3,Bloczk 19,Clark4-s addition to City of Grand Island, <br />Hall County, Nebraska. <br />RECEIVED <br />Jul 25 1939 <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, enc e <br />1941, authorizing the Register of Deeds to release the Old Age Assistance liens of record, I.Jugeby release the v lien this <br />2!... day of ... .lif!Ll.!!......, 1941./ <br />Register of Deeds <br />-------------------......................... ..-- --- ---- . --- ----------- - . Signed ..... ............... ................ .......... ----------------------------- <br />Witness Applicant for Assistance <br />VERIFICATION <br />not <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 />............ ... -- .....---------------------T...9...Ha.W-es---.._.........------------------------......----------------------- <br />County Assistance Director or Visitor <br />................ ..... ........ Hal -I ...-------------------.County <br />-------------------- _- NOVA ------------------19 39 <br />Received for record Certificate of Award for Application No -------- .......333.--101.---------------- (Old Age Assistance), (Blind Assist- <br />ance) at .... _._..2 ------ _-------------- o'clock and..... 3.0 ... _........ minutes ....P. ... M. in compliance with Sec. 68-258 Comp. St. Supp., 1937 as amended <br />by L. B. 389, 53rd Session Nebraska Legislature, or 68413 Com. St. Supp., 1939^^c <br />Book 1 Page 4 Signed.._ ............(...._....�............................ <br />Register of Deeds <br />