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This is a True Copy of <br />Certificate Originaly Issued <br />NEBRASKA N° 1.85 <br />----------------------- Director of Assistance-----------------_---- BOARD OF CONTROL <br />DEPARTMENT OF ASSISTANCE AND CHILD WELFARE <br />DECLARATION OF OWNERSHIP OF REAL ESTATE <br />❑ Old Age. Assistance <br />❑ Blind Assistance <br />................................... -.................................................... _.................... ------------------ ....................... -----------------------------------------_.....------...-----._.....19...--- -- - <br />Citr or Village <br />......... .. ......_........ FORM DA -7 Revised -4-44 +1 lei1 04111111600 ................. - <br />CERTIFICATE OF AWARD --- In comp T of A1[i._-_:. �.._..M described <br />real estate as a <br />Name of Payee----.-- <br />1. <br />ayee- -_ _-1. Leg Address____ -tea I-- ti _County---- �- ------ ---- <br />Original Grant $ ----- -_----------_--�s"`_ Date.._._------ ___ <br />2. Lel <br />Name of ChIlUraa for Tnwm •mlatanee Is Gnntoi <br />ill Dab <br />161aflem b to Pam <br />(Will be tilled in on1� it aced ae certificate for ehildren) <br />1. seearins aid for deDoadent children <br />:f <br />Now 111111111111111110 <br />4. <br />L <br />L <br />7. <br />S. <br />Signed <br />Witness <br />VERIFICATION <br />have investigated the ---- ----------- _._.--_- <br />to be correct to the best of my knowledge. <br />Applicant for Assistance <br />records and hereby certify the above description(s) <br />County Assistance Director or Visitor <br />To: State Assistance Director, ............................. _........... _....... ................ .... _........... County <br />1008 State Capitol, <br />Lincoln, Nebraska ..... ........... ........................................... _--------------- 19 ........ _....... <br />Received for record Certificate of Award for Application No ............. -................. .__......_......_.-__...-. (Old Age Assistance), (Blind Assist- <br />ance) at --- - ----- - ..........................o'clock and .............. ._...........minutes ._._..-..-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. <br />Signed------------ ---------- .------------------------------------------------....._..---------------...... ...........--------------------- <br />/ Register of Deeds <br />