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oR Paacs #06 4/6. a! «009058 na 278 84955 ‘Wasiuozos =) Sucre } uso none o suena mss mene ‘COMBI A ) AKO ALL MN BY THESE PaBSEUTS: a, of ee ee a a GH Age Assietance case Manor 31596. nd all other signitories horete, have of cloim to have un intorese other than Iife ustate in the following property, £0 ¥it: Qor 4 Wu mn "48 Lor 61 squaRE 520 2, Rach signatory horoto recognizes the existence of and understends ‘the nouning of those porticns of the Old Age Atsistence lew of thy Dis ‘riot of Columiiu whiel: road es follows: “any person, whoste(d)*e*aide or sbete én the buying or in any. : way disposing of the proporty of an old~uge ai font, without the ecnsont of the. Doard of Camissionsrs or its designated egency, sholl be guilty of s misdenosnor sad upon conviction thercaf shall be sentenced to pays fine of set nore than $500 or imprisoned for a period not to excoed six months, for both. (huge 24, 1985, 49 Stat, 749, ©, G40, #10)" "we tho death of a recipiant of a old-age assistance, or of the last survivor of w recipient merried couple, the total anount of assistanco since the first grant, topethor with simple in- torust at the rato of 3 por contum por annum, shell be deduct= fd and elloved by the propor courts out of tho progoods of his Proporty as proforrud claim against the ostate of the person 0 ssisted, and refunded to, the Trosauror of tho Unsted states to the ercdit of the District of Columbia, Joaving the belunee for distribution anong tho lawful heirs in accordance with laws wer. (Aug. 24, 1985, 49 Stat. 749, 0. 640, $12)" 3. Mich signitory emsonts to the recording of this instrunont ac~ cording to the rogulations of tho Beard of Commissioners, Dy Cu, oF their dosigmted agonoy, ond recognises the total of grate in aid 0 tho above named recipient ws u preferred cleim after his/her dosth agninst this property in favor of tho District of Columbia, 4, Bich signatory agreos that he will not participate in tho esle or.tronsfer of this property to anyonu fer eny purpocs, or allow any mortgage or othor oncunbrance to be improsesd against it, without the consent of the Boord of Commissioners, D. C., oF their dasigusted agency. Signed im WasieNOTG:, D. G., tnie edt day of, 29, "7A; in thie presonce oft 1 Ua eposedn oy. bileater cobinata, To Wer aR od Dlatnhoe of Solimbyn Maraby COPE tho ie/oru poreanhty well knom to mee ther bslorass eA ant Tie’ the Baek pt Seed au aoe naa ona som lly appasred befor po in tho said Diteget end Gelaaalodgod/tho said doclaraticn to bo his/her/thoir tot and aka. Given undor ay hand and aoel this_22- day of Le. 1966 Bek saiory'Poviso, Duc. Wy Comission oxpires__gh —¢ sf - roof

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