|
zoii
<br /> TOBEFILE�WI7H App��cation for Exemption
<br /> YOUR COUNTY from MotorVehicleTaxes FORM
<br /> 7REASUR�R by Qualifying Nonprofit Qrganizations 457
<br /> •Read instructions on reverse side
<br /> _.. -- --- --
<br /> ._._ _..._ _.,---- - . ..,.. .. .....__ _.._
<br /> Applicant's Name County Type of pwnership
<br /> GRAND IST.AlVD REACT �NC L �]Nonprotit
<br /> ._ __.. , ..--- ..__.. _. -- - .._-- - -----.._. _...
<br /> Street or Other Mailing Address County Number Corporation
<br /> . _ 1fi2r±. 5T PAU'L RU PO BOX 89�+ �+O _.. _...._._... �Pther(specify);
<br /> _ _ _.. _.. _
<br /> City State Zip Code State Where Incorporated
<br /> c�n Isr�vv rr� 6sso�
<br /> . _ ---
<br /> . . _. _
<br /> Identify Otficers Duectors,or Partners
<br /> � --- __
<br /> Title ��f� Name Address,Cdy,State Zip Cnde
<br /> _ -- --
<br /> _ . - - _.... _ --
<br /> ----.... ---
<br /> --
<br /> �]-- ..., n_rJLv' �1f�v:�v,Ax /L�'Zy R1..�� �"�. ..._.�d �], ._�� 1��34/..- .... _
<br /> � F�c� C'�: ,t�,�.;�, /o'� E_L��,ft.l�C_� ._.�c C.,� 3 a x --
<br /> __ � r1 ri�A . "'. -r2 fil/C U 4.(c�
<br /> ._..._..... =��--- .......----
<br /> Tr��.P.s ----- w��c;-r�r,�� m���s -z�z�.a7-r..�vn!P��n,� G i iv� �3���j
<br /> � . . --- — _. .--- --._ _ ...
<br /> LIST SPECIFIC DESCRIPTION OF THE MOTOR VEHICLES
<br /> •Attach additionai sheet if necessary
<br /> _ . . _ _ ,. ------..,
<br /> Registration Dale or D ite
<br /> Vehicle Make Model Year Body'fype Vehicle Identifir.ation Numb�r of Acquisi�ion if Ne,wly
<br /> Purch�ised
<br /> . ___.. _.._ _.__.,_.. __ T_ --- - ___. __. _--- —
<br /> ---
<br /> �, c� - �s's�� 1 �7�)---- f� �,a55 'E3� Cs�_i._.?�V_��'z� �s � ---+2�Ac;
<br /> . �
<br /> _. _
<br /> _.. . .. �
<br /> e�?. � t�.���
<br /> _............... __.... — --. .. ,
<br /> .iZtk3cdv i1J N?i'._L�
<br /> ................_ ._ _ _._.,.,...._..------- _._ _ ..-- ----_ - --..
<br /> Nature of lJse o(Motor Vehicle: Are the motor vehicles used
<br /> �Agrir,ullurai/Horticultural �Educational �Religious ,�Charitablo �Cemetery exclusively as indicated?
<br /> Give detailed description of use,including an explanation il mulYiple classifications exist: �YES �NO
<br /> /v I�7 W l� �/'�'1�k��N C' c L�r71 y�'��l/U t C J��'J o.;..1 `��=IU�I�
<br /> T� J� , r If No,give percentage: /
<br /> �7 s�.' 1-l1 W?r. )�1 VlS�]r�%�� �L��3iU�:r A:,,Ji�\:a✓� [y7 �1'1nNN 1�, G�G A-��l J.
<br /> ��������
<br /> )
<br /> a�c 1 � 20�0
<br /> ��- -��lF .F Under enalties of law,I declare that I have examin '
<br /> p ed this application and,to the best of my knowledge d 6elief,it is correct and
<br /> complete.I also declare that I am duly authorized to sign this exemption application,and that the organization ow ng said propert oes not
<br /> discriminate in membership or employment based on race,color,or national origin. �A��COUN7Y
<br /> fRFASURERS O�FRCE
<br /> G12ANG IS!_F�ND,NEBR.ASKA
<br /> S�g� .�^'"_'�G""'�/` T v;. .ar�.,....-----. .,....._.._._ t-C,�s ...................._ _l_
<br /> here ,Au�o�ed Slyri�t�e • _ _-- Title Dat�._r�J I�
<br /> �� _._.__.- __...... -----
<br /> � _.... ...._
<br /> FOR COUNTYTREASURER'S RECOMMENDATION
<br /> �,. �ry
<br /> [�PPROVAL COMMENTS: __.=�01.__.
<br /> �DISAPPROVAL __ _ _ _` ---..
<br /> ����� -- . -�a r�1�
<br /> Signature vf County Treasurer �� �
<br /> �,..,.. -— -----
<br /> �OR COUNTY BOARD OF EQUAI.I�ATION U5E ONLY
<br /> ------_..._.. . —_. _..--- , _.....
<br /> �J APPI�OVAL CQMM�NTS: --- --._ ..
<br /> i
<br /> u DISAPPRUVAL � __... ., . �.J-r �.._�
<br /> ------....,.
<br /> � � _.
<br /> r' 'iF��--- _ �(
<br /> � - ....._...
<br /> A horized�:_.._� _,. �_... __....
<br /> _... ...--
<br /> Signature pai�
<br /> i
<br /> Ne6raska Depaflme^^ �-m.�...,.,..� .��......... , �..
<br /> n[of Revenue Auth rized by Ne6.Hev.Stat.g77•2p2(1)(r,)(d),§60-3,185§60•3,789
<br /> 9G253�2006 Rc:v.5•2009 Supersedes 96-253-2006 Rev.11-20D8
<br /> PLEASE MAKE A COPY FOR YOUR R�CORDS
<br />
|