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<br /> 70 BE FILED WITH Appiication for Exemption FoRM
<br /> from MotarVehicleTaxes
<br /> YOU�cOUNTY by Qualifying Nonprofit Organizations ,,457
<br /> TREASURER •Read instructions on reverse side
<br /> --.. _.,.— . _..... __ _ ._ _.. ..,—
<br /> Applicant's Name County Type of Ownership
<br /> iiF.AR�L,ANll L[J"iHERAN HIGH SCI300L HALL__, �Nonprotit
<br /> __.._. __.—.. _.. ....._
<br /> Street or Other Mailing Address County Number Corporation
<br /> 3900 W HUSKER HWY ._40 _.._._. . . . ❑Ot��er(specify):
<br /> .. .. _. . _.__ .....--------... .
<br /> City � Staie Zip Gode State Where Incorporated
<br /> IdentiT Dffic �$�D •. NE ___ _ _ 68803 __ NE ��
<br /> GRAN[) .._ . _ _. ..
<br /> _
<br /> fy r rs,Directors or Partners
<br /> _ _.._ _ _. . __ _ ,- --, _ _
<br /> .. _..
<br /> Title Name,Address Gity StatE Zip Code
<br /> _ _ . , _... _ _ -- ---.---, _
<br /> -- - -
<br /> _ _._.. , C ',,
<br /> _� _ R�rr /�55GrYWt� 5�-LL �7�T��N/-�.-nnf Gt 1S 4n� --��—6�����
<br /> �c _ e/sc ,L;�ss .... y�'� L�1es _. !�s` ,�_
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<br /> r.�Q.sur�it.�.. �'�_� - 5(� .S_�1�sf �-�L�-
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<br /> ` - , ��'�^-4x�_.._ � f 'H-S�_`L��.?�%3 .S��,'C_`!G,o _ -
<br /> ��S _ l� _�ctr']�7.5 1!-p�1���.7 0i^ - . _.. �C�1s/a.tRr���'Q J
<br /> UST SPEGIFIC DESCRIP710N OFTHE MOTOR VEHICLES �
<br /> •Attach additional sheet if necessary
<br /> _ _.... __ Peglhaae
<br /> - � ion Date or Date
<br /> Vehicle Make Model Year �8ody Type Vehicle Identification Number of Acquisition if NLwly
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<br /> --- .. �3 .. S -s ! -. ��'�v l . _3-z1� 7�Z
<br /> _.._
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<br /> - �)C� ��_ .f�ri 4n � _ � cv9x.�5m _�2 -3 z�Cs_
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<br /> —Clvairn/�__.. _. .. ZcbZ _._in _. a.+� IGt►GGaz9 ..oari�r y�o i- i�:z��
<br /> Nature of Llse of Moior Vehicle:.-� __. - --- ,-..__ _. ---
<br /> - Are the motor vehicles used
<br /> �Agricultural/Horticultural �Educational �Religious �Charitable �Cemetery
<br /> exclusivety as indi�ated7
<br /> Give detailed description of use,including an explanation if multiple classifications exish ��S �NO
<br /> m ���„........_
<br /> �+,i}n . � ��,�„� ,��,� fi If No,give�r en��" � m" � �
<br /> ����� rr/�/ i/�7� i�Wv�[�[�JU�!
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<br /> ��CJuI'\ri/..7 ' ��.�.`�, . _.,.� �
<br /> 7
<br /> HALI�CUIJNTY
<br /> __ . ._ .. _... _ _._ - S iJFFi��
<br /> Under penalties of law,I declare that I have examined this application and,to the best of my knowledge nd belie��,�i� ,� N«� ,��
<br /> complete.I also declare that I am duly authorized to sign this exemptivn application,and that the organization ow
<br /> discriminate in membership or employment based on race,color,or national origin.
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<br /> s i g n _ •,j: '.� ��-1��Z�- ..— �(/ i"r[k-.�/ � /�' L�a�C r.
<br /> here /Authorized Signature Title �, Date
<br /> .__ .. _ . _ _. - -- .. .-�
<br /> �� FOR COUNTYTREASURER'S RECOMMENDATION
<br /> �APPROVAL COMMENTS: �.../..L�� ����.��D�, __ ..,_ _...... _.. ---.... .—
<br /> [�DISAPPf�OVAL __... --- -.. _ _...,�..
<br /> ` �7 /� �� -!v
<br /> � �. , �" .... _�� _._..... --..._... ._. ____
<br /> I Signature of County Treasurer Uate
<br /> __ ..... . - ---.._ _.— ... ._ _. -�
<br /> ._
<br /> FQR COUNTY BOARD OF E�UALIZATIDN USE ONLY
<br /> _ _. ._.._. _.. _ _. .. ___.,,...__.— _ ..---
<br /> ❑APPROVAL COMMENTS: _.......... .. _..,..,.,._._ - --..._ —..,_
<br /> �
<br /> ❑DISAPF'f�OVAL t. � �__ /��• n_..,...---,..
<br /> _. _
<br /> Au �onzed`Si J �
<br /> �..�. - .--. �.,..---- . --.. ...._ ...-- --
<br /> , gnature ��1e I
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<br /> Nc+braska Deperlmenl of Revenue uthofized by Neb.Rpv.Stal§77-202(1)(C)(d),§60-3,185§60-3,189
<br /> 96-253-�2006 Hev.5-2009 Supersedes 96-263-2006 Rev��7-2008
<br /> PLEAS�MAKE A COPY FOR YQUR RECORDS
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