|
Application fior Exemption �o �11
<br /> 7p BE FILED WITH from Motor Vehicle Taxes
<br /> YOUR CpUNTY qy(�ualifying Nonprofit Organizations 457
<br /> 7REASUFiER •Read instructions an reverse side
<br /> _,. - --........... ...rv.._ .....
<br /> - ... _.,.
<br /> Applicant's Name County Type oi Ownership
<br /> YMCA HALL . _-- �rvonprofit
<br /> �. --.�_...._ _.
<br /> Street ar bther Mailing Address County Number Corporation
<br /> 221 F; S�Ul`H FRONT S�T �F._O.. ❑Other(specify):
<br /> . _ P ..
<br /> City State Zi Code State Where Incorporated
<br /> GRAND �SLAND _ NE _�z$$(ZL..... _. _. �
<br /> __.,
<br /> Icleniity Otficers,Directors,or Partners
<br /> _ _ _.,. _.. .,.. ._ __ �
<br /> Title Name Address,Ciry,State,Zip Code
<br /> —.. __ __
<br /> ��r - -�,� r �' f l,�'t✓1 �Lr -� � _��+�c.J� G'�^G n• S Cr C ..�t���_�'..3� ...--
<br /> .r� _ � c[� �'i _,��.� E���r'I ec��i..e+-�.. �� Qr'i.���... 'r'�i ar S lc.�._ /9J�,
<br /> �c-� ... ��'�-- ��
<br /> �
<br /> �
<br /> _.��r�cr�e° ..._� �� i r �'ae1 • ��Q` .i. JG%11� �'. r_.h.. r�rX_!!.� ���.�----
<br /> r r���Ci"_f^ A ! �'�^ , C.�, �'� �r`. ►"C�Et. . ��tc� _...����' —
<br /> - ' �
<br /> -
<br /> . �
<br /> r��..f��r., t"'r�.���= tr� � �rn /v�.��
<br /> �jC�°�i'(,9� !'r^� er- O 1�1 ,, . �Cr
<br /> _. ... _.. ---
<br /> LIST SPECIFIC DESCRIPTIbN OF THE MO70R V�HICLES
<br /> •Attach additional sheet iT necessery
<br /> VPhicIP Identdicat
<br /> Registration Date or Date
<br /> Vehicle Make Model Year Body Type , . , of Acqwsition rf Newly
<br /> � iun NumbPr Pi�rchased
<br /> __�'� , - -- ��,y � . _ �'i��l. --- -
<br /> ... _. `�7_ -� - s16� r�-�//z�?/�
<br /> � .- ... _ . �..�._ .._� �""f�,� 1 ���r c�-
<br /> _.. _.._ _ _...... ._ - _ exclusivel as indic
<br /> Nalure of Use of Motor Vehicle: Are the motor vehicles used
<br /> y ated?
<br /> �Agricultural/Horticultural ��ducational �Religious Charitable �Gemetery
<br /> Give detailed description of use,including an explanation if multiple classitications exist: YES �NO
<br /> lja� UCY�'!.S .�fl�(� G(SP . �' �Gr.tsi�.4�� %� 5� C�v� �./' b C<!� i1 No,9i����� �.�o
<br /> 1`"�G's A'-r-t.8v� ���� G°G¢as�I� L c l f tr� '� �� �f j Y D c� !'1u l'� d'y r r
<br /> (_{�� �C i SS/�6�1 � �� � �
<br /> -tS� Cf� J�t
<br /> �av � o zo�o
<br /> �� Under penalties of law,1 declare that I have examined this application and,to the best of my knawledge nd belief,it is ddt��tC�pm�)NTY
<br /> complete.I also declare that I am duly authvrized to sign this exemption application,and that the organization o ing said pr_3'���05 bFFICE
<br /> qi5criminate in membership or employment based on race,color,or national origin. GRP,Nd ISt.AN'L`,IVEBRAS!{A
<br /> sign ��_ ������ ��Fs,�.�-ss ��:���aof-- l���y:.��v
<br /> --.. . .._ . _ _ _.
<br /> here Authorized Signature Tltle Date
<br /> _. _ __.. --- ---- ., _
<br /> FOR COUNTYTREASURER'S RECOMMENDATION
<br /> _ - --- - __ __ _..
<br /> ' y � ��- c.�G�_�+---�
<br /> [J�APPROVAL COMMENTS: ,..�f�!�__.._.�!
<br /> � ..._ . --
<br /> r
<br /> ❑ D15APPROVAL - -- '---
<br /> .
<br /> �, �/d� ��/.�L� �G7
<br /> _ _ _..._._., ..-- -
<br /> Signature of County Treasurer Date
<br /> _ _. _ _. _. .__ _...
<br /> �� FOR GOUNTY BOARD OF EDUALIZATION USE ONLY
<br /> ❑APPROVAL COMMENTS: - -----
<br /> t -
<br /> ❑DISAPPROVAL { r .'"
<br /> � _._...._
<br /> .._ _ ... ..
<br /> / � f '
<br /> � ,. ...--_—._, -- _.
<br /> ` _..._. .—_..... __.._ .T —__.,__..,.._..----
<br /> I Aut rized Signature % � Oate
<br /> i.
<br /> NabraSke oep�rcmeni oi ae�er,��e. . . ° _._ - n��r,or��ea by Neii.ae�.s�a�.§��-zo2ti)(c)(d)§so-2,1e5§so 3,ias
<br /> 96-253-2006 Ftev.5-2009 Supersedes 96-253•2D06 Rev,11-20D8
<br /> PLEASE MAK�A COPY FOR YOUR RECORDS
<br />
|