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FORM
<br /> TO BE FILEQ WITH Exemption Application 451
<br /> vou� {nr-����xemption on Real and Personal t'roperty by Qualifying Organizations —
<br /> CbUNTY ASSESSOR Read instructions on reverse side. —. --
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<br /> Failure to properly complete or file this a plic5tion in a timely manner shall result in a oun pprova o Ty�e ot`Ownership
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<br /> , �, t ' � r�� �T{�,�� '�f� , � Nonproti[Corporation
<br /> �� ��—� � �� ���v� l Other(SpeeitY)
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<br /> � --—" �� State Where Incorporated
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<br /> - ��a�tuai va�u � Pc c i �� •
<br /> � G�.. , C:� f� _ _���� ��- _ a _
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<br /> � y g r angible personal properiy,exce t licensed motnr vehicles._._.____ - - - -- -
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<br /> rl and eneral descri tion o a
<br /> L descri tion of real rope —
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<br /> 7itle of Officers,
<br /> Directors,or Partners Address,City,State,Zip Code _ _ _ __ __.,..._
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<br /> L�nda Timmons ___.__. PRES/CFO __ 4980 S. 118t�S�e�.,. a
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<br /> ---- —.Same.�G _a�.oxz�-_— � — _— — ---. —. .
<br /> _Cind�Sc�i�a�d�r _.—. �--
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<br /> •-------- — � g le3se mark the applicable boxes).
<br /> I'roperty descri6ed above is used in the followin exempt cate ory(p �
<br /> � AqriculturaVHorticultural5ociety' ❑ Educ�ttional � Religious �i Charitable �� Cemetery
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<br /> Give a detailed description ot the use ot the property: ��352.. 52�at�aG?_..___..
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<br /> Itural 5ociet does nnt need tb c
<br /> A ncultural/Horiicu � �
<br /> ,— g — =y— � omplete the(ollowing qucstions.
<br /> Is all of the property used exclusively as described above? � �YES �NO If Yes,state the number ot hnurs per week `��.���
<br /> Is a portion uf the property used for the sa�e oi alcohollc bevera�es. �` v
<br /> Is the property owned or used by an organizatian which discriminates in r� rv� N� n��:yt /CC � �
<br /> membership or employment based on race,color,or national origin? LJ YES un — � �
<br /> �� Under pena l ties o f l a w,I d eclare that I have examined this exemptlon appllcation and,io the best ot my knowledge an��� ��e&�y,"�d N���S�d�s,
<br /> Mivv
<br /> complete.I o de,clare that I am duly authorized to sign thiis exeinption appli�ation.
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<br /> • ��� V.P. Fixed Asse� Deve_lopment _!--L�'�11
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<br /> � � i — Title ...—_..—_ Pate
<br /> here Auihorized5igna re
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<br /> -- — ---- � FOR COUNTY ASSESSOR'S RECOMM�NDA710N
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<br /> COMMEN75: � _ �. l `.,�.�"�7�--- .—.,.._._—._.__. .—._--..
<br /> �APPROVAL —�
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<br /> API'ROVAL OF A PORiION - — --
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<br /> � � �.��-`��_�,',�-'� . ��.�.��
<br /> �ISAPF'ROVAL — - � Datc
<br /> ,Siynalur of o nly As�
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<br /> -- —"� FOR COUNTY BOA F EQUALIZATION
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<br /> I declare ihat,to the best ot my knowledge and beliet,the d tenni ahon reby made by the County eoard of Equalizatinn is cnrrect pursuan
<br /> to the laws of lhe State of Nebraska.
<br /> GOMMENIS � L' _
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<br /> � APPRQVEIa — l
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<br /> ❑ APPNOVAL OF A PORTION -
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<br /> u DISAPPROVE� ' -- � �
<br /> Signa un eoard r
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<br /> . .,_—.—. ��- � ��'�—"- "� � Awhonzed by Ne6.Rev.S;al�§77-2U2A1��
<br /> Ne6raska Uepartment ol Revenue � ^ r
<br /> 96-135-1999 Ftev.7�2010 Supersedes 96�735-t999 Rev.11-2��8
<br /> PLEASE MAKE A COPY FOR YOUR F��CORDS
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