Laserfiche WebLink
�-�/� <br /> ���� Appiication for Exemption FoRnn <br /> Nebraska Department af <br /> RE�NVE from Mator VehicleTaxes by Dualifying Nonprofit Qrganizations 457 <br /> •To de filed with your county treasurer, <br /> •Read instructipns on reverse side. <br /> ApplicanPs Name � 7ype of Ownership <br /> GRAND ISLAND C�NTRAL CA7HOLIG SCHOOLS �Nonprofit <br /> Street or Other Mailing Address Gounty Corporation <br /> 1200 RUBY AVE HALL �Other(specify): <br /> �i�y State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFIC�RS,DIRECTORS,OR PARTNERS OFTWE NONPROFIT ORGANIZA710N <br /> Title Name,Address,City,State,Zip Gode <br /> ) <br /> S <br /> DESCRIPTION QF THE MOTOR VEHICLES <br /> =,4Ttsch ar add���araf sheet,i�necessary. <br /> a� �j n��� � z F ,Q ������4'�v Registration Date or <br /> oto ehicle Make odelYear BodyT��� �� e icle I�Number v Date of ACquisition, <br /> if Newly Purchased <br /> 1 <br /> 1 <br /> a <br /> Exempt lJses af Motar Vehicle: Are t e mot r vehicles used exclusively <br /> ❑Agricultural/Horticultural Educational ❑Religious ❑Charitable ❑Cemetery as indicated? <br /> Give detailed description oi use,inclu ng an explanation if multiple use classifications exist: �YES �N� <br /> �.��� <br /> UC��1�-u�� "lY7� �Y l.J d niNJ�'�I 1�M�I�Y��S '� If N0���w4'����se: <br /> / � <br /> �jC�lvvl GC`�rU��i� <br /> GE� - 2 20�1 <br /> Under penalties of law,I declare that I have examined this applicatlon and that it is,to the best of my knowledge and elief,true,com 16�,i�n�dh1�6T.Y <br /> also declare that 1 am duly authorized to sign this exemption application,and that the organization owning the above-I [ed prvpertv�s not�li9C'�fi�it����CE <br /> in member5hip or emplbyment based on race,color,or national origin. Gf�NU:��,w ;.f:i;.SF:F,r(SA <br /> sign 1� -- .� <br /> ���"� 'A�thcrized a!ure Ttle Pate <br /> FOR COUNTYTREASURER R�COMMENDATI�N <br /> [r�,PPROVAL COMMEN7S: � ��'�°��� <br /> ❑DISAPPROVAL <br /> . /�-�.9 / <br /> Signature of County Treasurer Date <br /> FOR COUNTY BOARD 0�EQUALIZATION USE ONLY �� <br /> �Q APPRDVAL COMMENTS� ._. <br /> ❑DISAPPROVAL <br /> �:�—��-- <br /> Authorized Signatur pate <br /> Nebraska Pepartmenl of Revenue Authorized by Neb.Rev.Slat.§§77-202(1)(c)and(d),and 6D-3,185,and 60-3,189 <br /> 96•853•2006 Rev.B-2011 Supersedes 96-253-2006 F�ev.5-2D09 . <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />