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�° ���. <br /> �e��� Application for Exemption �o�M <br /> Ne6raska Department of <br /> RE�NVE from Mvtor VehicleTaxes by�ualifying Nonprafit Organizations 457 <br /> •To be filed with your county treasurer. <br /> •Read instructions on reverse side. <br /> Applicant's Name � Type of Ownership <br /> THE SALVATION ARMY �Nonprpfit <br /> Strset or Other Mailing Address County Corporation <br /> $1$W 3RD ST HALL []other(specity): <br /> City State Zip Code State Where Inwrporated <br /> GRAN� 15LAND NE 688p1 NE <br /> IDENTIFY OFFICERS,DIREC70RS,QR PARTNERS OFTHE NpNPROFIT ORGANIZATION <br /> Title Name,Address,City,State,Zip Gode <br /> or ce.� 1 S a. �. �$��3 <br /> '.r. : ow• �S we... 10. � 6$�0 <br /> a.r G�na� w•o�r� c-o 5. a r 73 .. E b'�� <br /> � DESGRIPTION OF7H�MdTOR VEHICLES <br /> •Attach an additional sheet,if necessary, <br /> � Registration Date pr <br /> Motor Vehiele Make Model Year Body 7ype Vehicle ID Number Date of Acquisition, <br /> If Newlv purchased <br /> a � � � 6 <br /> ri , � s� s� <br /> � L 1� <br /> � o d 3 ,� a� �GN 0 0 <br /> or ....� DI� <br /> Exempt Uses of Motor Vehicle: Are the motor vehiCle5 u5ed exclusively <br /> ❑Agricultural/Horticultural �Educational �Religious �Charitable �Cemetery as indicated? <br /> Give detailed description of use,including an explanation if multipl�usa classifications exist: �YES �NO <br /> �1 C.�l�. u� es—rr8 c�� a� ��� �v+ti L�--"'n� ca�-r..� Ge n.h..�...-;�' <br /> I No,give pe���:D <br /> �y Q,•'t��$ c�r��Q Chvrc.� �c.�2 J��:GS. �� �-4+ Ga-+►►�S � y�� �. a e. <br /> e�: C�E s �r,o r [��S rx..3�f� $.�a.l. o-3 fiC i�^G.3, ��rr e�J.f� ^�'p�-r.ac�E� <br /> V ��J(�` C.��O�r'�^�. . �7r�� <br /> �+�. W� p� ��.. �p �.►,� �<<.�- :.� ' �V�Y 1 5 �D11 <br /> �� 4 P �Gk�r���.� �4-t�-, � t3.�\� R� ,r.�.,�.�.s• <br /> Under penalties of law,I declare that I have examined this application and that it is,to the best of my knowledge and belief true,comple DFFIG� <br /> also declare that I am duly authorized to sign this exemplion application,and that the organization owning the above-listed operty d ,��gRASKA <br /> in ship or employ nt based on race,color,or national origin. , <br /> sign �;� !•'VVL�CIJ �Y� �0�� JP/"'r� ��! ��� ' <br /> here Authorize ignature Title� - ` � Da� <br /> FOR COUNTY TREASURER RECOMMENDATI�N <br /> [�PPROVAL COMM�NTS: �� �� 'a�� <br /> �DISAPPRQVAL <br /> /2 -zq�� i <br /> Signature of County 7reasurer Date <br /> FpR CpUNTY BOARD OF E�UALIZATIpN USE ONLY <br /> APPROVAL COMMENTS: <br /> �DISAPP�iOVAL <br /> /`��-�-'!�� <br /> uthorized Signature Date �� <br /> Nebraska Oapartmant of Ravenue �� Authorizad 6y Nsb.Flev.Stat.§§77-202(1)(c)and(d),and 60-3,185,end 603,189 <br /> 86-253-2006 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />