Laserfiche WebLink
�� , � <br /> �e�— Application #or Exemption �o�nn <br /> Nebraska Depertment of <br /> RE�NUE from Motnr Vehicle 1"axes by Llualifying Nonprofit Organizations 457 <br /> •7o be flled with yaur county treasurer. <br /> •Read instructions on reverse side. <br /> ApplicanYs Name Type of Ownership <br /> THIRD CITY CHRISTIAN CHURCH �j No�protit <br /> Street or Other Mailing Address County Corporation <br /> 4100 W 13TH S7 HA�-�- �pther(specify): <br /> Gity Stdte Zip Code State Where Incorporafed <br /> GRAND ISLAND N� 68803 N� <br /> IDENTIFY OFFIC�RS,DIREC7�R5,OR PARTNERS OFTHE NpNPROFIT ORGANIZATION <br /> Title Name,Address,Gity,State,Zip Code <br /> ,� 2 r d i�- �.Q r r e .. e ���1� i C�" E 0 <br /> � � � } -Z � <br /> �'e �t' _ _ �r r �n � o <br /> ��SCRIPTION OF7HE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> ---- f"' Registration Date or <br /> MotarVehicle Make ModelYear 8ody7ype Vehicle ID Number Date of Acquisition, <br /> If Newly Purchased <br /> � S� N <br /> I �e i�5 � .Z <br /> i � <br /> - e <br /> . , _ � <br /> Exempt Uses of Motor Vehicle� Are the mator vehicles used exclusively <br /> ❑Agriculiural/Horticultural ❑Educativnal �{Religious ❑Charitable ❑Gemetery as indicated7 <br /> Give detailed description o1 use,including an axplanation if multiple use classifications exisT: �y�YES �NO <br /> yr� <br /> � �� d'��"� �`" ���� U r � p�y ,,p "' ���� It No,give percentage of exempt use: <br /> J1�- �J-^��""`��� ��( ^'� /��GL x G V ��LJ.�i.11dll:Q <br /> �� v � ����i��`� <br /> a� � �-�.�C� <br /> NGV 2 3 2011 <br /> Und�r penalties of law,I declare that I have examined this application and that it is,to the best of my knowledge and belie true,complete,and correct.I <br /> also declare that I am duly authorized to sign this exemptinn application,and that the organization owning the above-listed roperty does not discriminale <br /> in member or employment based on race,color,qr national origin. TRFASURERS pFF�(:E <br /> Gf3ANp ISLAI;D,NEBRA5KA <br /> 1 <br /> S�g1A � � � I���aLIV�� ✓ ,/ r�dr�� <br /> here �uthorized Signature 7itle Date <br /> FOR CQl1NTY TR�ASURER RECQMMENDA710N <br /> [✓]�APPR�VAL CQMMEN7S: � ' ��' <br /> ❑ DISAPPROVAL <br /> � � - - / a y /�. <br /> Signature of County Treasurer Date <br /> FOR COUNTY BOARD OF EC�UALIZATION USE ONLY <br /> AP PROVAL COM M�NTS: <br /> ❑DISAPPROVAI. <br /> ����-'��� <br /> Authorized Signature Date <br /> N64raske bepal'Iment pf F4evenue Authorized by Neb.R8v.5tat.§§77-202(1)(c)and(d),and 60-3,185,and 603,789 <br /> 96-253•2006 Rev.0-2011 Supersedes 96-253-2006 Rav.5-2009 <br /> PLEASE R�TAIN A COPY FOR YOUR REGORDS. <br />