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� ' �.o � �, <br /> '1°�—� Applicat�on for �xemptian F��� , <br /> Mebragtie Figpa.rtryl�,ht of <br /> ��UE irom�MotorVehicieTaxes by�uai(lying Nonpraiit Organizatians <br /> ,. •7o be Hled with your county ireasurer. . /j�� <br /> •Aead Insirualio�s on re�rerse side. ^r <br /> /�PPI i's Nama <br /> -Fype af G\vnership <br /> S��� ��Nanproiit <br /> Sfreat or Qther M2111ng Address Counly ���Carporallon <br /> ��'�. � 6 ld �.',� �a�I <br /> "1' n Siate acher s <br /> � ZP�B SEalaWhere Inmrporated � ���� <br /> �F' S n-.��� c��c�� � - <br /> IDEN7IFY QFFICEFIS,piREC70RS,OF]PAR?TJ�RS OFTHE NdNP#iO�IT QRGAf�[IZATI(?N <br /> TNe Nama,Adtlress,City,S�ate,Zip Cpde <br /> �� Q <br /> bESCt�IPTION OF?HE MQTOR VEH]CLES <br /> •Attach an addfUanal sheet,If necessary, <br /> RagistraFion Date or <br /> A1nlorYehleleMake aiodelYear 9odyType YEhicleloNumber patenfAcq�isitto�, <br /> �'i�lewiy Purchased <br /> �:�;75� � � ,C,,,r� f f � 1� :� �70 . <br /> C r i/✓u(.�.-� �6 r C� 6! a Z <br /> Li. vr� � � - G . u.�`�F1�. 71 ` <br /> �.�.a <br /> Exempt Uses af Mo1pr Vehicia; Ate the motor vehicles used sxciusively <br /> Q A.griculturaVHorticultural �Educational ��['igious ❑Charitabie ❑Cemeiery esindicaiad? <br /> Giva deta��ad description of use,induding an expiaraa�ion if m�ttipla usazlassii'�cations axisL �YES QAtO <br /> ?� fiv��,�sp��r .��r�� ���� �to K�a � a �a <br /> �.P�'�a y�'�7�+�``s c�� c.e3.�-t:�.�°�,,'�r oc�7{'i�j s. ----�r�,������� . <br /> JAN 1 2' 2�12 <br /> Ura9ar periatGes oi Isw,l daclare ihat!have auamined ihis applicatiott and ihat it Is,io the besi nf my kriowfedge and baG (,true,compl�ie,and cor�ect E <br /> stso declare lhat I am d�fy aultmrizsd to sigr�this a%�emption applicafion,and ihat the cxganizsGon owning the aEovs-list praperty does no�l�(,i,rqft�t�N'Y <br /> In mem6arship w emplayment ba d on race,color,or na�onai origin. <br /> TF2��=.:'a:t�-RS C"r'1=1C� <br /> GRAfw�.�:;L.;'•.P�:!.;,' �3F:�;:SA <br /> 51 C,�11 �� <br /> �� . iT \� - �� <br /> here Authorized5ignature T"�le ' °�—�",.� pats <br /> FOR CpUNTYTI��ASl1RER gECpN{M�NaAT1ON <br /> �APPRQVAL CflMM�A€T3: � �r , �`�-'r� i'��-�Z-C.�.�1 <br /> ❑DISAPFAOVAL <br /> . � , , �--1� ��� <br /> Signature nF Cou�ty Traaaurer pate <br /> F�R COUNTY BOARD aF EpUALlZA17�N US��N�.Y <br /> �APPROVAL COMMENTS: <br /> ❑DISAPPROVAL <br /> � '� " '2 �1�1�- <br /> oriz gnalure Daia <br /> �4atxeska DapahmerH ot Fwenue Ainhmized by N�p.Rev.5iat gg 77-8P2(7)(c�and(dl,ar+d ata-a.�as,a�6a-s,ts9 � <br /> as-zs3-sooe F3sv_s-av�i supersedes ae�zas-zoo6 Rw.�zona <br /> PLEASE REfA11+!A CpPY FAFi YOUR REC�RDS. <br />