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�� 2012 <br /> -roa� i��owiTH Ex�mptivn App(icatiar� FoF�6� <br /> ��, ����p� f�rTax Ex�mption on Real and Persnnal property lay t�ualifying arganizaticsns 4�� <br /> ` Read instructions on reverse side. <br /> Failure ta praperly complete r,r fite this applicatian in a timely mannsr shalE result in a disapprevat of the exempt[on. <br /> ''Va e of Orga,za[ion Gounty Ccun;^�Na. 't'ype��f Owr:arship <br /> �SSIAH EV LUTHERAN CHURCH H�II 40 � �'JanprolifCorporation <br /> � � Stale.Whare Irx;nr�or�?ed � Olhar{�petity'� <br /> treai or pt}i�r 1.9ai'iris�Ad:9resa C <br /> 122 W 7TH ST N�BRASKA <br /> �.�� 5[at� i ip Cnde Actual Value Parcel or Locatior ID Nurnter <br /> GRANI�ISLAND NE 68801 856,092 SEE ATTACHED <br /> Legal dessripticn o:'real properly and�Enera!description of all tangible parsonal property,ex�vept licansed moior veh�c;es: <br /> 5EE ATTACH�D <br /> 7i4)e af ONicers, <br /> Name Dirackors,or Partners Addr�ss.City,S#ate,Zip Ccade <br /> --..._�_�._. _-_. _.--�-------------------------- --------�-------------�--��T-- ,� ----------�r--�------------- -- ------------�--�-�--------...._... <br /> e r� res� �d N� �b <br /> e s re.s;d Gv- ��t s;a�., � /.T �. �.� <br /> � � �n r� i�c� r • .TS � <br /> --��xa--_14.�►s°���1_� _.P�is��r----- —�7_7_��.k_�_�..*-.�r.sc���T�'I��rc�r--__�t�,l..��.._.���D-I------- <br /> PfC�78�t�J CC'SCYIi�B(�Hf)OVt.I$LJ52CI I!I tFIB fC1�IO1MIYl�P.XO'fl�]I l'.SCEy9f��(t�iease reiyrk the applicable bexrs): <br /> �A�rieultur�iiHcriicultural 6ocieh/" � Educa*.iaial �Religiou� �.r,haritah�le �Ce.�netery <br /> Gi��c a detaiied descrEption oi iha use oi the prepa�ty: p <br /> �a.r�C,'n� ,�o�s , ��urC �., V c�.�'So�tct9e.� G�+�d �ac�A �/GcCa..�,.� �o�s <br /> 'AgriculturalMortioultural Sooiety does not need to complete the fallowing questions. <br /> Is all ot thb propsrty usad exciusively as descrlbed above7 �YES �NO <br /> I��ri:�rtian nf ihe prcpritty used for 9tie sa:e p1�Jwhuiic bev�ryt�es7 �Y�.S �tdp Ii Yes,sta!e the rwrnhe�ni hours-per week <br /> ls the ptoperty awned or used by an organization which discrimirates in <br /> mer�orship or empl�yment l�ased on race,cclor,Qr nationa ori�'n7 �Yc5 �NO <br /> Under penalties cf I�tis,I declare ihat I have examined this examptipn appiication and,to the best of my�ki7owic.dg�ar,d�eliei,it is conect and <br /> compiEte.I a;so dedare tnat I a+n duly authcrized ic�sign tttis e�ern��tion applicatinn. n� � ��G�3��_��/'7 1 <br /> �� c3o <br /> s�r�n � 1��.�. /�-�/I <br /> h���,q Au:horiz�d6ignature 7itle aate <br /> -•°•-°------- .�_.�_._ __••---------�---••------- ���.•-• -•••••-�-_ _.._---•••--•••-••••.•-...�_..�--••-•--•---------•---� <br /> I � N <br /> FDR Ca13NTY AS5E550R'S RECOl4EMEt1DAT10 ------- <br /> �/ .q���i�Vl�� vvif�ViCi�i S, � �l/ �JYVt �� 1 `�'a�1 y� , <br /> I Y� me� <br /> / ` _____ _.___.__.__ ___.. ..__.. <br /> � A?PRqVqL DF A PORTIQN <br /> ❑ d���pF��U,� � c— t�--�� <br /> Sigr.atu ' euniy Assessor �ate <br /> ----_..._----_•--•_---------°-°-••---------_.•-----�.���-------.-___••..••-.._,_— --------___•••--°•-•-•••------•--------------------------_._-••••-�•------.._._..�----�._-•••--_•.•- <br /> FQR CQUNTY 90AR 0��Q�3ALlZATIpN USE qNLY <br /> I deefare,ihaf,tu'the Cest of my knawiadg�and fuelief,ihe rJeterrninaUcri herehy r,ade by:hc Ci�unty Fonrd nt Frauali-ratinn is r.errect pursuant <br /> to the Izv,'c of the State af Ne6raska. <br /> �A?PHOV�[] COMMENTS: <br /> __. <br /> ' A?PF16VP.L OF A PGRTION <br /> C pISAPPRGV�L7 , � ��l� <br /> ,ignstura oi Cour,ty E3oa d�,9 er <br /> Nabrdsku Gespar:ment ut aev^nue o� d ..tat.§77�20E.0� <br /> 36•i 35-1999 Reu 7-�07 o Supersedes 95-135�.999 Nev.11•'_008 <br /> PLEAS�tv1A,KE A COPY FORYOUR FiEC�RDS �EC 0 7 2011 <br /> HALL CDUNTY ASSESSaR <br /> GRAND ISLAND,NEBRASKA <br />