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, �� i��nwaTw E��mption Appiicati�r� �Ot�M <br /> ouR �fl�Tax�xemptian on Reai and F'ersorral Propertyr by t�ualitying �rganizations ��.� <br /> UN ASSESSQFt Read instructinns an reverse side_ <br /> .� Failure to properly campleFe csr flle this application in a timely rnanner shalE result in a tSisapproval pf the exerrrpiion. <br /> 'ame of Organization G'ounty Coun:�Ido. Type of OWnErship <br /> MOSAIC Hall 40 Q �'�"nprolitGaiporation <br /> �tree.i or Ottier 1.9aiii���]ArJdre�s 5tate lNhare Ircory�rrrated � C�iher i5pecityl <br /> 4980 S 118TH ST NEBRASKA <br /> �,ity Stato i ip Gnde Actual VaD�e Parcel or Locatiar,Ip MumG�r <br /> OMAHA NE 68137 <br /> Legal description of real property and�enera;dasc;iption nt all tangible p=rsonsl p>op�rty,excep4 licensed molor veh�cies: <br /> PERSQNAL PROPERTY(OFFICE-2846 OLD FAIR Rb) <br /> Tit1e of O�cers, <br /> Name Directars;or Partners Address.City,State,Zip Cvde <br /> ••---••.�-•-._--•-•.----- -- ----_.��_�__...-----..._T ___�_._--•....�•-••-••_•••-��-••�--- -- -------------------------------------------- <br /> Linda Timmans PRES/CEO 4980 S 118th 5�reet Omaha NE 68137 402-896-3884 <br /> Cind Schroeder CFO Same as above <br /> F'YC�]tl�'I�f UG'5CIIL�B(�BfJfJVB�5 l:S2C�I�thP,fUIIOWICI�exerript r.ate�f�t)�(;iiease mark the applica6ls bexes): <br /> �AariculturaiiWcr.iculiural SocielV' � Educa?ia�ial �Religiou� Q Gharitable �Cemetery <br /> Giva e datai!Ed dascr�ption of tha use of the property: <br /> Office Administra�ion. This property is used exclusively in full filling Mosaic's <br /> mission �o serve peopl.e with developmental disabilities. Masaic is registered with <br /> the Secretary of State Office as a Nebraska non profit Corporation <br /> "Agricultural/Horticultural Society does nat need to compiete the fol3owing quastions. <br /> Is all 01 the prpperty used exctusively a�describrd abova? �YES �ND <br /> Is��iartinr of iFie prorie!fi�used tut iri�saia ni elcahiulic beverages7 �Y�S �ND H Yes,st�'e the nt;rnher r�f hours per weNk <br /> Is the properiy owned or used by an organization which discrimirates in <br /> memEership or empl���yrr,ent basod bn race,acl�r,pr nation3l oriain7 �Yt5 �ND <br /> Under panalties c(I�sv,I de�lare that I havic examined this ax�mption application and,tu the test of m��know�adg�ard Celiet;it is coneci and <br /> r.omp;ele.I'� -are inat 1 arn culy a hcrized to sicn tlrs exern��tiun ap�tlicatiun. <br /> ,S1C�1�1 V.P. Fixed Asset Development )(;�i�-p� 1 <br /> ��r.� �A or a Slgnature T!tle pate <br /> ••-•-•-•___m_�__..---- .�.�._------°--- —_-.____...._.____��_.___._ --------------------------------------------------------,---.�-•--••.•-•••._•-°-°° <br /> I�� �OR COl7NTY ASSESSOR'S RECOMMENDATIfJP� � I <br /> � A?WfiOV!\L CoMM�tJTS: �!¢11an� 1 1.`�c�� <br /> - �--–– <br /> [� A?PAO+lAL.OF A PnATICiN <br /> � �ISAP?ROUAL <br /> Signatur o.County Assessor ate <br /> �••-..�-•-••.m__._...•---- ..�•-.•••-..--••,------------------••-••••......._..............�.• .-•�••••----•--._.....••.•-..........-•••-•••••.....••••_-•-••-------��-.•••-•-_•-----•••--•���.--°•------------------------- <br /> F�R CAUMTY BOA OF EQUALIZATIDN USE ONLY <br /> !deelare tiiat,ku t}�e haat a9 my knnw;edys and beliet,ihe deterrninaticn h�reh�r,ade loy Jie Cnunty Soard nl Fyu�liza7ion is cnrrec.t pursuant <br /> to�he lawc of Yhe�Y��te af Ne6raska. <br /> A�PHQVEU COMMEN'T5: <br /> �_�. <br /> ° A?PR�JVP.L OF A PbRTION <br /> � 1�16AF'PRGU�L� �' '� �,�,1-.. <br /> , gnature uf c�arrty :1em er - e� <br /> 1e6raska CJepxr;ment u�Rev_nue .Autharized by'deb.Rev.5tut.§77-202.0? <br /> ,6-13:-1999 Hev.7-c019 5uparsedes 96-135-�999 Rnv.Y i�'�OB � <br /> NOV 2 2 Zn�� <br /> PLEASE P�IAKE A COPY FQR YQUR RECQRDS <br /> NALL CE���•�i 1f hSSE�SOR <br /> Gi��Nl7 fS�.�1[�ti�3,�tiEBRASKA <br />