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� 2012 <br /> ]BE FILECI WITH Ex�rrrption �,pplication FoRt� <br /> Y��p forTax Exemptian nn #�eal and Persanal Praperty by Qualifying Organizatioe�� <br /> UPlTY ASS�SSQR Read instructivns an revarse aide. ��� <br /> Faiiure ta properly complete or ti{e this application in a fimely manner shalE resull in a disap�rovai of the exemption. <br /> � ' e of Orgarization Gounty Coun;y�fJa. '�'ype of Ovrr:ership <br /> NORTHRIDGE ASSEMBLY OF GOQ H�II 40 � ���'�prolif Gorparatiqn <br /> utreei or(7ther Maiiin�Addr�es State Wiiare Ircarpnr�'ec3 � �iner lupecityj <br /> 3025 INDEPENDENCE AVE NEBRASKA <br /> �.�ty Stato 7ip Code Aclual b`alue Parce3 or Loca[i�r.ID Numher <br /> GRAND ISLAND NE 68803 1�261�511 400149583 <br /> Legal descriptien o`re�l property and generai description��I a!I t�ngible parsonal p!op�rty,except licensed motor veh{ces: <br /> HWSUBLT1 <br /> 7ifls of OHicers, <br /> Name Directors;ar Partners Address;City,State,Zip Cnde <br /> - - •° •-- .-_._-_ - -.._•_-••_•• . - <br /> M1 �, k C TA�-`TT_�_ _ � S. R�--------U�--_s"Tt..���G�--A�..Tst+4��-------�. 8'�t13-- <br /> 5`TAr'okG� kSvL �i ►E o D Au � � <br /> � FR-� t��u o �GEwon� A�vC G�.�-M, � 8' 3 <br /> �fpYl.�_....µV12P�F_y_------�--------�- -- Rn-i? ----- --------�o--- �¢�SE_S}�o�._ ---. . . ltr�_.�...----- -�---N�..------ - ---�-� <br /> M�L 'goE 6i-- �F�li17---------- 3Z0$ M �F315 :�S �fCd"3 <br /> Prc:perty rsesr.riuzd ahnve is usad i!r the fnll�wirig exempt rztE�o�)�(�i;c:asE rriark the ap�licabl�be�ces): <br /> �A.gr�uul[uraVHor;icuHuralSocizr!' ❑ Educatinnai IXI RsEigious �Gharitable �Cemetery <br /> y,�� <br /> Giva a detal?�d�ascrption of tha us�iha�rop�y:���� � ���� � � <br /> u `"r-�,,R,� � 5,C. <br /> �� �°�' �� � � <br /> u�� ��� �� r������ - <br /> 'Agri�ufturalMorticultural 5nciaty does no1 need to cvmpiete ihe folluwing questions. <br /> la ail ot th�prvp°rty usad ezc!usively aa dastribed above? �Yt5 �NO <br /> Ir ra p:�rtinr,nf the prespe��ty�used ior iFiF saie nt z.lcoh�ulic qeverages7 YES �NO N Yes,State the nutnhw"of haurs per weak <br /> Is the prop�riy owned nr used 5y an organizatlon which discrimirates in <br /> mem�ership or empl�yment hased on race,color,er nat;cna!prigin7 �YES �fdq <br /> Under pena3ties ef law,I daclare that E have examined thi,exEmpti�n app:icAtion and,to the Gest of my tnow:edga ard�aliet,it is co;rect and <br /> comp;ete.I a;so declare that I am duly auth,ctized to slcn tirs P�ernf�tion applicatinn. <br /> S� �, � �;�� �� z� �1 <br /> ���y �Au:ho' Gd Signature ,le D e <br /> - - ••-•••-•..f-----•---- - - FOR COUNTI'ASSESSQR'S RECOMM�NDATiON- ----------------�_�....�..•.--.•-••-••----••--•--- <br /> -- -- - -------------------------------------- <br /> I---- - - ........__ I <br /> �APPROV!\L cat�n��r�rs: 7 <br /> L; A?PA��VAL OF A POR710N <br /> C OISAPFROVAL ��'���-���.� <br /> Siyr.ature unty Assessor Date <br /> • •-•_-••-_-�....---- ----°�_•-.._--••-••-__••--••_- ° •-�`--------------------------------------------------•---.._�.•-•-••••--••••--�•••�------------------- <br /> ••--�.�_���_T_..�-------�..��� <br /> FQR CQUNTY BQAR F EQUALIZATIQfV USE ONf�V <br /> !decfare i1�at,Lrr tha k�est uf my kri�iwiedye and�efief,the deterrriinaUcn hsreby r;ade by,F�e Cuunty Foard ut Equalizalion is�erre:c,t pursuant <br /> ta the I�v:s of the State of Nehtaaka. <br /> APNH��\�ED CDM'�A�NTS: <br /> � <br /> --• <br /> ; A?PROVAL QF A PDRTI�M <br /> C DISAWPHGVwI] / _�� <br /> ignature of C a;�rc1 ember <br /> �le6raska�apar;ment ut aevanua . ` ��r' 'f , ,� . 77.2b2.0� <br /> 36•135-7999%�ev.7-_07�Supersedes 96-135-�999 Rav.11-?008 <br /> PLEASE NIAK�A CDPY FOI�YOUR AECpRDS NOV 2 2 2011 <br /> ��:.L.. .:�'.l�.;i.�. . �j�.J�j,�.liS�l! ' <br /> GRkt'vli;;�_�. ... .���ASKA <br />