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�� 2012 <br /> -rcag� i���wiT� Ex�mption Appiication FoRM <br /> r v uR ta���x Ex�mptian on Real and Personal Praperty by Quali#ying organiaations 4�.� <br /> ` C UNTY SESSpR Read instructions on revatae sidc. <br /> ; Faifure ta properly comple'te or fil�this applicatian in x timely mannsr shall res�lt in a disapprovat of the ex�mpiian. <br /> . ' me pf rgar a[ipn G�DUnty Ccun;�fVo. 'Iype of 07rr:Ership <br /> T RY'S CHURGH-WOOD RIV�R H811 40 Q ��'}�protit Corporatior <br /> ` Street or Oth�r�,9aiiiri�Address State Whare Ircvrt�nr�:ec: � Oi?tar{Speci'lyl <br /> P� BOX 37- 1108 DODb ST NEBRASKA <br /> �i1y Stato i ip Gp;lP Actual V31ue Percei or Lacatior ID NurnL�er <br /> WOOD RIVER NE 68$$3 1,199,002 <br /> Legal descripi�cn o'raai property and gene;ai descriptian�f all tangible parsonal p!oparty,except licensed moto;veh:cies: <br /> WOOD RiVtR VILLAGE FIRST ADD TO WOOD RIVER ALL BLK C(CHIJRCH)#400177269 <br /> W�OD RIVER VILLACE CHAMBERLINS ADDiTi�N LOTS 1 &2 BLK 2 XC W 7' (RECTORY)#400178176 <br /> Titl�af Qtticers, <br /> Narrse Direckors.ar Partners Address,Gity,State,Zip Code <br /> - - - _�_.�W------°- --------°.•-_-•.•••-•••-._..�- °---..�_..--•-....-•-------------- -----------------Y-------------�..-----�--•--••••- <br /> ° ••• • •••-.�..�-------------�.-�---- <br /> � ° "f �ry/� ,ufi ' d,n r��-r n f- t� �r I �r I v _ � � ��- ----- <br /> ���� r �5 J I 1 Y1�c n V� ' Xl g /a g l5 <br /> a � � . �t" i 0 a L o�d , � � 3 <br /> Preper hj cESCrii�ad�hnve is usad in the ic�llowing exetnpt�teyriry{��ie�se rnerk the applicabiP boxKS): <br /> �A�ricultura:(Hcr,iculdural Society° �Edt�ca�onal �Religinua �Charitable �/Cemetery <br /> - ------ - 7'C <br /> Giva a detailad description of hc use of tha prope�y: . � <br /> `� �� "" `_ s�2���-- ��- a� -��-� }tr��' <br /> �.�.�. .,�° <br /> �, �. � �,e�..; � � �_ � �-x-.�-. �,.�,�.� � � <br /> c�-}-�4. �.�.,,�,�� �`�`�: '���- " <br /> � . v _ <br /> 'AgricutturalMorticultural S�ciety does na�nae to complete the folluwing quas4ions. � ��� <br /> � d� �a _,u•�c�-, <br /> Is all ot[he propar[y usad exc�usively as described above? �YtS �NO <br /> Is H�i:,rtior.nt the property uKed tut ifi�saie of alcoYiulic beverayes7 Y�S �NO I!Yes,std?e the nurnY�e�q'h�urh per waek <br /> Is the prop�rty owned or used By an organizaiidn which discr:inirates in <br /> memGorship or emplo,yment based on race,color,or naticna!ori�in9 �YES �fdp <br /> Unde alties ct lasv,I deJar ihat I have examin 37is exarrption app;ication and,to t e best of my xnow:ed e ard b lief;iti5-4orrect and <br /> cnm��efe I• o r'ecl�re t�at I arn y autt.crized tn sic this eaernptEon a �c.atinn. �j-��� �� <br /> ��/� /4S�-f'�� . <br /> . �' �n � . ���_ <br /> s�g _ � ; --� � -3��._.�-��y. <br /> ��y :h rized Signa4ute Ttle �� Date <br /> –...-_••••-•_�.----�•-_•-•••••---•-�••- _•.-----_- —_------.-_----._-••-••••--•-•-.•-••-•.-�-•----•------------------------------------_---•–•. <br /> ---------- F G(3UMTY A55ESSOR'S REGOMbAEPII]ATION <br /> �APPFiOVAL CO���viE1;5: _�� P.,;;,.�� ��d�� .._.�__.�.. <br /> L A?PROVAL OF A P�RTIUN <br /> ❑ LlISAPrR�VAL � –'�q`��_.v <br /> Siyr.atur o�County Assessor Date <br /> ..__•-.-�••��-�.--.••_-°°°----.��..�._T---__.._•------ --_._.__._._._-••-•_-_- ,-.••-•••--••--••••..•._•-•-.�_._.__..�----------------------------------------------------•-��--�.•••.•••••- <br /> FQR COUNTY BOA OF EQUALfZATIpN USE pNLY <br /> 1 deetare tliat�IO T�IP,k1@SI Uf.TIY KfIfJW�dfJ�P and uelipf,the delerrninat:nri h=reby r.,arJe hy,he Coiinty Foard r�}Equalizatinn is cerrect purouant <br /> to<.he lav�s of the 5tate cd Nebt25ka. <br /> �A�PHQVEl7 C�M�IENT5: <br /> L; APP�iOVAI.OF A PbNTION <br /> -----•---_ -••-••.•_- -••�_•••••-•_••--°-.••-•.._.._ -----------------------------------,_���.._���_-°--°••-•--• <br /> ❑ DISAPARGVMD � �����I� <br /> Signsture uf Gour� ua� hieml�ar pate <br /> 'ehrdska Gspnrtment uf Aev=nue D��lu[hgriz�hyj�@4���.Slut.$7)-�02.��. <br /> .6-135-1999�eV.7-POY 0 Sup�r�ndes 96-135•7999 Rev.11•'DOB � ( <br /> i. I�L l, <br /> PLEASE MAKE A COPY FOR YOUR R�CORDS H��� �'Q�NTY ASSESSQ�{ <br /> GRANp ISIAND,N��RASKA <br />