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��° 2012 <br /> T E FILED WITH Ex�mptian Applicati�rr �o�M <br /> Ydup fo�Tax�xemptian on Re�1 and Personal Property by Qualiiying Organizatians ��� <br /> C u SESSQF' Read instructions an reverse side. <br /> FalEUre to properly cortsplete or ii{e this application in a Eimely manner shalt resull in a disappravaE of the�x�mption. <br /> tia e f Or anization G'ounty Goun.y IVo. '�ype�f Ov+n�rehip <br /> T BITH HOME Hall 40 � ����ProlitGol'pofatiar, <br /> „p'eet or 4thPr 1Aai:ing Ad:9ress State 1Nhzre tr;,•orfi�rir;�iPd � Oih�r(Specilyl <br /> 4720 RANDOLPH 5T N�BRASKA <br /> �_j�y StatQ iip Cade Actual b'alue Percel or Locatiar,In Nu%nbcr <br /> LINCOLN NE 68510 PERSONAL PROPERTY <br /> Lagal descriplicn o°real property and generai descripGon af ail i�n�ible personal propeR�+,except licensed moior veh�cies: <br /> PER50NALPROPERTY <br /> ��OLD FAIR RD), <br /> Title af Q4licers, m� <br /> Narne Airectats.or Partners _Address.City,State,Zip Gade <br /> Prepe�j cescriiazd ahnve is iisad in the fd3nwiri�exerript�t�yn���(riieat.e rri5rk the apr.�liGaWP bexF) <br /> �A�ricultura!/F{criiculiural Sociery° � Educational �Refigiqu� �Charitable �Cemetery <br /> Gi�a a dstai!ed d�scription of tha use of the propa�ty: <br /> p��c� S�a�.. -�v�- ►"es�i D na.l ��.i-�h cAstie� Proc�ra�v-n S <br /> "agriculturalMurticu€tura!Society daes noE need tc�completa the toll�g questions. <br /> " Ic all of the property us�d exciusively�s desui6ed above? YES �NO <br /> ls a tiottior.uf the pres(sF��usad fur The s�le ni alcohoiic beverages? �YtS ND li Yes,stn:e the+iurnher n9 hnurs per week <br /> Is the property owned or used hy an organizatian which diserimir,ates in <br /> memhership or empl���yment hased on race,ccbr,or naticna!origin? �Y�5 �JO <br /> Under penalties of law,I de�are that I have examined this ezemption app;ication and,to the best of my�nowiedga ard baliet,it is torrect and <br /> c I aisn d�clare T�at I ar�i culy auth;crized to slCn th;s e.xemptinn appl!catirm. <br /> � r� �a���� <br /> s r g �- �i��or ��c����,5�i- Ct-v <br /> �AuJiarized Signafure T;tle Date <br /> ��� <br /> •- _�W___..._-------------• •- -------_•_••.-••••-.•--------------------------------------------------------------------------------------•--•°---------•-----•--------------------•-J <br /> �DR COUM7Y ASSESSOR'S RECOIIMMENDATlC3N � <br /> �A?PFIOVAL CONME�JT.i: ���0 !� r" �"��� <br /> L A?PRJIAL DF A POATIpN <br /> C ❑ISAPFROUAL ,—'��` �� <br /> Signalure ` ounty Assessor ❑ate <br /> r --••-°-°••.-•-,----------.W--•••-•-� �_.�.•---•----------_-•_•_••-•••••..� -- ------------------------------------------------------------�-•�--••..-------•-----------•---------------°-•-I <br /> I <br /> �OR CaUNTY EIOA OF EQUALIZATIph USE qNLY <br /> I decl�re.11iat,tu the k;est of my knr�wiedg�and belief,ihe dnlsrminaUcn h=rehy rz.ade hy,he Gau=�ty Fo�rd nl Fyua(iz.atipn is�errect pursuant <br /> to 2hr lau•s of the St�te c�f Ne6raska. <br /> � APPHOVED GDMMEN75: <br /> � A?PF1CtVP.L OF A PCJF�TIJN _•••••-___„_ ___------------- <br /> T <br /> -----------------------•---- <br /> - <br /> ����� - -- - <br /> ❑ DISAPPRGV�Q �"� ��+� <br /> .ignature ui L'o rt� ar �.9emi�er ? <br /> �ehrnska Gapar;ment u��evenue o e . ,�1a4.§77-�02,0! <br /> 38-135-1999 Rev.7-?01Q Supersedes 96-735•7999 NeV.11-2000 ' <br /> HALL CDUNTY H�����0� <br /> PLEASE MAKE A GOPY FOR YQUR I�ECDRDS GRAND 15LAND,NE�R�+�� <br />