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2012 <br /> ���Epw,T� Ex�mption Applicatia►r� �oRM <br /> YpU� iar7ax Ex�mptic+n on Rea! and Persanal Prop�ert}r by Qualityireg arganizations ��� <br /> COUN7Y F,SSE55OR Ftead instruttians on re�erse aide. <br /> � Failure to properly complete nr fite this appii�atian in a timely manner shall resuit in a disapprova[vf the exemptian. <br /> ;vame of Orgarization Counry Couny fV�. 'lype of tlwr.ership <br /> WOOD RIVER MENNONITE CHURCH H�II 40 � PlonpralitCor��oratior <br /> � Sta1e�^lhare Ir;r,or anra?ed O1her{5pecily) <br /> ireei or Crttisr TAai�inp Addre�s I <br /> 14988 W HUSKER HWY-ATT: hiEAD TREASUR� NEBRASKA <br /> �i�, Stato 7_ip C�ide Actual Val•�e Parcel or Locatiar Ip MumUer <br /> WD�C]RIVER NE 68883 808,155 400196719 <br /> Legal dascript!en o`real property and gene;a desoription oi ali langible per�onal proparty,ex�,ept licensed motor veh�cies <br /> CAMERON TWP 25-11-12 P7 SW 1/4 (CHURCH) <br /> Title of Ofiicers, <br /> Narr�e Directars,or Partners Acidr�ss;City,Sta4�,Zip Cvde <br /> _ ••- �.------- -°••-••-•.�.___----------------------._.--.•••--•.•-.•-- ....•.•••••••-•.•._--••------------- <br /> :�,�---------SNA2�------ �iz�.tSu.�+z S.I SD'" 1� I� A/� 1.��5 3��D l I PN <br /> sT.a �rc.� zr-�,.d�. .A�s'r. � w S-� � '� ^,� �•u . Al� G���3 <br /> Prept�;Ty c6sr.riUzd ahnvr is�:�ad in the followiriE exNrript c.xtE�nry(��ieas6 rri�rk the applVr.able bexes): <br /> �Agr:culturai/Har�icuRural Sociei�l" � Educational �Religious �Charitah�le �Gemetery <br /> Giv�a detai!ed dsscnption oi tha use of th�prope�ty: <br /> W�l�-.C� CRrG(/�f� ��viC�S. D���lDai.QC �F.�in.�s, <br /> (sw-5�.�..oey�� <br /> 'AgriculturaUFlorticuftura(Society does not need to cc�mplete ihe following question5. <br /> ��ali oi th�praperty usad exc;usively c�a described abov�7 �YES �NO <br /> Is a jioCtinn oi ihe prG�3e."ty used fur tYi�saia nf alcohaic 6everages? �Y�S �hlO U Yes,s1atP tha rturnt�er o?hnurc per week <br /> Is the proparty owned p�'used by an organization which discrlinlrates in <br /> membarship or emplcyment b�::sed on raoe,color,er naticna:orig!n7 �Y�5 �NO <br /> Under pcnaltics cf lasv,I da�lare ihat I have examined tliis exemption app:ication and,fo!he Y�est oF rc;y know{edge ard bolief,it is ca;rect and <br /> comp;ete.I aiso declare thzt I arn culy authrsrized ta slgn th:s r:�ernptinn ap�licatinn. <br /> S��� ��-�-,�� �d�� — l JCE��C.1�'�- ���.�s'�� � <br /> n��a� �Au:horized Slgnature Title flaie <br /> -- -- ••• •-- - �••••-••••-_--.-••.--°•.•--•---• �_•_••-..��.••-.••••------- <br /> L -�. �-•-•�...^--.�-• ._------.�.-•°FOR G6UNTY AS5ESSDR'S RECOMPu9EtdDATIDAI <br /> �f, APPHOV.AL CONMIE�JTS: �.✓ � �...,. n.V� ���`c�E�� <br /> �C ------- <br /> � A?PADVAL OF A POaTIrJN <br /> C nisaw�ROV,a� „ l-- 1q— l �-- <br /> Siar.atur o Cuuniy Assessor DatF <br /> �� _�-.--••--•�-----------• -• '- _• •• .��_..•-----•-------------------------••-�•.••••-_-•-••••••--•---_-_ <br /> � T f FOR COUHTY BQA aF EQUALIZATION US�C1NL,Y <br /> I der.lar�thac,ko t�ie rest uf my�cnowledy�and uelief,iha detprr7�inaiicn h�reby r•,ade by,he County Foard uf F.yualization is�errec:l pursuan4 <br /> to�h�lav;s of The.4'.t��Te of Na6ta.ka. <br /> �A?PROVEiJ ��M�dEN'75' <br /> -•-. <br /> ' A?PRCSlP.L OF A P!'1FiTiON <br /> ❑ uisa��r�ov�o � ��'! ;� /c�/-/e`1— <br /> 5i�nat o Cour nar 1,9eml�er 7a.e '-- ° ' <br /> e6rsska Depurment uf Revenue N O V 2 tQ„'Z 0 7'qe4.Rev.Stat.§77•to2.0� <br /> 0-13�-1999 FteV.7•c01 p Supersedes 96•135-1999 H4v-9 b2008 �' <br /> PLEASE MAKE A CQPY FOR YOl1R A�CORDS HA�.L COU��Y /•1S`�ES'u(i!i <br /> GHANDlSUIND,NESRASKF. <br />