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�� z012 <br /> 7C] E FIL WI7H Exemption A�►plication �0��'� <br /> Y A fa�'Tax Ex�mption on Fteal and Personal Proper'ty by Quali#ying Qrganizatians �S� <br /> ` � SSE SC7Fi Read instructions an reverae side. <br /> aiEure ia properly complet�arffle this applicatian in a fimaly mannsr shalt result in a disapprovaf of the ex�emptian. <br /> Count Gaunt�No. CYPe of Oamership <br /> �ame Or. '� tion y <br /> �all 40 � Nc'nPrctit Gorpr�ratior <br /> Y M A � Dtner�Specityl <br /> Streei or pther Ylaiii���1 Addr�ss Slate Whzre Ircorr�prated <br /> 221 � SOUTH ST NEBRASKA <br /> Stato iip Cn:ie Actual Value F�rcel or Locatior,ID Num�er <br /> c'jv 5,282,855 40D004097 <br /> GRANa 15LAND N� 68801 r� <br /> Le�al descript;cn o`rezl property and genera:description of all tangible parsonrJ p%opaHy,excap4 licensed moto'veh:cies: ��r ��r 9� l,�Z <br /> ORIGINAL TOWN ALL BLKS 52 &53&PT VAC KIMBALL AVE (LAND OWNED BY THE CITY aF GRANb 15LAND) <br /> ANb PER50NAL PROPERTY <br /> Titfe ai Oiiicers, <br /> ���Q pirectats;or Partners Address,City;State,Zir Cvde __� <br /> -- --• ------._.�..- -- - -•--- °°--------•••�----------- ---------•.•------- <br /> _..••-------.._ ---_..----•�- <br /> -- •°- <br /> .... � <br /> �._—_____"T—" --.....—__"""'_--�__n""' r ��C <br /> � Y^_.' 1� I"cpS�rrKP � v�CPr' W�l , <br /> � -- ie� rC � o� r S � <br /> r� ' r <br /> _ R 5• ` /' • <br /> - f ---- -- ------ - ��c�-- ,e� irr _ .�--w, 3� _.Y.�1.`�x � --- - --����-------�-�----- ��- -- <br /> '-� ��. d[ � � �� �1 <br /> _ o� <br /> Pt'e{ierty cescrivad;�bnve is usad iri the:folinwirip exe!npt�Cegnry(piease rnark the ap(�licable k�oxes�: <br /> ❑A rc�ltura!(Hcr:icultural Society' � Educaional �Religio��� �Charitabla ��g'netary <br /> �, • �� <br /> Giv�a datal!ed descr?ptian af[he use of��prepe�ty: <br /> �l� ra ��t� ; �?h� �`S �ts"�� %� s+-� dr 1� :� c�r.���v�9 r�x w�s- <br /> L�C � f.:��f C�1�� v r� �Gr/'" /7a Yl f'3� ' ���t e ��1.liC �I S S%Drl . <br /> � �� <br /> �P � <br /> ^AgriculturalMorticultura}Society does nat need to complete the following questions. <br /> 1� <br /> "s all oi tha prnp°rty usad exc�usively a�described above? ��}G YES �NO <br /> Is H p�rtlor.�if Th�prope�ty'used ior the saie q1 alc.ohoiic beve;ages7 �YwS �f0 H Yes,sT�?e the nurriber r�f hcxir;per we.ek <br /> is the praperry awned or used by an organi�atian which discrimiratas in <br /> membership or empLrymerrt b�sed on race,color,or naticnai origin? ❑�'�� ��p <br /> Under penalties cf law,I daclare ihat I have examined ti�is exomption appiication and,to ihe test ot my knowiedga ard 6elief:it is corr�ct and <br /> cpm��ietr:.I ais�declare that I arn culy authr,rixed to sinn ihis e�ernptinn aprititatinn. <br /> 5��� � ��-� _ L�css'%��ss �%,��- l��� ��ll <br /> �Au:horird 5igna4ura Title �aie <br /> her'e <br /> - ------------------------�--�-------------��-�------------�-�-------------------�------------��----------.....-----------�--�--------------�--�-----------��----�� <br /> ---------•-•"---°-°"_--•------°__---��.�.�---°---f...•-------°Ft7R CQLIt�TY ASS�5SOR'S RECONIMEMDATI�N <br /> �A?PROVIL <br /> GOMtv1EEJT5: <br /> L; A?PR(7JAl.OF A PO�iTlON <br /> � I]ISAPFRbVAL ❑ate _ <br /> Siynature a unty Assessor <br /> –° •- _�•_---°--- ••..T- _•---�••--- <br /> ---•�-----°.•-_-------_•••r--�_••••----------�..�....--------°•----- <br /> _�•-•�----°----.�_—...__.�•••--�--•--°•--__•--- � __�.'FQR COUNTY 90AR[7 F�QUALIZA71qN US�t7NLY <br /> i dac:lare liiat,[a triP hest.o'f my know;ads�°and baliel,the dr,le�rciinaticn herehy r,ade by;he Cniinty Poard r�i Fqualic.atian is cerrPt.t puruant <br /> ta th�lav�s of the wtate of Nebtaska. <br /> �,l Ai'PROVEI] C�M?utEN'7'S: <br /> / <br /> � A?PROVAL(7F A PpR-fiON ----°°°-----�•••-•_---•°•-------------°-----_•-_.-----------°------- <br /> ••_--�•-�T– -•----- <br /> �l/� <br /> C DISANPHG4�D �. <br /> Sig��&ture oi . � �B td hlember _ � <br /> .4uthot�zed by Ne6.Rev.6tat.§7-zOZ.�� <br /> !pbruska I�ep�r;mant ut aev°nuw � n <br /> ;6-73_1989 Rev.7-;07�Suparsedes 86-136-1999 Rev.17-P006 D E C p� S REC�U <br /> PLEASE MAKE A COPY FOR YQUR RECORDS HALL CqUNTy ASS;�SSd� <br /> GRAND ISLANU,N�BRASKA <br />