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�� 2012 <br /> �s�Fi��n wi�� E��rr�ptian Appli�a�i�r� Fo��,� <br /> vat��+ forl'ax Ex�mption fln Fi�a1 arsd Persanal Properiy by c���iitying �rganizatiaa�� �y <br /> TY.�.S5E5SpFi Read instructions an reverae alde. 6F�� <br /> \ Faiiure to properly co+nplet�ar fife this application in a timely manner shall result in a disappravaf of the�xempiipn. <br /> �� Orgarization County Counry Iv�. "Fype of Ovrnersnip <br /> CALVARY AP05TOLIC CHURCH H811 40 � P�onpro�it GcrPcratior, <br /> Street or pttrer�Aai:ir��AddrY�s State`Nhare ir;r;�rr�oraie,d � �thar iSpecity'� <br /> 515 S OAK NEBRASKA <br /> C.ity Stato 7ip Cr�da Actual Val�e p�rcel or Lacatior ID Nu;r�ber � <br /> GRAND ISLANC] NE 68$01 384,518 <br /> Legal desaription o`real properiy and y�anerai description ai a11 tangible parsonal prop�rty,ex�,spt licensed motor veh:cies: <br /> PIER PARK 5UB LT 1 #400076985 <br /> PIER PARK 5UB LOT 2#400076993 <br /> PIER PARK 2ND 5UB LOT 2#400077027 <br /> Title a4 OtEicers, <br /> Name Direckors,or Partners Address.Ciiy,St�te,Zip Code <br /> -- -------��_.._. ---.-__---------— -- - �..__... -_•. • --------------.-•-•-•-•••••-•••••.-•�-••-•--.•••-°°�•••••...............------ <br /> uS r l d 1 .c� :' ... � �-��-._��� G.T N 6���/ <br /> S r.c�C � �-.� - � ,✓ c �� _ <br /> Piepe;ty d�ficrii�ad Hhnve is usad in the fdiowinp exempt c.�•ze���ry{plea�e rri�rk the appfcak�le bexes)� <br /> �A�r:cultura:/Hcriiculiural Societ.P � Educa=io�ial �Rakigiou� �Charit3ble �Cemeter� <br /> Giva a datsi!ed d�scrption of�he use of 1he property: <br /> CC�u���. S�ar,'ur � ,���( /��1,yb�r .�c�`v;�`�l <br /> "Agri�ulturalMorticultural Sociery daes nat nead ia cvmplete the folluwing q��estions. <br /> i�all oT[he property usad excluslvely as dssdihed abova? „�YES �NO <br /> I�a portinr.nf the prpryerky used fnr ih�sa:E n!alcohuilc beve.ragc�s'� �YtS �Nq 11 Yes,st_?e the nurnt�e:�r�`hourti per vreek <br /> Is the prop�rly owncd or used hy an organi�ation which discr�miraies in <br /> membership or empluyment qFsed on race,ccl�r,or naticna!ori�in? �Y�5 �NO <br /> IJnder pena3ties cf lasv,I declare ihat f hava examined th;s ex�mpiion appiication and,to the best of my;�cnow!edga ard�etiel,it is carrect ar.d ~ <br /> comp;etF.I a;so de.clare that I ar»culy authcrized ta sirn this exernti7iem appGcatipn. <br /> �� � C �- " <br /> 5���'1 :' �!'��rC l� -%2—�/ <br /> ���� : orizad,iignaCure 'fitle Date <br /> -- -------------------------------------------------�°-°•- --°-------- —°----------_•-•_ -.• . "---�....•••••-••••-.•--------------------------------------_-�•-••�-------------- <br /> �flR COIiNTY ASSESSOR'S RECONEMEtVDAT10N T mm_�� <br /> n.'Pu:7\��:L CDMINFN75 <br /> L; A?PRC>VAL OF A POF�'IUN <br /> C DISAPFRpURL <br /> Siynature or G u� Assessor p�tv <br /> .�_,�--.-•----_.�..._....m._..-------------------------°.••••-•••••--°--..•-----•..�-••-••••.-•••°-------•-°•--°-- -- -----------•-•------•...••-� ...... ..�.--..--.YV.___________, <br /> FQR COUlVTY�pARD Q QUALIZATIQN USE t7NLY �� <br /> I der_Eare that,tr}ihe 6ast ut my:cr�nw�edg=and peliet,the dr Isrrrunation�isrehy r�ade hy,he Gniir�ty Board ni Equafizatinn is�crrFr.t pursuant <br /> ta[hc Izv��of Yhe SYate c,f Nei�raska. <br /> � Ai'PAt?VED C�MMEN'TS: <br /> .�. <br /> ! APPR�VP.L qF A PC�RT3c7M <br /> ❑ uis��pr�ov�p <br /> /—J� <br /> Sign�ture u! our:ly Br �d� , l� <br /> Je6raska Gspar;ment uf qgv�nue Authorrzed 6y'de6.Rav.�iet,g/7.c .p i <br /> �6•73�•1999 aev.7-�pYo 5Uper�edes96-135-1995 Rev.11-:,00� <br /> DEC 2 9 2011 <br /> PLEASE MAKE A COPY Ff�R YOUR RECURbS h�ALL CpUN 1 Y f�55ES50R <br /> GRANpISLAND,NEBRASKA <br />