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- 2012 <br /> C BEFIL�DWITH E�����,�� /��pl��'i[����� �$��i�i� <br /> YOUq forTax Exemptic�n on R�al and Persbnal Property by�ualifying Organizati�+�s /� '`� <br /> COtJ TY:,5SES5pF; Read instructions an reverse si��. `�� Y <br /> , FaiE�re ta praperfy complete er fi{�ihis application in a timely manner shall resull in a disapproval a4 t92e exemptian. <br /> Nams of Qr�arization County Ccvn:y fVo, Fype��f O�rmersn;p <br /> � ����nprolit CorG�ratipr, <br /> CAPITAI. HEIGHTS SWIM CLUB Hall 40 ❑ <br /> �treet�r Othar 1�9ai;irig ArJdreas Staie Whare Ir�r,orpnrs?ed � !�tn=r(Spacily�i <br /> PO BOX 5582 308-385-�758 NEBRASKA <br /> City Stato i��(;��;�p Actual Val�ae Percel or Locatior.ID NurnL-�r <br /> GRAND 15LAND NE 68802 35,300 400398109 <br /> Legal des�=rlpticn o`:recl property and y�enera;descrip6on of all iangible parsonal p!op�rty,exoept license•�motor veh:c;es: <br /> CAPITAL HEI�HTS 3RD ADD PT LT 1 BLK 2 <br /> �TAXABLE P�RTInN-#40D153289) <br /> Title af Otficers, <br /> Natne Direclors.ar Partners Address;City,StaYe,�ip Code <br /> -------- -----------------------•-------°-°-°._._�.....��--••------...._..._......•--•.....�. .....--•--•--.. _. ...._..----••-•---�-• <br /> -------- ------------�..�-�--.�••-••.�..-------------.�.••••�-.T--------------- j'-..••.�••-••... <br /> L(v �7C � 9 r�l w7 � �/d�7�r ra�^,✓ /II-�.� /[�� t�(7` <br /> .,�" %I`l�af c,-ff .�, � y�aJ C°r� � —.L G� �� !7 <br /> Prc:perSy c;escribad;�tinve is tisad iri the follnwin�exe!ript csteynry({iieasE rriark the ap�licak�le 6ex�;s): <br /> �A�r:culturaiiHcriicultural Society° � Educational �ReEigiouw �G'haritable �Ge'netery <br /> Give a detaiied descr�ption ot�ha use of the prepe�y: <br /> �l.��I1*rl�j�J ��7 <br /> '?,gri�ultural/Flurticuftural Society dnes nat need to comp3ete#he following questions. <br /> 'r all oi?h�proparty usad exclusively ea desGrib�d abova? <br /> 1�a r�orYlor.of ihe prcrie�fy tased for TYie sa;e ni alcoholic beve°a�es7 ihe>n'hnurti per week <br /> Is the pr�p�Yy own�d or used by an organiaaiion which di5cr�mir,ates in � <br /> membership or empl�yment based on race,cclor,ei'naticna!on�in? <br /> Undcr p�na3ties cf 13tiv,I declare that I have examine � my icnawiedg,^ard beliel;it is correct and <br /> r.omp�etG.I a;so decl;�re that I am culy auth,r.rized io sign <br /> /� -2�?.il <br /> 5 D g 51 � �-{! ��%'G+.��-L 'r` <br /> ��}r�y {wihoriz�d5ignzture Date <br /> ------°°_••--•-•_•-_•._�_---- _.--.•••••.•------------_.-•-_.•-•••••_..�._..____ ,._. ------------------. ................... <br /> FqR CaUNTY ASSESSOR'S REGOAAMEPdBAT10N <br /> C AP�F;MV�>L CDMIviE�JTS: ��`�' '���7 l�_'.��• -� <br /> 1.� L�`--��(_r__..r„� <br /> A?RAUVAL DF A P!]R71UN <br /> ❑ ❑ISAP?RpVAL � ���a�� <br /> �Si�natureo C n •?.ssassor �ate <br /> . ��.--•-•-•••••-�• -�•••--�•----------�..-------°°--�•••-•....----- - -------• ---•-•----------------- .._....._�..----------°•.......................................�.... <br /> FOR COUNTY HAAR �GpUlzLfZATIpN US�pNLY ��� <br /> I decfare il�at,ta 9��e k;est of my knr�wierJy°and l�eliei,the deterrriinati n herehy rr•,;ide hy,h�e Cnur�ty Board r�f Fqualizalien ie cerrect pursuant <br /> io the lav;s of the State oi Ne6taska. <br /> � A°PHQ\�Eb COMM�N'1'S: <br /> ' ' �--------------- ----------_-- .---�--------------------------------------------------t ; �-��.�n--;, r^ -- -- <br /> ' A. 1'ROVP.L OF A PC7RTlPN <br /> � �� <br /> ❑ u�sF�PPHGVwb � ' � <br /> , �riaturr�ut Lourry 8oard hleml� �; (��L�I' <br /> 3hrasks pepar:ment ut Revenue . th � e y�e6.Rav.�tdt.S%7-cp2.p' <br /> 5-13�•1999 Hev.')-P010 Supersedes 9fi-195-1999 ReK 1'I•3�OH (� <br /> �I'iL�. l,�U��a�:y �'�ivJ�.��i.i� <br /> PLEASE MAKE A COPY FOR YOUR R�CORI7S r�At��i�;E_�f�i.�,�������a <br />