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2012 <br /> ��a �����pW�T� E�emption �pp4i�atiar� �o�r� <br /> YOUR tarTax Exemption on �teal and Personal Property by Q�alifying Organizatiar�s <br /> GQUN7Y ASSESSQR Read instructions on reverse side. ��� <br /> � FaiEure to properly to�tsplete or fife this application in a tim�iy rnannsr shali re&ult in a disappro�a!ot khe exemptiur+. <br /> tiame of qrgar�iza[ion Caunty Cou.�c,�IJo. � iype�af p�rmersnip � <br /> CEMENT LObGE#211, AF&AM Hall q� � r��=rprotiYCorF�arutior. <br /> �trrc;i or Qt�i�^r y9ai;i.>is]ArJdr�ss State'J�/har�Ir,c�rr�rir�ir:d � �=�th..r{Specil/1 <br /> 906 MAIN ST NEBRASKA <br /> Gity Stato iip C:�dF ACIJRI b��31�J& Parcel or Locatiar.ID Nu:nb�r <br /> W�aD RIVER N� 68883 19,539 400176521 <br /> Legal des=flpiicn o`real pr�perty and Aenera'desc�lptlon a�a11 tan�ible parsonal p!npert�,exGept licensed moio,�veh�cies: <br /> WOO� RIV�R VILLAGE N 56'OF W 1/Z OF L07 11 & N 29' OF 5 7Z' OF E 25' OF LOT 11 AND N 29' �F 73' OF LOT12 BLK 20 <br /> (MA50NIC LODGE) <br /> Title of Otficers, <br /> Narne birectors;ar Partners Address,Cit),State,�i�Csade <br /> --•-••.••�__ ..-.-.•-•�-•.•-•.••••••••••••------°° --�•••••------- ----- ••••-.-••......•••••-•••••..•-� <br /> -- • ••--•°-------------------------------- <br /> ------•--.•••••••-------------------------------------------- <br /> �� <br /> ' _�'n/_ , <br /> _�G�l,ri /.�f�� F _._ <br /> _---------------------------------------------------------.......�----------- <br /> ...._. _ _i - <br /> Prcperty d�sr.riu�ci arinve is l:sad in the followJinp exe�rnpt r.atsgory�(piease rnark the appl:cablA hexes): � � <br /> �A.gricul�ufa!;Hariiculiural 5oc�ehj" � Educa±ional �Reli�iou� Charitabla �Gemetery <br /> Give a detsiled dascr:ption oi tha use of tha prepeKy: <br /> ����•nr.��- , c�.�.� ..� <br /> "Agricultural/Flurticuftural Society daes na1 naed to compiete the Palluwing qu�stions. <br /> Is all 01,h�prnp�rty usad ex��usively a;descri6ed above? �YES �NO <br /> ls a riartJor.of 1Fie prcpert��used iur ihe sai�nf alc:ohuiic beverttgas? �Y�S ,�Nq It Yes,s1ate the n�rnF�er pf hours per xeek_ <br /> Is the proper'ty owned o,'used 5y an organization whlch discrimirates in - <br /> membership or empl�_�yment based on race,color,or naticn3!oripin? �YES ��d0 <br /> Undcr pcnalties cf lativ,I declare that I havic examined this axamFtion app;ication and,to ihe t�ast pf my knawiedga ard beliei,it is carrcct and <br /> r.nmp;ete.I a;so dec.lare that I arTi duly auFhcri�ed io s!r_,n this exernpTion application. <br /> ���r� � /� a a� / <br /> ���� ku.horizad5ignatu ;le Datc <br /> -°---••-•••-••°---• FAR COUPITYASS-------- --------•••......... --�..---------------------�._...•••.••••.•- I <br /> -- - - - ._...... .- . <br /> TlON <br /> � ESSOR'S RECOMMEP90A _............._,_ <br /> ! ,a�wHOUa� conrn��r��rs <br /> ; APPR��lAL DF A POATiC�N <br /> n. <br /> ❑ DISAPFROVAL � ,� 1T�'� <br /> Siyr.ature i uniy Ass6ssnr ❑;�tN <br /> °---•,......-.-,.--•.-••-...,._,.�....................------------------•—.W•_--_------------------ -- --°--°°—°-- .-°°°°°°-------°---------------------,._�......••••. .__ I <br /> FOR C4UNTY 9pAR �EQUALI2A71qh USE ONLY <br /> i decEare tlist,[ry t�ie hest a'(my Kn�iwiedg�and belini,the deterrninaticri h=rehy m;�de by,tie Coimty��ard a�cquafiz.:�lien is�erre�-t perausnt <br /> io th�lav;s of the�Y�te of Nebr2ska. <br /> � ,aPPHOV�D GOMAAEN'7'S: <br /> � A?PRO�IP.L OF A PDR71pN <br /> . - ••-•---••-..�..- ---------------------••. ..... <br /> ---- ---...... .......... <br /> ' -r� mr .}.x.,� N �� { '� <br /> i � <br /> ❑ DISANPF1GV�p G�::::__�,- `� � � <br /> � �,.. <br /> .i�nsture o Courty n�� .1e ier p��e <br /> Neb dska Gspu�;ment uf Ravenue � AuthCf'�kffi td 5 t ��r02.0? <br /> S6-1g^-1999 ReY.'7-�010 SupePeedes 96��1�5-1998 Rev.77•?pOfi LJ C <br /> PLEASE MAKE A COPY F�RYOUFi RECORDS 1'�.P:_'_ �;��_.iii�� r7.uaE'-���� <br /> �;F'•�. ,,�',.�'r.. ...._ ���.W'.r;i�F.SE�� <br /> f�:�`,; <br />