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..�-�� 2012
<br /> ,T�, ����W�T,� E��rr�p�ivr� Applicatic�n �o���
<br /> vo forTax Ex�mption on Rea1 and Personal Property p�y Qualifying Qrganizatians ��-�
<br /> 1,1 7Y,4 ESSOFi Read instructians on reverse side.
<br /> � Faiture ta properly tnmplete ar fiEe this appiicatinn in a timely rnannsr shal!reaull in a disap�rovsl of the�x�mpiian.
<br /> G'ounty Ccunry No. 'iype of O�rmcr�n:p
<br /> Name of prgarl�a[ion � PJ��rpYetit Ga�pora[ior
<br /> CENT NE CHILQ ADVOGACY CENTER H811 40 � �����r(Speci�y'�
<br /> Streal or ptFier�7�iiinn Ad^lress Sfate.lNhare Ir:,nrpnr;�ied
<br /> PO BOX 844 -721 W KOENIG N�BRASKA �
<br /> Stato Zip Cnde Actual VaP�e P�rcel vr Locatior ID Nu!nL�r
<br /> ��ty 400056992
<br /> GRAN� 15LAND NE 68802 142,910
<br /> Legal description o':real oroperty and g�nera!description of a!I tangible parso�al proparty,except licensed moto;veh�cies:
<br /> KOENIG &WtEBE'S ADDITION W 6' l.T 3 &ALL LT 4
<br /> Title af Oti'ICers,
<br /> Name i7irectors;ar Partners Addtess.Gity,Sta4e,Zip Ccrde ----•••--------------•°--•---------
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<br /> Prepnrty c:esr.riiizd dt�nve is u�zd in the foll�wirip exe!ript�.ategnry((�iezt::e rnsrk the mppl'ir.abls bexea): '
<br /> Gharitakila �Cemete
<br /> �Aariculturab'Hcriicultural Society° ❑ Educa?io»al ❑Religiou� ry'
<br /> �p �y,, � �
<br /> Giv�a datsl?ed descrlption oi'he use af tha prepe'ty- r-(��'�I']„$ �,�- ��T�frV1�1�'S `3 1 (. �h�J'Q V�L��`r �''��"'� �1 ���y
<br /> �� ti�� ��'.�f�iw�, �er�s�r�,.w h.a�t ►�e.t►� c�'�c�r��'�. t�-�rJ�v: rvt�d�c�� �X..�zvw� ��
<br /> �,�;��.cf Q bw� v�°�h n.�.� A�.,c c�.�.d.�c�e d v� �.t i s r t�n.-� a ��►,�+t e� �s. �Iv�N��t,t..ct��-� �c l G�+��u�
<br /> ,�� .N,�F,�,, ✓1�vt -i�f�v�+✓l� �►��(ti rytc.►v�l"��vi�-br"t�.
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<br /> '?,griculturalMurticufturai Sociaty doas not naed to complete the f�lluwing questions.
<br /> Ir all ai the property usad e:cclu&ively�s des�ribed above? �,YEu �NO
<br /> I�a(�:�rtinr.nf the prcperty�uned tur tYi°saiE ni�.lc.nhuiic Y�evera�es7 ❑Yt5 �NO 11 Yes,sT�a'e the+wrntie�n`hour4 per v.�r^.ek
<br /> Is the proparty owned or used 4y an organization which discrhnirates in
<br /> membership or empleyment foased on raoe,�olor,ar nat;cna!origin? �Y�5 NO
<br /> llnder pcna3ties cf law,I dedare ihat f have examined tivs ax�rrption app;ication and,to fhe��st oF rry knowiedge ard belief,it i5 carrect and
<br /> r,nm�i;ete.I aisa decl�re thzt I arn duly authcrized io sign this exernp91�7n appfcatlon.
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<br /> �� � �1�-�'�-- �Xf, . �i� ��T� i� �2- l i
<br /> ��yy+ �Auch ad ignature [� �9r TYIa Date
<br /> ��GA �r � ��15 `�D7- �7���
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<br /> -------°-----'••.-_-----•------•-""------•••----- ---- --- • �OR CQIIPITY ASSESSQR'S RECONIfJIENDATION
<br /> �A�PHOV.�IL CDN�viENTS:
<br /> C; A?PROVAL OF A PORTION
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<br /> ❑ o�sAPFaovpL � oaze
<br /> 5iqr.ature o'C unty Assessor
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<br /> •••�---°-------•.�_--- ----�•- FQR GAUNTY�DARb F EGl4JALIZATION USE qNLY
<br /> {declare ihat,ko ihe h�st o'f my Kn4wietJy.°.and uelie(,the deierrninatinn Fi�r�rby r.:a.de by;he Gniinfy Poard c�f F.quafiz.aTion is cnrr�r.i pursuant
<br /> to th�I�we of the�tale c�f Nebraska.
<br /> I Y. Ai'PROVEU COMYIEN�T5:
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<br /> NOV 2 9 Z011
<br /> PL�ASE MAKE A C�PY FORYOUR R�C�RDS
<br /> HG��qND I�SLAND,N��RASK�R
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