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. 20�2 <br /> �� �� °W1�" Ex�ra�p�ior� Appf6ca�ian �v�r� <br /> A <br /> c ^ss�sSaF �°� �� �ml�tian on Real and Persanai Propert}r by Q�alifying Orgar�i�atians ��� <br /> Read inatructions on reverse sid�. <br /> Faifure ta pr eriy mpl�fe or�Me this app�itation in a timely manner shalt result in a disapprovaaf of f)�e sxempticsn. <br /> 'ame of Or�arization Couniy Ccun'r,�IVo. -lype of OwrErship <br /> C�NT N� CQUNCIL O AL HOLISM Hall qp � Monproiit Corppratior <br /> ulr�ei Ur OtFier h9ai:inC�Ad;JrYas 6tate`Nfiar�Ir,corpr�r;�;er! � Q1h�r(Speciryl <br /> 219 W 2Np ST NEBRASKA <br /> ���`1 State Zip Cr�de Actual V31ue p�;rce;or Locatior,In Nu!riber <br /> GRAND 15LpN� NE 68801 N/A N/A <br /> Legal descript;en n`:real properiy and generai descriptian ef a!I langible pars�nal prop�h'J,excepf licensed motor vehicies: <br /> PER50NAL PROPERTY <br /> _...� <br /> TiEle at QNicers, <br /> Name Directors.or Partners W __ ^Address.City,State,Zip Gode <br /> -- --�•••.----------Pr.�_•J-,•__-- --•--------•-..�.�..- ---•---- --�•-----°-°•••-••.••�».--•------�--�---•-° - - • - ------------ ----- <br /> 0 i�r�r� --- —`--- -- � ...... .. ,,...,_... . <br /> �_ - <br /> rep�rty descriuzd ahnve Is�isad ih the lollowi ig exerript cateyr��y�(�iiett;;e rriark the appfca6l�bpxes): ����-jr <br /> ���.�� <br /> �Agr:�uNurai(Hor.iculiural 8oci�ty' � Educ3tiarial �Religious �Charitable �Cemetery <br /> Giva a detsi!Ed description ni tha use ot tha property: ,� ,l „ ��1 ,, , n � <br /> (� P rp�uiG�ps �C���� �D�d C�a � W v�� +'G�c� C�.�CL�L b� w- :^���s .� <br /> ►'�(� R'p� �L��)(JY� �r0 I�t.[.j'T')�. �v � - <br /> d� i L.i b �.�;o < <br /> 'Agricu r /Horticuftural Society d na1 eed to compiete the f�lluwing q��esti ns. / <br /> �,ali ot th�prn�srty usad exc�usively as described abova? �YES �NO �� �� <br /> r/�Ir a t�:�rtinr.of t�ie prnperty used fpr TPie s�ie ot alcohoiic beverayes? �YES ❑ND H Yes,sTaie the nurriber<�`hcxirs per week <br /> Is the property ownad oi used by an organlzation which discrlmirates in <br /> mem�ership or empl�yment based on race,ccl,�r,or naticn3!prigin? �Y`c5 ❑fdq <br /> Under penalties cf lasv,I da:lare that I have examined thi�exemption appiication and,to the besi oF my��cnowiadga ar,d belief,it is conect and <br /> r.om��isle.I a'so declate ihat I ai�i culy authcrixed tn sipn ihis e.xr�rnt�tinn appiicatinn. �� ��� �S� <br /> \ . <br /> � <br /> ��� �ku[horitad aig�ature .__ 7i;le � pate � <br /> •---,�•-••••- ------- •• •• -----------•-•.--••••- ----------------•-...-••..- -••---.. <br /> COIJNTM ASSES50R'S R£COMINENDATION <br /> ._.. . . .. . FDR,•— - --...... ....._. -�-.-••_•�----- .._ _.. ._..___�__� <br /> �q'���U�ai GqNME1JT�: � <br /> � A?PRDVAL OF A PORTION <br /> C DISAP?RpVAL �.` '�� <br /> Sianatur �,Ceunty Assassor p��F <br /> •---.-••-•••�••---••.�..�.---•---�.�.�_��---------------------------------------------------••-.••-•-• --- -•-------------.--•-•._ ••--• ............. -•--••-Y.. -,-, <br /> FQR C(3UNTY E7OA QF EQ0.10A�IZATION US�qNLY �� <br /> 1 deckare iliat,[n Phe hest uf my kriuwiedyP and�elief,ihe de9errninatic;ri h°rNhy r;.ade hy,f�e Gnii+�ty Fcard r�f Fquali-r�lion is eerrec.i pur,uant <br /> to�h.lav�s of Yhe�t�te c1 Nebta.ka. <br /> i Ai'NROU�D COMMENTS: <br /> � �--. - � <br /> � �y�� , fi <br /> C A?PROVP.L OF A PC�RTION �G� <br /> ❑ L71Sf�i'PRGV�I] ��, p V � ��' " '� <br /> .i�r�sture u aunty em r pa�� <br /> Ichreska Gspar:mant uf Rav_nue p 4`����9u�ho`�i��y,�J�tt,`F(p,V,}:i�I.§7'7-ep2,p i <br /> ��6-139-7999Rev.7-?OYOSuptlrsedes96•135-`999Rev.77-?0�H �1'1�� �"��'��� � <br /> CeRAf�D f �c'��' <br /> 1�.'�;;a�4J,I'w',�:sk=i�-,� <br /> PLEASE MAKE A COPY FQR YOUR REC(�RDS <br />