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zo� 2 <br /> TC�BE FILEq WITH ��(��p#�o� ��p��(,'��i�{� Ft�F1111f <br /> YOUR f��Tax Exemptian on Fteal and Personal Property by Qualifying Organizati�r�� /� <br /> C�UN7V ASS�SSQR �Eead inatructions an reverse side. °R�� <br /> FaiEUpe to properly tomplete ar f34e this appiication in a timely manner shall res�ll in a dl5approvaE of the axempti�n. <br /> ,Vame of 4rgar,ization County T Ceun,^y�fVa. -fype of O�rtnnrsnip <br /> CRISIS C�NTER H811 4D � �J��rpralitCorporuCior <br /> Streei or Qth�r Viai�in_ry Arldres.ti' Statr'Nhare Irr,orpors?ed � C�ir�r{upecityj <br /> P�BOX 5885 NEBRASKA - <br /> City Stato Zip CndF Ac9ual b�ab�e Percel or Locatior I�Number <br /> GRANQ ISLAND N� 68802 316,368 <br /> Legal descripticn o`real property and genera'description ef a11 tangible parsonal property,except ficensed molo'vehicas: <br /> GOODWIN SUB LOT 1 (927 E 14TH 57)#400136724 <br /> KALLOS SUB LOT 5 (2903 W 4TH 5T)#4D0050633 <br /> RDUSH SUB LOT 8 �LK 1 (2D�5 KINGSWOOD DR)#�100085984 <br /> Title of Otficars, <br /> Name Airectors,or Partners Address,Gity,State,Zdp Cad� <br /> --__.�.•-_•--_•_-.- ------__-•_.�----�._�.rQ-----°---...T _.-•••_•••----^�—_ -------- } ••• ----------------�----•-._..... <br /> - °••.•••.....-------- . ..-.--••• - ------ <br /> i ti r� iu1 d�f� �� �a� I Wr fi'� -----�'r- r�.. -1 �E. ��va4 <br /> '� �-e..a r� �ard1..V`�c¢.CJ6,c;:r �a X_ �1v�� . Ca�-�.n�t-1^� la,rid ,�1`1 C—!. [�`�4 p.� i <br /> e�s� Air � r 6�Si.£4' �•v �t-�-��.6 G.ry: �C. �?�t:.r.�Z S�Ar�..A �E �� �1 <br /> ----�s1r11�,.'r'1:�\�r�,.�-_------��_ �cc-r���_�'sw+�wr ._��f��'�----- -- —�*3�.' .�...s.a-�C��-�---------1•.��:..�R.Ao�'�---------------- <br /> q <br /> Pt'cpert�j ue�r.riU�d ahr�ve is�:zd in the fvllowing exr!ript r.a'te�nr��(��:ease rnrark the ap�i:cable bcxes): �� <br /> �AgriculturaiiHcriiculturel Sociery' � Educa!io�ial �Religioue �G'haritable �Cemeter� <br /> Give p datailed dascr�ption of thc use of the prepe�ty: 1 (� { <br /> ��` ��f t9., 1 Q C..(R•��6 nS EYu�'Ci''�`❑ �L �� rt G h 0�..SC. V.C:�'Irl,$ �t �O Y'rl��G J\Q�tr.��Gbri� �.KV�.G A <br /> �` <br /> 'AgriculturalMorticufturai Saciety does nnt need to complete the foliowing questions. <br /> �s ali o1 th�property usad exc;usively es described a6ova7 �Y�S �NO <br /> I����ortior.uf the pro�3erty i3ned iur tYie sa�E n1 rlcohuiic heverr�ges? �Y�S �NO �f YP.F,51a:e the nVrnr�er n!hours per weNk <br /> Is the pr�pewy own�d or used qy an organi:.atian which discrirnirates in <br /> membership or empl��yrr,ent hased on race,ccl�r,Qr nat;cnai ori�in? �Y�.S �Pdp <br /> Under penaltios of I�sv,I dedare that I have examined tlii,c�emFtion app�ication and,to the hest of my knpw�adg�and Galiel,it is carrect and <br /> r:omplEte.I a;so de�:lare tnat I arvt ciuly authcri9ed ta sir.n tfrs e�ernritinn applir.atinn. <br /> ���� �,�la.t ;e��— �Xt-t..:�..�J,�/���"�r 'r �� r� <br /> �e�r� �fw4horiz�d SignaYure TiYle Date <br /> •- ° ---°----------•°•••-,--------• --° -�••••-••�------------- -------------------°••-••••-•...�._. ---°•-•••••--••--�•,-----� <br /> � � FOR GOUPI7Y ASSESSOR'S RECO►uIMENDA710N <br /> �_._. __ .. _._. . <br /> A'PRoV.�a� GD^�!MEn�rc T �i� n .-r,r��i'1� ���_i�_}r� _��.�__.._. <br /> �' <br /> �; A?PRO�JAL OF A POATl�JN <br /> C �ISAP?ROVAL � � �`'" `�� <br /> Si�naiure ` a ify Assessor Date <br /> . •--- -- ° - --••�••••_ -----• ------°----------------------------------------•----------�•••�•�•-•-�-------------------------------� <br /> -- - - <br /> ---•------ -------.�.•-•���----�•. � - -- --- -------- FOR CAUN7'Y 80AR F�QUALf2ATiQN USE ONLY <br /> I declare iliat,to t"ie rest of my knnw�erJge and uelieT,the deterrninaiicri 1ir.reby rade hy.he Cnunty 6�arc1 nt Fyuaiizalion is�errect pursuant <br /> tn,Fe lav's of the.�'.tate of NebraFka. <br /> �APPRDVE37 COM?�AENTS: <br /> L; A?PRS]VP.L OF A PpRTI�N --•-•••----------- <br /> ••••-•••-- ...•--•-••�......•••......._��....�....•-.•-• .. ... ................ <br /> -- ---••••------ ----------------------•-• <br /> � �/� <br /> C DISAPPHOV�I] <br /> , ynature o Gcwnly �1e ar Cl <br /> ._ __._.. ..__----- --- - yt <br /> 'e6reska Uspar;ment oi Rev�nun � .0.utho��aed 6 d�e4. o.� 102.a i <br /> 6-73:•1999�eV.7-'�10 SupeYSedas 96-135•7999 Rav.11-�008 <br /> NOV 2 8 Zp11 <br /> PLEASE MAKE A COPY FqR Y�U�i RECORDS HALL CCjU;��Y ,y���SSpR <br /> GRANd ISLA�dD,,NE�(�ASKR <br />