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�� 2012 <br /> rn��Fi��aw��� E��mptiQn �pplica���r� �����' <br /> YOUR ffl��°���xemptian on �teal and Persorral Property by Qualifying Organizatioa�s ��� <br /> � TY AS5ES5QR Read instruGtions on reverse alde. <br /> Faifure te prrrperly complete ar fi{e this application in a tim�ly manner shalE resutt in a disapprovaE oB ti,e�xemptian. <br /> '�am ��f rgarizatio <br /> G'ounty Ccuny fVa. Eype ot Cv+narsn:p <br /> C IS O CORDERO D� DIOS IGLESIA Hall 40 � e1�'�ProtitGorperatiar <br /> S[ate�Nhare Irr;nr�r�ra:ed � Other{SpetFfy) <br /> �tre o CTt1i°r�,1ai;i7g AfJdress � <br /> 1 2ND ST(�VANGELICA LUTH�RANA) NEBRASKA <br /> �,i�, Stato Zip Gnde Actual Value Parcel or Locatior ID Number <br /> GRAND ISLAND NE 688Q'� 253,809 <br /> Legal descript;cn o`real property and gene;ai description at a!I tangible p�rsonal property,except licensed motorvehicies: <br /> ORIGINAL TOWN W 16'LT 6 &ALL LT 5 BLK 71 (#400006081) <br /> ORIGINAL TOWN E 5q'LT 6 BLK 71 (#4000D6103) <br /> Tit1�aS Ot1`icers, <br /> Name Directots,or_RarYners ----- Address;City,State,Zi;��ode ...•-•--------------------••._. <br /> -°--...------ - ------*.•- ----•-°---------- -••• -----------•••-•...-•••-------- --- -----� ----- ------ --- --------------- -- ---------------- <br /> � .�o r <br /> [n d�vt d . ��" � • �- �i � _.�._.�.� <br /> Gr,vt � E � J _ �'��S t+�r� l �'. . � ��� � <br /> .�,.� -' ✓.-e.�r�i 1 .S�3 __ NA s`' ° r��.-� � �i _.._ <br /> �,=-`-�',n2_--�lle..r�w..,✓Y o----=-.._ -�-. �.l�+?�1.--'---��'------�--�`�_�_�__-�.G..._�'_�f1__�_..-�------------ <br /> �G/_���3.1.�� <br /> Preperty desc.rfued a�inve ls usad I�i the tdlnwir,�exerr�pt cateynry(piease rriark the applicat�A baxes): <br /> �Agricul[ur�iihlcr.icWiural Sociehl� � Educ�4ianal �Refigio��a �Charitable �Cernetery <br /> Giv�a detai!ed descripiion of ih�use of tha property: � ' <br /> �� p �� � � �� <br /> � � �.e.v-v��-� <br /> 'AgricufturalMorticultural Sociaty does not naed to campiete the following quastions. <br /> 9fi alI o1 th6 prop��ty�used ext�u�ively�ra described abova? �YtS �NO <br /> Is�p:�rticm of the pro�3erky�tis�d fur ths sale ot zlwhuiic:treverages7 �YES �Nb H Yes,sta?e the�wrnher n'hours par week <br /> Is tha property owned ar used by an organi;.aiion whfch di5cr�mlrates in <br /> merrbe�'ship or emplpyment based on race,:.clor,or naticna!orig'n7 �Y�S �NO <br /> Under penal4ies of Iasv,1 dedare ihat I have examined this t�;errption app;ication and,io the best of my know:edge ard belief,it is correct and <br /> com�iidte.I a;so declare that I trm eul auth��rized to sign ihis exernptinn applicati�in. <br /> n <br /> S� � � J l /O�� ��/ <br /> ���gi �Au:horized" atu � 'f;tle ^7���� I``nl /_� bate <br /> � ( b �,�/ <br /> -- °°°---------• --._•-•_---_°•---•-------°-°• _--••••••-----------�---•-••-••-•- -•_--.••.....--------------'°°--•------------------�_...-•---------------•----�..... <br /> �o�t caurrrv Ass�ssaR°s�FCOrar��ND,ariaw <br /> I__ __--- <br /> Ft <br /> �APPf-IOV�aL CONME�JTS: � ���� - <br /> [ i A?PACJ�JAI.DF A PORT1dN <br /> ��1 <br /> C DISAPrRpVAL `--�-��— �� <br /> Siyr.atur a o nty Assassor p�tF <br /> --------_-••�_.__-------_•.--_--••-••�--- <br /> -----•-°•_•_ ••••�---------°••-•••- .-•-_ --•._._.__..----------------_-•••-�� _-_•••-•�-•-------------._...._�... •.••••.-•.. <br /> �'QR COUN7'Y BC1A OF EQUALiZATIQh U5 <br /> 1 decfare tliat,tu the k:est af my knc�w:edg�and k�eliet,if�a deterrninaUcri hsrr�hy r,;ade hy;he Cnunty Board��t f-_qualiz.�'linn is cerrect pursu�nt <br /> ta the lav;s ot Yhe.Slate ot Nebraska. <br /> � A�PFIC7VEU COMMENTS: <br /> �, <br /> LA?PROVAL DF A PCJRTIOM --•••••••_•-._----------._•--•• •_�- -•-••••••------ ����---�i=--�� <br /> C DI6AI�PFtGUc1J � a/ ,c+� <br /> .ignatur u Caur rd: emt�er Da±e <br /> �Jebruska Gopar:ment ur Revgnue (?��¢SW��yI i����y;��77-�02,Oi <br /> 96-13�-1998 Rev.7-�010 5upersedes 96-135-1999 Rev.11-20ofi �vv�Y i /i J � <br /> GRAND tSLA�1D,N�BRASKA <br /> PLEASE MAKE A C;OPY FOR YOUR RECQRDS <br />