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2012 <br /> ro �Fi��nwir� Exemption applicatir�r� �o�P,� <br /> Y��H torTax�x�mptian on Rea] and Personal Property by Quaiifying Urganizatiar�s <br /> �Q� n������p� 4�� <br /> Ftead instructions on reverse side_ <br /> • F2i{ure Yv pre�perly campiete ar file this applicatian in a timely mannsr shall result in a disap�iroval of the exernptian. <br /> �ame pf prqar,ization G'oun?y Coun°�fJo. 7ype af G�r�r:ership <br /> EPWOR7H VILLAGE WC Hall qp � Nc,nprofitGcrG�ratior, <br /> utreel or(3tYi=r Mailing Addrs.=.s State Whare Irr,or�inra?ed � Other,SpecFly) <br /> 2317 N KRUSE AVE NEBRASKA <br /> ��ty S[aio 7.ip Go^7rs Actu21 b'alue P�rcel or Locati�r ID Nu:nber <br /> GRAN❑ (SLAND NE 68803 161,307 40D033941 <br /> Legal descripticn o`real propetty and genera;desnripUan�t a!I t�n�ible parsonal p!op�rty,except Ilcansed motor Veh!c;es: <br /> COLL.EGE ApDITION LTS S & 10 BLK 10 <br /> 7itle af Qiiicers, <br /> _Na e t^ __ -rectors,or Partners Address,Gity,State,Zip Cad <br /> -- •---•�-_�_�•.••••••. • / ----•-••-••�-.-•.••-•••__ ..�•••.•--_�-�--- ---------- -- -°--°-°°°••-•--••--•-•.••._�W__....�.� --- <br /> o��.c�r� . �s � � c..3 ��----.. <br /> - ` � r �. � , � � ___. <br /> o��:� _�,�.�-�-- ---�C'.Q.G..�k r'� _ �.�-�-.�-�---��---------------- - ------- -------- <br /> PYC�7L'�fif CL'&CI'1178CI AFJf)V�IS IiS�C�I`i thP,fUII04'IFl�P.%9!flnt C33Y,E�f)��(piease rri:ark the applicabl=bexes): <br /> �A.gr�culWra!/Hcriicultural Societv' Educatiorial �eli�io�a �haritable �Cemeter� <br /> Git�e a defai!5d descr:ption of ha use of tha propeKy: �r i I � / �e(�r Q �� �� ��\� <br /> �� l �J � <br /> "Agricultural/Morticultural Society daes not need t�complete the folluwing questions. <br /> Is all of the property usad Exc�u&ively aa desc�ibsd abova? t.`'i �NO <br /> Ir n p:�rti�r.af ttte ure�ie."ty used iurtFie Ea;E nt alcohuiic F�everages7 Y�S �'(�!q liYes,slaie the nutnhe�o':hours per keek <br /> Is the property ownad or used by an orgartization which discrimirates i7 <br /> membership or empL�yment b�sad on raoe,�cl�r,or naticna�oripin? �Y�S �0 <br /> Under penalties of lavi,I dedare lhat f have axamined this exemption app?icAtion and,to the test of my know,edge ar,d�eliet,it is cankct and <br /> comp:sle•I a;so r'ec:l�rv t�at I am culy auth„rized ia si_r.n this Pxernriiicrn applicati�in. <br /> 1 , <br /> S 6�w"6 � � �'es 1 c�e.� ��C� � � <br /> ��.y�� u;FrorizedSignsture 7itla Daie <br /> I-- ---------------_-------•••-.••••�-----------��•------------•------------------------•_._._.••••••--•••-••.�-------------------------------------------------•-�••••-•-...-••--------°-------- <br /> FOR COL]NTl'ASSESSOR'S RECOMM�NDATIt7N I <br /> �A?PHOV.�1L CONMIENT.i' _� m���-- � l — _ C�� ^.. _._.._._. <br /> C; A?PROVAL OF A P!7RTIUN <br /> C �ISAP�ROVAL � <br /> Sigr.atu e 'Cuunfy Assessor �te <br /> -••••-----------------------------•�--••••.--°--- •-,------------ ------........---•-------------------------------------------------------------.•-•••.--...................•----------------------------------------- <br /> I-------------- ------------ FOR Cf]iJNTY 8DA D OF EQLIALiZATIQN t1SE C1NLV I <br /> I decfare tliat,tu 9F�e rest uf my knnw;udys and beliet,ihe deterrriinaticri h=rehy r.,ade by:he G�xinty Foard nt Fyu:�fiz:�tion is r.i:rren pur�unnt T <br /> to the lav;�of the�t�te cf Nehraska. <br /> � A�PFiOVEl7 COMMEN�TS: <br /> L; A?PRC]�JP.L OF A PGRTIJN <br /> C <br /> QISAPPRGV�D /��I JvL <br /> iqnature nur�ry parr emi r },, .. <br /> Neyraska despar;ment ut Revenue �z@dby'Je6.Rev.Stat.§77•2p2.05 <br /> $6•735•7999�pv.7-,�70 SupePSedes 96•13S•7999 Hev.Y b2008 <br /> NOV 2 9 zoli <br /> PLEASE MAKE A COPY FOFi YOUR AECaRDS <br /> MQ�..�. V11�1�i 1 r,.'7uL�:'_� ' <br /> GRA�i7���f�� tl�t�8k::.�;- <br />