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�F�"`� <br /> 2012 <br /> r�� wrr� Ex�rr�p#ion App�i�atian ���� <br /> Yo�A torTax�x�mptican on Real and Personal Property by Qualifying Organizadians 4�� <br /> pUN FSSESSQFi Read inatructiona an reverse side. <br /> �. FaiEure ta properiy ctsmplete ar fife#his application in a timely manner shalt res�it in a disappravat af tl�e exernptian. <br /> i\ame of Or�ar,ization CounSy Guuny No. -type of Ownership <br /> FELLOWSHIP OF CHRISTIAN ATHLET�S Hall 40 � P7enproi;t Corporaiion <br /> Sbeei or(7[hiar Mai�i>ig Addrr;ss State`Niiere.lrr;�rrinY�fed � Oth�r{upecity) <br /> 828 DIERS AVE NEBRASKA <br /> �,�ty Stato iip Cnde Actual Value P2rce!or Lacatior ID MumGer <br /> GRANd ISLAND NE �88d3 N�A N�� <br /> Le�al des�_ripticn o[real property and�6nerai description nt all tangible parsonzl prop�riy,ex�ept licensed moto;vehic;es: <br /> PERS�NAL PROPERTY--OFFICE FURNITURE AND COMPUTER <br /> Title of O4ticers, <br /> Name Directors,�r Partners Address,City,State,Zip Cvde <br /> .-�•---- --••°---�-j- °t--S --•-°• •---�••••-_ ._••-� -•-- °•..___.r----------------.�•�•_f ---------t--�---•�r -••- <br /> 7��75��._ i�- {tiC. va1(�� �Stia. �:2c.�tr ���W- �t.f .I� � �av�c� ZS�evd N � �5y� �(�� . <br /> � 9o-3oa ..� <br /> ���---- ------ -------------�.._--- -------- -------� _..---�---------------------------------------- ........ ....-�---- -------- <br /> � - <br /> preperty descrivad hhr�ve is i;necl in the fdlowin�exe*ript c�•t,egnry(�iieasE rnark the ap�licable boxes): <br /> �A�r�cultura?iHcr.icultural Soc�ebj" � Educational �Reii�ious �Charitable �Gemetery <br /> Giv�a datai!ad dascri tion of tha use of iha property: <br /> �t� a..� r+e¢.�-i� �rz�. � i�l,r- Ce��1— ��.s� :�t-��a�1ca- �-��5�.,p �� CIM-n-�:�.., �•i-�..�e�s C �e� ��,�c.5 <br /> yr�n� 1N1 i�CS�+ <br /> YC`` �l1Vll5�I� ^�GC 1`�Y'C tN \�ri��V-NF.�:`�C�q �1bE5 �f�+�ti. d..rf' �}T'��'� � <br /> �� <br /> "�griculturalMurticultural Society does not need to c�mpiete 1he tolluwing questlons. <br /> Is all 01;he pra�°rCy usad ezclu�ivEly aa described above?. '�YES �NO <br /> Is a portioh af the prcpr�rt��used for ttie sz��e nf ak:vYiu!ic 6eve.rages? �YwS �NO II YP.F�si:�iP tha nurnFier o?hnurs per week <br /> !s the prop�rty awned or used 5y an organizaYion which discriinirates in <br /> merr,bership or employment based on raoe,calor,er naticn3!ori�in7 �Y�5 �f30 <br /> Under pcnzlties cf la�v,I declare lhat I Fave examined ihis cjxampti�n app;ication and,to the best of my know!edga ard beliet;it ia correct and <br /> r.nmpiste.I also declary ihzt I a+n duly authr,rized to siCn tirs exernr�Tian appf;c:afion. <br /> S�C�1"! � � t"�'r�: ��t���Ivf Ch—�.9 — i� <br /> ���r� Au:horiz �Ignature 7itle Date <br /> --••.._---------°•-- -------�••.------._••.._ �__•••------ -°--_..__ _•-••-•••---�•-� •_•--•••°-- -----°•-°------- <br /> FOR CQL1tdTY ASSESSQR'S REC01�lENlE►dDAT1dN <br /> �A?PF10V.�aL GD�dIv1EfJT5' � L '�"��� --- - <br /> Lj A?PRQVAL OF A POF771CJM <br /> C �ISAPFRQUAL � �� ��t k�•—� <br /> Signa ur o` o nty Assassor pate <br /> -.._•�..�-----_••-._----�-- ._...��__.._•.--------��•--•-••••------.••-- •• ----- •°•_•_•••..._�_ ..�••-••--°•• --•••••••••••.••-•..-------� <br /> FpR CQUNTY 9OA OF EQU�ALIZATION USE OMLY <br /> !decf�re ihat,tu t�ie k�e�t uf my�nnw;edy�and ueliP(,+r,��9iRrR�:nat:or�r�=rFny�,:ddF ny,he Gnunty Poard nf Fqualization is n:rrer.t pursuan4 <br /> to the Iav;s of the�tate of Ne6raska. <br /> �Ai'PRQVEL? COMUENTS: <br /> .�. <br /> ! A?PROVF.L OF A PGRTiON •--- -------•_ ---------°•--- ----------- �-•• _• •••-•�-� �•.•--••--••• ----••-•��........-----••---•---- <br /> ❑ L7israPPRov�u ��� r� - , J.� <br /> ig+iature of COUnr uard A �er � '�� !e. d �' j''�.�,[, _ <br /> vehrdska Gapar;msnl ui Rev^-nue �4utho;ized by'Jeb.Rav.�tat.§T7•za2.�� <br /> 96-13=•1999�gv.7•e010 Supersedes 95-135-�999 Rev.11-200P ��`` � � �O�� <br /> V <br /> PLEASE MAKE A COPY FOR YOUR RECORI]5 �;�,�� C��`��� ��CF-SS��S <br /> r;::=.i'n ae!AND,(�Ef�hoSKf� <br />