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20� 2 ��w��+ Exemption Appl�catic�r� �o�� vou� for7ax Exemptian on t��al and Personal Property by C�u�lifying t3rganizations 71'ASSESSOR Read instructions an reverse aide. �� �- • Failure to properly complete or file this application in a timaly manner shall res�lt in a disappraval ot the exem�tian. Name af Oraanization G'oun?y Geuny Na. '1'ype pf Owr:ership FIRST BAPTIST CHURGH-CAll�O Hall 40 � r�O�Protit Corporatior, Staie lNl�are Ir,cor��ra?ed Otn�r{Specilyl SUeet or Qttisr 1.9ai;ins�Address 1' P� BOX 117- 107 NILE ST NEBRASKA �� StatQ iip Cnde Ac[ual\'alu� PFrce3 or Lacatior la�IuYnLer CAIF20 N� 68824 827,569 Legal desaript;on o`re�l property and�anara�description^�ail tangible parsonal proparty,except licensed motor veh�c,es: CAIRO MAYFI�LD VILLAGE ORIGINAL TOWN LOTS 1-2-3 BLK 16(CHURCH) 1 Q7 NILE ST#40017�264 CAIRO MAYFIELD VILLAGE ORIGINAL TOWN L�T 4 BLK 16#400170272 Title af Ot1`icers, Narne Directors,or Partners Address,City,Stata,Zip Code -----------------._•------------°--•°--- ---••--- ---_�••--•-�••••--•__._._.— - ••- _�_��.•••••••- --- --------------------•----------••••- -- �.e-K 8a 1 r �s�-o r �/0 3 �-�'�l� � �l3vx d a G'a.�"ro n� (o�� .� r ir. ' •r � �7. _:��ns�m. .�e��r.�',� ----��5_ C e m m cc��C.h�, ue• �rr.�vid.�3i�'t�,cl �C� c3 __�.lar.�tar�-��1��- -- ._�v��u.�__,�_�'__�-_+_�99 ��'----��`��_ +�a-� �� -- — --r-------0----------..�....�.......��_l�ah-------�_10��7,�, Ph[�/lCr� 3 ' 5� ' - � 4� h��Z� Prepe;t�!cesr.riozd abnve is tised iri the Tollnwin�exernpt cztegofy{r�feasE rnnrk the appl:cable bexes): �Agricultura�/HcrticuRural Soc:erj" � Educa?ional �Reli�iou� �ChariteFile �Cemeter� Give a detai!ed descriptian of ihe use of th�preperty: y,� �',g (�,�� .h�-'I`�'��f./ 1` r�- ��DL1Jr j�Ll,h17Q�$�'s -}�Di^ a�1 a,�`�,'++�.s r�.�w�n9 t-a �+-h� �;►-s�t 80..�h�t c�,,�v�!-; �� C°n_.i v-o , � ,- "Agricufturai/Fiurticuitural Socizty daes not need to cvmpietz Yhe foilowing quastions. la all nf the propsrty usad exciusively n_destribed abova? �YES �NO Is�t�ortior.of the prcpe`ky�i�sed fnr tYie saie nf r�lcohuiic bhverag�s? �YES �Nb H Yes,sinte the nurnbN?nf hourti per wpek �. Is the pr�party owncd or used by an organi�ation which discr�mir,ates in membership or employment bFsed on race,ccl�r,ar naticn�!oriAin? �YcS �NO Under penalties ot laav,I dealare that E hava axamined thi�cjxGmpiion app;ication and,10 4he G�st of ml�knowledga ard beliot,it is carrect and com��iet�.I a�so declare That I am duly autr.r,rized tn sien th;s exernriiian applicatinn. j � / y� r r� I w�� Auih �d igna�t�ef /C . !� /7�� 7,/e��4�t-3.�Q 1� n�LVS -�Q"f / �� �hon� 3v�-�0�l7-513/ ------�-------------- -------------�--�----------------._-----------__----------------..___.-�-----------�-----------�---------m......---�--------- �OR GaWNTY A55�SSOR'S RECOMMEN�]ATION � rs;�^Fi%GU:�� GOM1FIv1EFJT5: � ta L1 llC ��" � c3 ._..... � APPROVAL OF A pOqT1JN � C DISAP?R�VAL � r " � Signature ` owriy Assessor Date _�--•••-•-...�_------_-••._..�__ �_••••,.------------._•--• • •• •- - -- - - -- -----�•-•--•-•.-•••••••••••.-••••-••-....••--•-••-••-.--••-..---------� - FOR COIJNTY 9QAF? OF EQUALI�ATIRN U5E t3NLY I--- � 1 ciecEare ihat,tu P�ie hest.uf my knfiwledye and uelieT,ihe dr:PerminaUnn herehy rrade by che Cniuity Foard nf Fqu�Eiza'linn is;orrec.t pur;;uant to thr lav;s ot the�4ate vt Nebraska. � A?PRQ\�ED GOM�lEI�fT5: �„m; A?Pi�QVA.L OF A PC�RTiON ________________ C OISANPRGVW� .,E'"'�°'''�� igr�ature ui C�iurty Bonr mliar ?`4','� J:tITJ�'e ,. � =.:""''' Nehraskd Clepar;meni ul 79v°-nue ..' " Autho;izgd l7Y!du6.Fdv.Stat.§77-202.01 56-135-1999Rev.7-201�Suporsedes96-135-;995Rav.11-?OOfl D�� 01� PLEASE MAKE A GOPY�QR YOUR A�CORDS r-�:c�� s41��Ei �,•;.. _ ;�,}� �r:l t �;Q�- �_. -� ;.� �r"��iy�'.��i��-�`�LD, :�.�" -�:J1. ��.�..