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� 2012 <br /> �s��i���wiT�t E��11"i�1�lOCi l�ipr?�ICc��IL]f1 Fo�M <br /> YOUR torl°ax Ex�mptian on �deai and Personal Property by Qualitying Qrganiaati��s ��� <br /> DUN ASSESSpFi Read instructions an reverse side. <br /> j FaiEure to prcrperly camplete ar fite this applicatian in a timely manner shalE rssult in a disapprova!of the exempt[an. <br /> Name of 9rgarization Coun?y Gounry IJo. Type nf Ov�r:ership <br /> FRIENDSHIP HOUSE INC Hall 4Q Q ����npratitcorporatior <br /> Etrae.i or OtFier Maiiirrc�ArJdr�ss State'Nhare Ir,��rr�orated � Oiher(Specity'� <br /> 4D6 W KOENIG NEBRASKA <br /> Gity Stato 7_ip Co�e Actual Value parce3 or Locatiar ia Numter <br /> GRAND ISLANp NE 68801 245,517 <br /> Legal des,rip4icn o`racl qroperty and�enera!description ai a!I tan�ible parsonal propert'�,excapt Ilcsnsed motor veh�cies: �I � �� ��� <br /> RAILR�A�ADDITI�N E 1Q'�F LOT 7 8�ALL LOT 8 BLK 99 (406 W KDENIG)#40D08fl745 '�iv�� <br /> KOENIG &WIEBE ADDITI�N LOT 5 BLK 1 D� (fi22 W KOENIG)#40qp55872 <br /> Title a1 Qti`icers, <br /> ��'On__�-�DSrne--°__--------------bire(k IVP 11��1'P�0('_•��1�----�-�-p`-...... . A���„j��r Iq�'Z;�Cade�.Y.�,�...�----------------------------------------•-• <br /> �u a � ��� . . b <br /> r rr' e�N. - OD �Q Ces� Q_ r►v �ro� s u" ,N'� SYQI .�.�--- <br /> ;t � 6 r►ne� �t � r r <br /> _ s�h��_.� �."'►e�. -- S��-�T�'��^-?{=----rt---��------�.�.l.�.�,1_��s�--�!"r�, ---��l�i�--�- ---�----�--�K�,'0�---- <br /> Prcparfi�descrivad�bove is iised in the foliowiri�exempt rA'teyr�ry(pieare rr�ark the ap�lica�ls 6cxes): <br /> �A�r�culturaf/Her,icultural SocietV" � Educs±ia�ial �Religioue �aritable �Gematery <br /> Give a detailEd description of ih�use of ih�property: o <br /> �Q�s ���Wuy �Q�� c4e� �, r��w�� �. 3�y �uy �o�,� <br /> ��a�. �, ��eh, � <br /> y� �fr�f -tf��,ky suE�u��e d�p��,r�euc� , <br /> "AgriculturalMorticulturaf Society dves nnt naed to compiete the foliowin questinns. <br /> Ir all oi the property us�d�xGUSively aa described abova? ES � <br /> I��fiartior nf the property used tur the sa�e n1 e.lcoho:ic bever�ges7 �Y�S � t1Yes,steie the r�urnt�e>o!hnurs per week <br /> Is the properry owned or used hy an organization which discr:miraies in <br /> membership or emplu�lment based on race,eclor,a nationa:oriain? �Ye5 PJp <br /> Under penaities of Ip+v,I dedaro that I have examined ih;s ezemptian a�;ication and,to the tesE of my know!edg�ard 6alief,it is conect and <br /> com;iisie.I a;so d�clatr�that I arn duly auth�crized ta sipn this exern)�ttnn applicatinn. <br /> sig� �t�"�'� �, � .------ �e `�iv �`r r �-3D- 0�� <br /> �y��r� �Ru°.horizea�ignaY�rE 'fitle Dafe <br /> ia� <br /> - -------------------W.._.•_-..••_•••••-••-.�..�m�_-------�.�..•.--_-_-•-•••••_-_-••-•._°_.--------�.-�•_--• ••• -°-------------------------------------------�•-••••••�•.------------------------•- <br /> I FOR CQUNTY AS5ES50R'S RECOMtu9EFJ17ATiON � <br /> �A?NF1L7vAL COMAdENTS: <br /> u A?PRpVAL bF A POATIC'�N <br /> C DISAPaROVAL 1— l��t� . <br /> Si�r.aiure ; wity�Ass6ssor patN <br /> -----°—°----_-•.-•�-•--•.•--�-•••-----____---------- ----�----------- --.._._--••-•••_-••••��-----------------••_--------�.••••--•°--•••_�.-- ..............� <br /> FOR COt1NTY gC6AR F EQUALtZATIpN USE t]NLY <br /> I de,Eare that,tc�the k:�st af my;vir�wir�dg�and beliei,the detQrrninatic;n h°rshy madr by:f�e Guiuity E�;�rd r�4 Equatizalion i3 cerrec:t p�ursuant <br /> to thF Iav's of the.�'.Yake r�t Nebraska. <br /> APNHQVED GOMM�I+fTS: <br /> ••. <br /> � A?PROVAL OF A PCJRTiON <br /> C QI5APPHGV�D : •,:.•x-�,�.���p a p',C�" ^ /��/vL <br /> :. �°•�_4-; �� e,� <br /> .ic�naNre u ourty uarr em Nr , `,.::a--�`°:'' ,'"�a!� <br /> �lebruska Gspunment u��evenue Authpri��d 6y d b Fav.�tai.�77-e02.0? <br /> 36-135-1949:Te617-c`010 Supersedes 9&-Y 35-;999 ReV.i t-3�08 �C� 0 [. L��� <br /> � v <br /> PLEASE IviAKE A COPY FORYbUR l�ECORDS �.;/�:`_I.. 1�,.'�+,i;;�,��` wt�;c:�W�C�Ei <br /> C.���.�,i. .�u,_i-.'`:.�.t�+�=�i�;;SKA <br />