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___._�.-.a <br /> TO BE FI�.�[]WITH Exempfiion App�ication �o�M <br /> vou� forTax �xemptian on �ieal and Personal Prap�rty by Glualifying Organizations 451 <br /> COUNTY ASSESSOR Read instructions on reverse side. <br /> Faiture So properfy compfete or file this eppiication in a timely manner shali result in a disapproval of the exemption. � <br /> Name of Organization Coun County No. Type of Ownership <br /> S' <br /> ��1C�'- "j����..7 t C ��,. � �,_��_;_,a�� �- +� 5 �NonprofitCorporation <br /> '�.... .—�� � <br /> 5treet or otner Mailing�dress � Sta e here Inwrporated � Omer(Speciy) <br /> �' ���� C� �:.���.:-�~ C_�:.k �rtk.. �GC� (�� <br /> Ciiy State Zip Code Acival Value w Parcel or Location IO Num6er <br /> L....' �� ��. �l�_ <br /> Legai description o(r9al properry and gsneral description nf al!tangible personal pro�cept licensad motor vehicles: <br /> �t n� �1 Gl S ��L GL.[� � <br /> ��\�ono l o-�y , i�e��s..r'a�� y �N�a��+-��� i�`-�-�c�n ����L <br /> o� r e�n r� �lc� �1 co.�, <br /> Title of Officers, <br /> Name Directnrs,or Partners Address,City,State,Zip Code <br /> _ ��C+���� <br /> Property described al�ove is used in the following exempt categary(please mark ihe applicable baxes): <br /> �AgricWturaVHorticultural Society" � Educational ❑Religious yyCharitable �Cemetery <br /> c� <br /> GNe a deiailed description ot the use of the property: � � <br /> provislon of healthcare <br /> services to the community <br /> "AgricWtural/Horticultural Socieiy dnes not need to complete the following quesbons. <br /> is atl of the property used exdusively as descnbed abwe7 YES �NO <br /> ls a partion ot ihe property used tDr ihe sale ot akahalic beverages? YES �NO !f Yes,state the number of hours per week <br /> Is the property owned w used by an organization which d'iscriminates in <br /> membership or employment t�ased on race,color,or national origin7 ❑YES �NO <br /> Under penattias oi law.I eclare that I have exemined lhis exemption application and,to the 6est of my knowledge and beiiet,it is corract anrJ <br /> compleFe.I Iso declare!ha am duty authorized to sign this exemption application. <br /> sign `�' C.� 1 ��, - ��. �i <br /> here '°'�ihorized Signature Title �� Date <br /> FQR COUN7Y ASSE550R'S RECOMMENpA'1"IpN <br /> � APPROVAL COMMENTS: <br /> ❑ APPROVAL OF A POR710N ' <br /> ❑ PISAPpRpVAL �'��c�41�. <br /> Signatur ol n�y Assessor Date <br /> FOR COUNTY BOA F EQUALIZATION UBE QNLY <br /> I declare Chat,to the best of my knowledge and belief,The determinatiDn hereby made by the County Board of Equalization is correot pursuant <br /> to the laws of the State of Nebraska. <br /> �APPROVED COMMENTS: <br /> ❑ APPROVAL dF A POR710N 'n '� i`\ ��S <br /> k . ��, r i <br /> N � i i� l �.;�«: � <br /> ❑ DISAPPROVEd .J � � U��L� <br /> gnature ot County em r ry n F�+ i�q� - ' <br /> Nebraska Dapariment ot p�renUa uihotized by Ned.Rev.Sta�.�§77-202.D1 <br /> 96-135-7998 Rev.7-201Q Supersedas 96-135-1988 Fev.Y i-2008 r, , � <br /> M �(� �t Y� I"tJ��4'��`,'v4.d� <br /> �i Yl l_�., E.J�.1 U i�l : ,• <br /> PLEASE MAKE A CDPY FOR YQUR RECdRDS ��•i'r;�'�`'�?;`;��`�``�i�'.I\s'���r���� <br />