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�ro s��i�o wr►� Exemption Appiication Fo�M <br /> rouR forTax Exemptian on Real and Persariat Property by C�ualitying Organizatians 4�.� <br /> COUNTY ASSESSOR p���p�fln reverse side. <br /> Fallure W property campiete ar flle this appiication in a pmely manner shall resul!in a disapprovai of th�e exemption. <br /> �n Caunry No. 7ype of Ownership <br /> Name W Onyaniration �Y <br /> tn onc�l rcj �f rh�e �o rS �+ur�fcP �Q.,��:��tcG;F�r���on <br /> 5lreet or Dther Making Address ��� Sfads Where Incaporated i �7,�Other(SP��Y) <br /> s�, �l�h s + <br /> C� gtate �ip Goqe Hchial Va1ue Parcei or Locatsal f�Nucn6er <br /> �fi�n �lQ.-,c� �► 1 J-�3# 4oc�oozS��f <br /> txya�deyscripiion df reat propeAY aLnd genera�deaGrip6on a�f+au�ngtible pe�onal property,exoept ucensAd mo�or vel,ides:_I 0 SQ P c:aC��(S � \�-�i �,�n N.i r� <br /> - � l'4.b�t. � I" ' 1 `Gt=t c1. � e� S I .t�' la '_ ' _ <br /> ..rnG L '�iJl � � �C`.Yl S'C�� � � <br /> . . �bE O}D�iC01'S� . . . . . <br /> Narne Directors,or Psrtners Addr�s,City,State,Tip Code <br /> r " .rG-� .L� .z�c( �3 C�T° ' � <br /> Properly des[xi6ed ahc>ve is u�d in Me fotlowing ex[mp!category(Plaase rtk�rlc ne appGcahle 6aues): <br /> �AgriculturalRlorticullural Sodety" ❑ Educational �Re6giaus ❑Charila6le ❑ Cemelery <br /> Give a deraiied desaipaion d the use d the ProperlY. ` c ,�� C <br /> �c���.+ • r c.,- �� � <br /> 'AgricutturaVhbrticulturai Spciety dnes not need to camplete the folbwing questions. <br /> Is atl ot the properiy used mcGusively as dEr.aibed a6ove? �YES ❑NQ <br /> Is a portian d the prpperty used ipr the sala�sloolwlic 6e�er'ages? ❑YE3 �NO If Yes,state the num6er nl hnurs a=-��� <br /> Is the prapeny owned or used by an wganizabon wltieh disaiminates in <br /> memUership ar empioyment basetl on raoa.oabr,ar national arigin? ❑YES �NO <br /> Unerer penal9es of law.1 dedare tl�at i have eramined this eooam�app6cation and,to the hest d my knowled.5e a--a€ - _ - <br /> canplete.�also dedare mac�am du�y aunwrized b sign►nis mmmption app�tion- <br /> ., ," <br /> SICJ 11 �'� � ``r � � � �,�l.�0 r`{aCL�5�r I� �/ a. <br /> her� Auttiorized Signawre TNe - - <br /> FQR CQUNTT ASSE55pFt'S RECOMM�NDAT'ION <br /> APPROVAL COMAAENTS: �rJ�rvti Ll Y ��" �c'�l <br /> C <br /> ❑ APPROWAL OF A POF�fK)N ' <br /> ❑ q15APPROVAL � � y�" \� <br /> Signauue d Assesser �.,�W <br /> FOR COt1NTY BOAit EQUALQATION USE ONLY <br /> I de+dare ihat.to fhe 6est d my krqwledga and hsliaf,the delermina n hareby made by ihe County Board af�:a-za:�- s^.�:—w.�..,�.:s-: <br /> 10 the laws of the 5talg d Ne6raska. <br /> � APPROY�D COMMEN7S: <br /> �' <br /> ❑ APPFtQVAL QF A PORTION ,..r�. �C " .-, � ['� �' <br /> i F..'H a <br /> __, c��., <br /> � I '_� . : .; �.. <br /> ❑ I7ISAPPIiU'VE� ��� _ �/�" <br /> nature d Counly eoard Z _ ' <br /> ►�mravl�Uepartme�%d� � � � .w�.. :. ._._. _ _., <br /> Je� <br /> . 88-19.5-Y999 ReV.7-20Y0 Slpe'sedes 98-Y9�18BB R9Y.11'dMr � �...� t ���� , � <br /> i�� Y�< �1 �.":� �i�..��°1 <br /> � �[ � . <br /> ���.�r.i{��_,�.,.''.: P�i..[i{ �,w Y�,�1 <br /> PLEASE MAK�A COPY FOR YOUR RECORDS �-B "'`"' <br />