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• <br />. , . . . , , aril <br /> ein--Z— Application for Exemption FORM <br /> Nebxa oepemasm <br /> REn,VENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> -To be filed with your county treasurer.de. <br /> • •Rand instructions CIi rellarSS aide. <br /> Applicants Name Type of Ownership <br /> GIRL SCOUTS-SPIRIT OF NEBRASKA ®llpt <br /> Street or Other Mailing Address County Corporation <br /> 2400 WILDWOOD DR HALL ❑Other(speciy): <br /> City Stale rip Code Stale Where Incorporated <br /> GRAND ISLAND NE 68801 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Title Name,Address,Citg Stale,Zip Code <br /> Sec of- - sit' <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> _ •Attach an additional sheet,If necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model War Body Type Vehicle ID Number if Acquisition, <br /> /'l'on,e mgd 17-kikar 0 R"o CD•-■A c i/vrr>,p mc.v. <br /> -run.r f&- <br /> //-0,,.c nq4 --rreANer /ys-y Ccunoo-42 .,h„ /ho 40 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> ❑AgltculturaMHorticulturat %Educational ❑Reegwus ❑Clwttffile ❑Cemetery as Indicated? <br /> Give detailed description of use,including an explanation N multiple use classYications exist onYES ONO <br /> N Na give percentage of exempt use: <br /> Under wallies of law,I declare Mal I have ermined this applii a6tal and that it is,to the best of my knowledge and belief.true,oonplete,and coned.I <br /> also declare that lam duly authorized to sign this exemption application,and that the organization owning the above-fisted property does not discriminate <br /> in •--., • o enpgyrnent based on race,color,or natforW origin <br /> sign y� �r ( �i' 6 v1Gh �.�r.-- ///- �o - .•20/� <br /> here i►�., , -,shwaaae TNa V ate <br /> I FOR COUNTY TREASURER RECOMMENDATION <br /> ❑APPROVAL - COMMENTS: <br /> ❑DISAPPROVAL <br /> ■Signature of County Treasurer Date <br /> FOR COUNTY BOARD OF EQUALIZATION USE ONLY <br /> ❑APPROVAL COMMENTS: <br /> ❑DISAPPROVAL <br /> At/Molted Sioneture Date <br /> Nebraska pepernwn of Revenue ANhoamd by Nee Rea Sbb fM 77-2020Nc)and M).and 609,166.and 60.3,169 <br /> 062632006 Rat 84011 Supersedes 96253•2006 Raw.5300e <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />