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��=ter Application for Exemption FORM
<br /> Nebraska Department of
<br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457
<br /> •TO be filed with your county treasurer.
<br /> ISIIIMECCEMI •Read instructions on reverse side.
<br /> i Applicant's Name Type of Ownership
<br /> HALL COUNTY LIVESTOCK IMPROVEMENT ASSOCIATION FONNER PARK ®Nonprofit
<br /> Street or Other Mailing Address County Corporation
<br /> 700 E STOLLEY PARK RD PO BOX 490 HALL ❑Other(specify):
<br /> City State Zip Code State Where Incorporated
<br /> GRAND ISLAND NE 68802 NE
<br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION
<br /> Title Name,Address,City,State,Zip Code
<br /> PRESIDENT TOM DINSDALE PO BOX 1528 GRAND ISLAND NE 68802
<br /> 1ST VICE STEVE KUNZMAN 2408 RIVERSIDE DR GRAND ISLAND NE 68801
<br /> 2ND VICE STEVE DOWDING PO BOX 5315 GRAND ISLAND NE 68802
<br /> 3RD VICE MONTE HEHNKE 4019 NORSEMAN AVE GRAND ISLAND NE 68803 ,
<br /> SECRETARY GREG BAXTER 2121 N MONITOR RD GRAND ISLAND NE 68803
<br /> TREASURER STEVE HANSErPESCRIPTIONOF THE MOTOR VEHICLES 1420 STAGECOACH RD GRAND ISALND NE
<br /> •Attach an additional sheet,if necessary. 68801
<br /> Registration Date or
<br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition,
<br /> it Newly Purchased
<br /> •
<br /> SEE ATTACHED T,TST
<br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively
<br /> Et Agricultural M ult
<br /> orticural ❑Educational 111 Religious ❑Charitable ❑Cemetery as indicated?
<br /> Give detailed description of use,including an explanation if multiple use classifications exist: ®YES ❑NO
<br /> 4-H ACTIVITIES, COMMUNITY ACTIVITIES, PROMOTIONAL ACTIVITIES
<br /> ,OF AN EDUCATIONAL OR CHARITABLE NATURE, HORSE RACING AND If No,give percentage of exempt use:
<br /> AGRICULTURAL EVENTS INCLUDING THE HALL CO. FAIR, THE NE STATE FAIR oz.
<br /> AND STATE 4-H HORSE SHOW
<br /> Under penalties of law,I declare that I have examined this application and that it is,to the best of my knowledge and belief,true,complete,and correct.I
<br /> also declare that I am duly authorized to sign this exemption application,and that the organization owning the above-listed property does not discriminate
<br /> in membership or employment based on race,color,or national origin.
<br /> sign
<br /> c14-t----1A. "4'∎ H,,,,.¢n 1.--PYPC V—P & CFn 11/5/13
<br /> here I Authorized Signature HUGH M MINER JR Title Data
<br /> F•0°CQYsr7V TREASURER RECOMMENDATION
<br /> /APPROVAL
<br /> RECEIVED -•- --- --- >x,l 1 4 `.. 4 4 F' �j' <':.7
<br /> ❑ DISAPPROVAL NOV 8 2013
<br /> HALL COUNTY r Signature of ounty Treasurer Date
<br /> 7REASURERS�ITY BOARD OF EQUALIZATION USE ONLY
<br /> ,,,,,,......yyyyyy,,,,,, """" GRAND ISLAND.
<br /> I�.APPROVAL COMMENTS:
<br /> i❑DISAPPROVAL
<br /> I. TYlre /n
<br /> • , Authorized Signature Date
<br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stat.§§77-202(1)(c)and(d),and 60-3,185,and 60-3,189
<br /> 96-253-2006 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2009
<br /> PLEASE RETAIN A COPY FOR YOUR RECORDS.
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