Laserfiche WebLink
*VI <br /> iser-L- Application for Exemption FORM <br /> Nebraska Department of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •To be flied with your county treasurer. <br /> mmil •Read instructions on reverse side. <br /> Applicant's Name Type of Ownership <br />' IGLESIA DE DIOS EBENEZER ®Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 2228 N BROADWELL AVE PO BOX 486 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, ip Code / / <br /> t4.06.� Carte P f%rttD llt Wed r3-14 I cr nd it /tic ODD . <br /> J I c�e�r- re 0a4-4. A ,11.•_ .• ' a . / YCe <br /> Mlle' �'*s r - ' . 'W�ni. '.�a/.rir an. <br /> if ,._ ,a a '- . 77� � ,_ynr____ 41Li <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> • <br /> Registration Date or <br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition, <br /> II Newly Purchased <br /> �a _. Iti 1 5'0 61 lid/ 285WS357.41VKSb7fl <br />• <br /> 31vc aid .2000 2; U5 IBBAKCShc3fPOlp/76- <br /> t-1-t vtol 2Oo7 y ,yobcalk/ JtblrA36267501fl3/ <br /> Exempt Uses of Motor Ve icle: r� Are the motor vehicles used exclusively <br /> ❑Agricultural/Horticultural ❑Educational / Religious ❑Charitable ❑Cemetery as indicated? <br /> Give detailed description of uise,including an explanation if mull' le use classifications exist: 7 YES ❑NO <br /> V AV I, If No,give percentage of exempt use: <br /> lJ Se_ Cam- c It v to4 4 G V i hts r <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• -motion application,and that the organization owning the above-listed property does not discriminate <br /> in .' . • • . • ment based on race,••%national origin. <br /> sin -.r.--s.. <br /> _... .... , (-leaf /km,— ////947 <br /> here I Authorized Signature Title Date <br /> / RECEIVE S- TY TREA�S,UyRE�R RECOMMENDATION ��� 77! �G2 <br /> El APPROVAL DCOMME S: �✓'� �� <br /> ❑DISAPPROVA NOV 1 9 2013 <br /> HALL commis; • Sig�e of ty�surer Date <br /> TREASURER <br /> GRAND IULAND�NE UN BOARD OF EQUALIZATION USE ONLY <br /> APPROVAL COMMENTS: <br /> ❑DISAPPROVAL <br /> • , C / 71M°Hi <br /> 11 Authorized Signature Dale <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. <br />