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FE FILED WIT Exemption Application FORM <br /> YOUR &pr?py. Tax p',on on Real and Personal Property by Qualifying Organizations 451 <br /> COUNTY ASSES Read instructions on reverse side. <br /> I omplete •r file this application in a timely manner shall result in a disapproval of the exemption. <br /> I Name of Organizatio pp (\��,,/) r ///•�d Cou�n.�(y�. Coun No. Type of Ownership <br /> I rs.- fro-ILK LAN;{t,f i ti 5( Milt& ( pL1rL R. Nonprofit Corporation <br /> Street or Other Mailing Address State Where Incorporated ❑ Other(Specify) <br /> 090 Ca (Cif;44 . Na <br /> /d / State Zip(C�oddee Actual Value Parcel or Location ID Number <br /> GItyeir k,rA IS l d ` DE 6S8D3 <br /> Legal description of real property and general de ription of at tangible personal pr rty,except licensed motor vehic es: <br /> . C;,r7+ad LID,y,ts 4 of fut 3 r W 4y 'o+ L,+ R RLncb= PAr-rn:,c <c c/2/4/ �" (.,,r,�nl Aut • <br /> #Uw7 /sZ ?36 ni/SC YIPGds ,p£ St igCW iv t/rrlia d9do 1v9GSro <br /> Sr'Aint~ers Add;a<ln„ 1379 N Ce.fur 54- ('7fw.I hL...d„wiz 6Eiot *aond oO7-3 <br /> Title of Officers, <br /> Name Directors,or Partners Address,City,State,Zip Code <br /> ��rar-o , A: .i . , G. • <br /> :ivy r _ u YRa1Fi'!7•"SYl us- 4_ 4e.. lr ,: .tr. <br /> J.. '..5) . ��, 1. . •... A . ∎.10 <br /> T• 11111 nth=e5Na a r.._ . . s <br /> niiiiMiM 'a vzr s' <br /> Property described above is used in the following exempt category(please mark the applicable boxes): <br /> 1 ❑Agricultural/Horticultural Society" ❑ Educational Religious ❑ Charitable ❑ Cemetery <br /> Give a detailed description of the use of the property: l._+'1 krgA n,,;.,,rtr'a V r- 7 en 8 m✓ca o far fa--ta6k,4" <br />' "Agricultural/Horticultural Society does not need to complete the following questions. D`[ 1 8 <br /> Is all of the property used exclusively as described above? RYES ❑NO < !}' <br /> Is a portion of the property used for the sale of alcoholic beverages? ❑YES R.NO It Yes,state the number of hours per week <br /> Is the property owned or used by an organization which discriminates in <br /> membership or employment based on race,color,or national origin? ❑YES NO <br /> Under penalties of law,I declare that I have examined this exemption application and,to the best of my knowledge and betel,it is correct and <br /> complete.I also declare that I am duly authorized to sign this exemption application. <br /> a' - _ _/ <br /> sign _ ( S / e- c s-ihr //air <br /> here •uthorized Signature Title Date <br /> FOR COUNTY ASSESSOR'S RECOMMENDATION <br /> APPROVAL COMMENTS: - a <br /> ❑ APPROVAL OF A PORTION /`' <br /> ❑ DISAPPROVAL ts l , . ' �, _ - ,.� 1 ^ tip'" t� <br /> Signature c[[s``��unty Assessor Date <br /> FOR COUNTY BOAR.`,.• EQUALIZATION USE ONLY <br /> I declare that,to the best of my knowledge and belief,the determine ) hereby made by the County Board of Equalization is correct pursuant <br /> • to the laws of the State of Nebraska. <br /> • <br /> X APPROVED COMMENTS: <br /> ❑ APPROVAL OF A PORTION <br /> ❑ DISAPPROVED , /375 At tC-L_ /�ds-c26/2), <br /> Signature of County Board Member Date <br /> 4lebraska Department of Revenue Authorized by Neb.Rev.Sta1.§77-202.01 <br /> 96-135-1999 Rev.7-2010 Supersedes 96-135-1999 Rev.11-2008 <br /> PLEASE MAKE A COPY FOR YOUR RECORDS <br />