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2\015 <br /> smen --e - 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 /> •Read instructions on reverse side. <br /> Applicant's Name Type of Ownership <br /> BIKES AND TRYKES OF CENTRAL NEBRASKA ® Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 3004 W FAIDLEY AVE HALL ❑Omer(specify): <br /> City State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION <br /> Title Name,Address,City,State,Zip Code <br /> ~-Pre$l 6.14 Do-otc\ kr.itus Zoo B Si-yea- Sic\ •hiE In Ste <br /> V t(,3/resiclza4 Sarci" Sczo,rcc Zoo 8 54ret4- She\10e WE (1887 . <br /> Sir. 14.V.si 6rtSory 'Sobs V4S%04- 6.k Rd 4-3z G3,UF 68861 <br /> '(reaS R..becv. SP'4h`f 3oos VJ Stelt.7 Park psi&3z 61, AJE (or$'ol <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Motor Vehicle Make I Model Year BodyType Vehicle ID Number I Date o Acqusition, <br /> if Newly Purchased <br /> Rc Tro..lars ZOIZ 'IXIIsT Fif<AQ E itelgcM511451 <br /> • <br /> Exempt Uses of Motor Vehicle: sau�ss Are the motor vehicles used exclusively <br /> as❑AgriculturatMorticulW21 ❑Educational ❑Religious 1'la Charitable ❑Cemetery indicated? <br /> ''_TT 71-041 es' <br /> Give detailed description of use,including an explanation if multiple use classifications exist: EYES ❑NO <br /> V)C, C1Ve 0. not.n.r' ,� SetUl(�- Or�an,2c_TPe� - wk.. Pr0\11 C�. <br /> It No,give percentage of exempt use: <br /> +lle ra�lnV 1 L .Seri\_�r's``"" ' r,;Sctau,a -,..c�,wl6,as i T ._ 4v-v;. -r `a;\\ <br /> ba wool 4o wS b',ku \-D \o lta .&ki-ls. <br /> Under penalties d 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 oo?r\ V,P. tiIlai <br /> here ■Authorized Signature "d Title Date <br /> FOR COUNTY TREASURER RECOMMENDATION '/ I <br />• �PPRbVAL COMMENTS: -'"/""-T — �P-�' A- `S'S, 77 <br /> RECEIVED <br /> ❑DISAFPROVAL '� <br /> NOV 1 4 2014 �--:A-ice <br /> Signature'orGei my Treasurer Dale <br /> FOR :OUNTY BOARD OF EQUALIZATION USE ONLY <br /> HALL COUNTY <br /> TREASURERS OFFICE <br /> Vapppnvnt GRAND ISLAND,NEBRASKA COMMENTS: <br /> ❑DISAPPROVAL <br /> Au•oozed Sig : u'O' Date <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stat.§$77-202(1)(c)and(d),and 60-3,185,and 603.188 <br /> 96-253.2006 Rev.a-2011 Supersedes 96-253-2006 Rev.5-2039 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />