Laserfiche WebLink
X61 <br /> eta—_-- Application for Exemption FORM <br /> Nebraska Depanmem 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 /> GRAND ISLAND CENTRAL CATHOLIC SCHOOLS ® Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 1200 RUBY AVE HALL ❑Other(specify)' <br /> City State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Title Name,Address,City,Slate,Zip Code <br /> 6l I 1111 I=tia ' ingtitanIIIr!�'°AMILIWARI I ritalti ;i 6 <br /> C',1 . <br /> vet♦ A dot. L. ' r /f,../ • a. �,p <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> *act_ I 'kYod/ l7C/0G_ea�Taxi le r Lilt Fig): kr AI, Registration Date or <br /> y• or tele Make a Year Type e e � Date of Acquisition, <br /> �_ t k s /I SO r ft Newly Purchased <br /> iii�af1 ._ �_" , ►1: .r K y n . _Wfl LD igrr.. .._. . <br /> ,��yy _ .�. iw_ •� IIRear . , c�I : . , r.•T1 <br /> [liftla ifieSi�kZ 1i PwTlA :i i• _ _i _ / __st <br /> Exe pt Uses of Motor Vehicle: Am the motor vehicles used exclusively <br /> ❑Agricultural/Horticultural Educational ❑Religious ❑Charitable ❑Cemetery <br /> as indicated? <br /> Give detailed description of use,including an explanation if multiple use classifications exist: l ,EWES ONO <br /> Veit-ices?) r �� '✓i(31 rt If No,give percentage of exempt use: <br />• <br /> U.f+ ch <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 properly does not discriminate <br /> in membe hip or employment based on race,color,or national origin. <br /> sign 0. (x.c,..-- Sidvp.e.--,,,, ).,.,.,- Ii 4 —144 <br /> here I.Authorized Signature Tile Dare <br /> w R COUNTY TREEAAS�UREEyR RECOMMENDATION i • <br /> AP OVAL •RECEIVED;,J fv�MENTS: /- / S �_ ��� <br /> ❑MS PROVAL NOV 2 5 20 14 <br /> e � 4°Q1� -8-��' <br /> TN L.COOS T /Signature o my Treasurer <br /> Date 9RANO ISLAND.NEBRASKA OUNTY BOARD OF EQUALIZATION USE ONLY <br /> ..APPROVAL COMMENTS: <br /> ❑DISAPPROVAL / <br /> 1,4 4( , 1,// l-!• -75 <br /> sized Signature Date <br /> Nebraska Department of Revenue Authorized by Nab.Rev.Stat to 77-2o2f1)Ic)and(d),and 80-3,185.arid 803.189 <br /> 98 253-2008 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />