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2)615 <br /> tl�.LZ Application for Exemption FORM <br /> Nebraska Department of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •TO bellied with your county treasurer. <br /> •Read instructions on reverse side. <br /> Applicants Name Type of Ownership <br /> HALL COUNTY LIVESTOCK IMPROVEMENT ASSOCIATION FONNER PARK ® Nonprori <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 PRESIDENT Name,Address,City,State,Zip Code STEVE KUNZMAN 2408 RIVERSIDE DR G I NE 68801 <br /> . EV Da 1 PO BOX 5315 G I NE 68802 <br /> 2ND VICE: MONTE HEHNK 4019 NORSEMEN G I NE 68803 <br /> 3RD VICE: GREG BAXTER _ _1 N MONITOR RD G I NE 65803 <br /> SEC: STEVE HANSEN 3421 STAGECOACH RD G T NE 68801 <br /> TREAS: MIKE JAKUBOWSKI 3510 S BLAINE GI NE 68801 <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year BodyType Vehicle ID Number Date of Acquisition, <br /> If Newly Purchased <br /> SEE ATTACHED LIST <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> Agricultural/Horticultural ❑Educational ❑Religious in Charitable U Cemetery as indicated? <br />• Give detailed description of use,including an explanation if multiple use classifications exist: uYES ONO <br /> 4-H ACTIVITIES, COMMUNITY ACTIVITIES, PROMOTIONAL ACTIVITITES OF <br /> AN EDUCATINAL OR CHARITABLE NATURE, HORSE RACING, AGRICULTURAL If No,give percentage of exempt use: <br /> EVENTS INCLUDING THE AHLL CO FAIR & NE STATE FAIR & STATE 4-H HORSE <br /> 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 oigin. <br /> s <br /> sign ` ,�,\ L\ 5 (/ke/2).EKEC-V..g -&- CEO 11/12/14 <br /> here Authorized Signature HUGH M MINER JR Title Date <br /> FOR COUNTY TREASURER RECOMMENDATION <br /> RKPPRJVAL OOMMENTS: •6S, i RRk—CO #4.41‘- 77i7®.42-7 <br /> RECEIVED <br /> DISAPPROVAL <br /> NOV L 4 14 /Cf )/Q1-4422,@—) <br /> Signature of County Treasurer Date <br /> FOR COUNTY BOARD OF EQUALIZATION USE ONLY <br /> HALL COUNTY <br /> TREASURERS OFFICE <br /> LAPPROVAI GRAND ISLAND,NEBRASKA COMMENTS: <br /> E DISAPPROVAL / <br /> ay/ate! /-1.5 "15 <br /> • 'l prize" inn. ure Date <br /> Nebraska Department of Revenue Authorized by Net Rev.Stat.§§77.202(1)(c)and(d),and 00.3.185.and 00.3,189 <br /> 98-253-2006 Rev.8-2011 Supersedes 96-253-2008 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />