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��f .s C NOV . ,. '2.314. A 16• 1 b Nebraska Depzronental Application for Exemption FORM REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 • •To be filed with your county treasurer. •Read instructions on reverse side. Applicant's Name Type of Ownership NEBRASKA STATE FAIR BOARD ``I/ g Nonprofit Street or Other Mailing Address SO/ t Fennc,r,P4.-k .e i.� St, 2.00 County Corporation e11 W 2Nv^ E 1 PO BOX 1387 HALL ❑Other(specify): City State Zip Code Stale Where Incorporated GRAND ISLAND NE 68802 NE IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION Title ,1,L ` Name,Address,City,State,Zip Code SLL. il,aek . DESCRIPTION OF THE MOTOR VEHICLES •Attach an additional sheet,if necessary. Registration Date or Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition, it Newly Purchased Clicn-.k,+ /a p4ia 2004 Saki 241RJF-52E f92#71/15. CH.vvak4- S;tvcntao Z6o3 9ittt -frucfc /6GEx14f7S322767fir atrtnf?+ " krelltr_s . 2612 4-•jaor 16'ntk✓6En SAT 29G441 Exempt mppt Uses of Motor Vehicle: Are the motor vehicles used exclusively Al• Lr AgriculturalMorticultural ❑Educational ❑Religious ❑Charitable ❑Cemetery as indicated? Give detailed description of use,including an explanation if multiple use classifications exist: IfA YES ❑NO I If No,give percentage of exempt use: 131cS^c.� 0,01Y�d,tny vtktde.-S art bt_ 4 it 43 kieb eastutySlat - ` % /"�{Vt GKnwc., �fO:!•(-i r C apas'y ua. nay. t Y e )JeJor C"d t �r;eul{itit is A �i 1 (c j a�cLSl�a 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 also declare that I am duly authorized to sign this exemption application,and that the organization owning the above-listed property does not discriminate in member. ip or employment based on race,color,or national origin. sign n / _ Ar Ii__r L.A. . i A t.t_/ .r 14 //�o%lI �' Authorized ign ere Title Date here � .pia-3�z-/�ZO FOR COUNTY TREASURER RECOMMENDATION 1 Ei• Pno'At RECEIVED Z`OMMENTS: ,2e-1- ' 45• e 'J7-r7OcZ ❑DISAPPROVAL NOV 1 3 2014 ��3'� a"r�� /"-�_ i, Signature of County Treasurer Date FOR COUNTY BOARD OF EQUALIZATION USE ONLY HALL COUNTY TREASURERS OFFICE pAPPF OVAL GRAND ISLAND,NEBRASKA r`9)MMENTS: ❑DISAPPROVAL ,4 7 /,�A// . it.-i I /-13 .'5 •�i'r.rized '• ature r ' Date Nebraska Deparlmentaf Revenue Authorized by Neb Rev..Stat.5477-202(1)(e)and(d),and 60-3,185.and 60-3,189 96-253-2006 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2039 PLEASE RETAIN A COPY FOR YOUR RECORDS.