Laserfiche WebLink
aat6T <br /> Nebraskaben pa�m ntot Application for Exemption FORM <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 /> OVERLAND TRAILS COUNCIL BOY SCOUTS OF AMERICA ® Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 2808 O'FLANNAGAN ST HALL (specify) <br /> ❑Other <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 �Na�me,e,Address,City,State,Zip Code <br /> Prctr,er-i- Mark.Mnusrti . <br /> i . u • ••t• • V u . .• . h a • Isla ..ao-5 <br /> VP It1ocI..Rt 3- <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Motor Vehicle Make Model Year g Date of Acquisition, <br /> n, <br /> BodyType Vehicle ID Number Date of Purchased <br /> it Newly Purchased <br />. I;MC- 199La �nyo..n 16TF675RITi033nK <br /> Ford l°t9-1 LOT ,rvren}r nrr...1 1F\LP 41FLVEDD33.1.-1 3-1-1-14-1 <br /> HLu.lnwrlc_. 2014 Tro�lcr 5"l'SLzr32'{71ENZD4o1Y 3-3i-14 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> ❑Agricultural/Horticultural E Educational ❑Religious ❑Charitable ❑Cemetery as indicated? <br /> Give detailed description of use,including an explanation it multiple use classifications exist: g YES ❑NO <br /> 6M C.- ear-°N° 1CLu3t.te_-,3¢..e,-a4 CC.ns4 u.a2� <br /> i FO(d- CLlxr� 0gxJJT:ts-i-Tr.rc.- C N.G.; <br /> If No,give percentage of exempt use: <br /> mon_1 r1y1e.r-C?cs,t, l - --Ja`.i'1 r•..-q:.:.a.r of a r._rv.c a l.i:,.,.-L\ :.0 <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 origin. <br /> here r?�ature 5atiu �x a�J e i t%l7/a0 i y <br /> Aumonzed Signature The Date <br /> FOR COUNTYTREASURER RECOMMENDATON ' <br /> [i]'APPRCVAL RECEIVED COMMENTS:/ A41,5:5... .r77-..g.e9 42- <br /> ❑DISAPF ROYAL NOV 1 9 2014 t -1/27,/, p J-� C <br /> • ' r /" <br /> Sign WCodaty Treasurer Date <br /> FOR COUNTY BOARD OF EQUALIZATION USE ONLY <br /> HALL COUNTY <br /> TREASURERS OFFICE <br /> 5GPPRCYAr GRAND ISLAND,NEBRASKA rnJ MENTS: <br /> ❑DISAPPROVAL <br /> /.ji7, 41 13 -!S <br /> rA on .. 7'• ature Date <br /> Nebraska Department of Re.enue Authorized by Net Rev.Star.§§77-202(11(c)and(d),and 663.195,and 50.3,189 <br /> 95-253-2006 Rev.8-2011 Supersedes 95-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />