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G15 <br /> 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 /> ABUNDANT LIFE CHRISTIAN CENTER ® Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 3411 W FAIDLEY 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,State,Zip Code <br /> PRESIDENT STEPHEN G, WARR/NEIR 3008 rDAHo AVE GRARiP TSLAN2IJE 62g03 <br /> SECRETARY NAA/eY VANCE 3o5 At WETZEL &RANDSS49AJD, NE 68801 <br /> -TREASURE-1 XEN WARREN 3'/IS CO STATE GRAMDLSCAAID,NE 66, 8o3 <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> M.:to:Vehicle fake I Model Year ' :1-4,-Type zhid:c 1D Nurr.ber Date cf Acquichica, <br /> if Newly Purchased <br /> FORD F-55o t7/ono8o&23 .goo& MVS?ALeMReg ag-P IFJ2AF5&F9.b/5055 <br /> CHEV 990.5762066g /495 SPORT VAN /GAG639/<e95.TI '/680 <br /> TRAILER 19 60 a? WHEEL ENCLOSE'P 4Y 6 X 'I <br /> PyEVRoL�T 1490 /Soo5a&1R&RAI 16-NEV/6K4'LFlig @io <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> ❑AgricuturadHorticullural ❑Educational I Religious El Charitable ❑Cemetery as indicated? <br />• <br /> Give detailed description of use,including an explanation if multiple use classifications exist: M YES ❑NO <br /> All vehicles are used primarily to transport various church groups and equipment to and If No,give percentage of exempt use: <br /> from church activities.At times they may also be used to transport trash,tree branches, <br /> etc.to the landfill,haul maintenance equipment;and occasionally by outreach ministries <br /> for things like helping people move. <br /> Under penalties of law,I declare that I ave examined this application and that it is,to the best of my knowledge and belief,true,complete,and correct.I <br /> also declare that l am duly authorized sign this exemption application,and that the organization owning the above-listed properly does not discriminate <br /> in :•.•.- hip or employment based n race,color,or national origin. <br /> sig .ts- Res/ of //- N-/V <br /> here-/°--k ignature Title Date <br /> FOR COUNTY TREASURER RECOMMENDATION <br /> ,PPROVAL RECEIVED COMMENTS: 4;-"/"."174-t- <br /> " ( ' ' /VS 6S' 77° c, <br /> ❑DISAPPROVAL <br /> NOV 1 3 2014 2` v <br /> /Signature Treasurer <br /> Date <br /> HALL COUNTY FOR COLINTY BOARD OF EQUALIZATION USE ONLY <br /> TRCAGURCR3 OFFICE <br /> GRAND ISLAND,NEBRASKA <br /> APPROVAL COMMENTS: <br /> ❑DISAPPROVAL / //jj <br /> ��L/ <br />• <br /> + �,✓� /-/3 -is <br /> on :• igna ure Date <br /> Nebraska Department of Revenue Akxhohzed by Ned Rev.Stat.§§77-292(11(cl and(d),and 603,185,and 603,189 <br /> 98-253-2006 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />