Laserfiche WebLink
Mar 06 2015 12:33FM Goodwill 0 3083849231 page 2 <br /> TO SE RLEDWITH Application for Exemption FORM <br /> YOUR COUNTY front Motor Vehicle Taxes C <br /> TREASURER byQ�ityMyingvg Nonni�tietaeesiOrganizations 457 <br /> Apoanrs Name <br /> �ed om/ OaW t\ TJak,4-ryas c} iliCt f k` i]S Tar 44 r11 .X.Ronpr otm Streetor Ot'er MaFsAdders* County Number tes <br /> on l tooy 5 G .11:14.1 P ^ C e,/ `Z10S ❑oer(spotty):rate State TS\arc �S 1 D �� <br /> Identify Oficers.Dtecbre,or Partners <br /> The Name,Address,City,State,Zip Code <br /> Ve r -PtdityA <br /> UST SPECIRC DESCRIPTION OFTHE MOTOR VEHICLES <br /> 1 *Attach additional sheet If necessary <br /> Registration Date or Date <br /> Vehicle Make Mouth YatV Cody Type Vehcle Idensscatpn Nuatcer of Accaysion d Natty <br /> Purchased <br /> e)n-v Ioo3 Mal,bit LCLIZSEIF ZEt39lynci 4sVer4 3 itr <br /> _- •. - It . _ C:. 3• . • • ., - -, •:: q <br /> Si <br /> Nature of Use d MotorWINN : Are the motor vehicles usad <br /> ❑AgrIwlNraWotiw al SI Educational ❑Religious ❑periyfaa ❑Cemetery ecossieely es k,mrate? <br /> Give Beta bu desorption of use,Indudinp an expMogan if mmul t classifications exist hams <br /> _- ZYtS ❑no <br /> s-�Vcr Cc-c-- $1tCA(t ri Al) Q.{Ld . -0.- c i tamYms tt No.give peroerLya: 16 <br /> cl\I livid ex 5s"tP err% t C c\k te..1 <br /> A.cr 1 v1Vt., < <br /> &AZ 4cdvY. t in . <br /> Under penalties of Ms,I declare ihel I have exambed this apppaOon and,to the best of my Knowledge and belief,it is coact and <br /> compytr.I atee declare Mat I no dWy authorized to sign this creptiom epptwtlen,and Nat the organisation omens said property does not <br /> diecdmnpe in membrtip or smpleylMnt based co race,color,or national origin. <br /> sign o J u te�-ls <br /> here Fl3 <br /> Date <br /> FOR COUNTY TREASURERS RECOMMENDATION 1 <br /> ROVAL RECEIVEtMENTS = " t fiC24'4--'14.5:al #77—n <br /> ❑DISAPPROVAL <br /> MAR 6 2015 ;_ G �-2+A— -�6=.rte--' <br /> 0 Signature of Cou Treasurer Date <br /> I HALL COUNTY R COUNTY WARD OF EOUALIZATION USE ONLY 1 <br /> ,,,�/ TREASURERS OFFICE <br /> APPROVAL GRAND ISLAND,NEB ffet <br /> J/J/J❑l DISAPPROVAL Al(/reI ti/ C g7101.5 <br /> ''.rued'- ',to <br /> - Date <br /> Neentle Marmon/or AeWaa Autadzed by Ne0.Rex sot l77a02fI)10301144 3.1a5 0&0-31m <br /> 1e-2532005 ibc tacos aw•raadd 96253-2000 Rev.11-2000 <br /> PLEASE MAKE A COPY FOR'YOUR RECORDS <br />