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2010 <br /> TO BE FILED WITH Exemption Application FORM <br /> YOUR for Tax Exemption on Real and Personal Property by Qualifying Organizations 451 <br /> id <br /> COUNTY ASSESSOR Read instructions on reverse side. <br /> Failure to properly complete or file this application in a timely manner shall result in a disapproval of the exemption. <br /> Name of Organization County County No. Type of Ownership <br /> CPA•TEHt AlFd,A5KA rah&c 50Frry?IL p55)C64t/0i✓ Hall 40 Nonprofit Corporation <br /> Sheet or Other Mailing Address State Wherg Incorporated ❑ Other(Specify) <br /> 5sy 2c%h Q(Zfi 5KVt <br /> City State Zip Code Actual Value Parcel or Location ID Number <br /> E440 i 5L/1N6 MC 69601 <br /> Legal description of real property and general description of all tangible personal property,except licensed motor vehicles ;F [ <br /> 5or EQvidomE,tir Yy <br /> N.1 <br /> APR 3v2015 <br /> Title of Officers, <br /> Name Directors,or Partners Address,City,State,Zip Code <br /> MARIt <br /> VA Ai /°2E5 1•00/1 5P-1 £ ter; 6RAAIQ (S(ANp NC 6 81at�'i <br /> R yAA) °NE1t-. vice Pit sal£ur 4124 &)�}Nom£ G i run Is-7 ,`f'1 <br /> b L £ TAR Z'1 WYANIs / - 'N CAD £ 6, r o/ <br /> ! _ _:_4..r. r/2 2 U.ftR ' P( N / NO 1 £ lr7£gr <br /> M%k.f - <br /> Property described above is used in the following exempt category(please mark the applicable boxes): <br /> ❑Agricultural/Horticultural Society' ❑ Educational ❑ Religious H Charitable ❑ Cemetery <br /> Give a detailed description of the use of the property: /T E(!`EA TM MA-L 4- comfier/rill( &Mt. ,' so fT/AG(, Ia.() <br /> anta 9„ey 74 4' - / <br /> *AgriculturaltHorticultural Society does not need to complete the following questions. <br /> Is all of the property used exclusively as described above? CJ YES ❑NO <br /> Is a portion of the property used for the sale of alcoholic beverages? ❑YES ®NO If Yes,state the number of hours per week <br /> Is the property owned or used by an organization which discriminates in <br /> membership or employment based on race,color,or national origin? ❑YES 2 NO <br /> Under penalties of law,I declare that I have examined this exemption application and,to the best of my knowledge and belief,it is correct and <br /> complete.I also declare that I am duly authorized to sign this exemption application. - <br /> sign 141 an% 2k%r pituie,e0,1 e/- 0"/S <br /> here Authorized Signature Title Date <br /> �., <br /> FOR COUNTY ASSESSOR'S RECOMMENDATION <br /> 7( APPROVAL • COMMENTS: Fl�/ a `'t y —(1- a ra- <br /> n APPROVAL OF A PORTION / <br /> I <br /> ❑ DISAPPROVAL , - - - . • , -`-�+�- C, - t%.- ,_..J <br /> Signature o • n y Assessor Date <br /> FOR COUNTY BOARD c-EQUALIZATION USE ONLY <br /> I declare that,to the best of my knowledge and belief,the determination hereby made by the County Board of Equalization is correct pursuant <br /> t pk to the laws of the State of Nebraska. <br /> l APPROVED COMMENTS: <br /> ❑ APPROVAL OF A PORTION / <br /> ❑ DISAPPROVED * /�) <br /> /K <br /> Sig re o Co Bo m Date <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stet.§71-202.01 <br /> 96-135-1999 Rev.7-2010 Supersedes 96-135-1999 Rev.11-2008 <br /> PLEASE MAKE A COPY FOR YOUR RECORDS <br />