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06/30/2015
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06/30/2015
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File with Exemption Application - FORM <br /> Your County for Tax Exemption on Real and Personal Property by Qualifying Organizations 451 <br /> Assessor Read instructions on reverse side. <br /> Failure to properly complete or timely file this application will result in a denial of the exemption. <br /> Name of Organization County Name Tax Year <br /> Hope Harbor Hall 2015 <br /> Name of Owner of Property State Where Incorporated <br /> Hope Harbor Nebraska <br /> Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number <br /> 610 W. Division St. $190,000.00 400007193 <br /> City State Zip Code Contact Name Phone Number <br /> Grand Island NE 68801 Aaron Ross 308-385-5190 <br /> Type of Ownership <br /> ❑Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization ®Charitable Organization ❑Cemetery Organization <br /> Name Title of Officers, Address,City,State,Zip Code <br /> Directors,or Partners <br /> Gerald(Fred) Ruiz President 3203 Kennedy Way, Grand Island, NE, 68803 <br /> Sherma Jones Vice-President 3339 Roselawn Dr., Grand Island, NE, 68801 <br /> Lynn Rathien Treasurer 2723 Lakewood Dr., Grand Island, NE, 68801 <br /> legal description of real property and general description of all depreciable tangible personal property.except licensed motor vehicles: <br /> Original Town, Lots 3844, Block 85 <br /> n <br /> All furniture and fixtures =F ; ? <br /> Property described above is used in the following exempt category(please mark the applicable boxes): 1p+Cp�'L 6 f(015 <br /> ❑ Agricultural and Horticultural Society ❑ Educational ❑ Religious ® Charitable ❑ Cemetery6H44rj" ±i.i 1 <br /> Uy r . <br /> Give a detailed description of the use of the properly: t rs _1 0. <br /> r <br /> Property will be used as a Service Center for Hope Harbor. All staff,with the exception of Direct Care Staff,will bet out <br /> of this building. All homeless and near homeless applying for General Assistance and shelter will apply in this building. The <br /> donations for general assistance such as blankets, household items, etc. will be stored in this building. Shelter residents will <br /> attend classes and case management sessions in this building. Classes such as Financial Peace University will also be O <br /> All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. <br /> Is all of the property used exclusively as described above? _ ®YES ❑NO <br /> Is the property used for financial gain or profit to either the owner or owner or organization making exclusive use of the properly? ❑YES NO <br /> Is a portion of the property used for the sale of alcoholic beverages? ❑YES ®NO <br /> If Yes,state the number of hours per week <br /> Is the property owned or used by an organization which discriminates in membership or employment based on race,color. <br /> or national origin? ❑YES ®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 k ,o,,, yj Executive Director 6/17/2015 <br /> here IP Authorized Signature Title Date <br /> Retain a copy for your records. <br /> For County Assessor's Recommendation <br /> Xi Approval COMMENTS: Pa/n a‘tr ZZ- a <br /> ❑ Approval of a Portion •/� <br /> ._�. fir r •- 1—1 <br /> ❑ Denial Signature o Vu ty Assessor Date <br /> For County Boar• of Equalization Use Only <br /> I declare that to the best of my knowledge and belief,the determination made by the County Board of Equalization is correct pursuant to the <br /> laws of the State of Nebraska. <br /> Approved COMMENTS: <br /> ❑ Approval of a Portion /et!A. I / <br /> ❑ Denied t/rrl,''`_iLl tr ,/ o 3o') <br /> •ature of aunty"a,Meter r Or Date <br /> County Clerk:A legible copy of this form showing the final decision of the ••unty Board of Equalization <br /> must be delivered electronically to the Nebraska Department of Revenue within seven days after the Board's decision. <br /> Nebraska Department of Revenue.Proberly Assessment Division Authorized by Neb.Rev.Stet.§§77-202.01 and 77-202 04 <br /> 96435-1999 Rev.1-2014 Supersedes 96-135-1999 Rev.7-2012 <br />
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