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e^-.---z___ Application for Exemption 91, 6 i(.,_ ' FORM <br /> Nebraska Department of <br /> RE <br /> s dENUE 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 /> NEBRASKA STATE FAIR BOARD <br /> ®Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 501 9NNER-PARK-RD E200 Pc * ..,), 13?7 HALL Other(specify): <br /> City State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68802 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION <br /> Title(' a Name,Address,City,State,Zip Code <br /> '*See. a�+Rri of IIS'}lrwq <br /> DESCRIPTION OFTHE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> i I 1 Registration Date or <br /> Motor Vehicle Make Model Year Body Type Vehicle lD Number Date of Acquisition, <br /> 14 Newly Purchased <br /> CkliC0la Iu..ala 2004 SclitLW% 2411AJp526—8_4124 7 415 <br /> lilacvtrnlc ' S•tlueri,do 2003 '12 +vv.-hrurAc e0G4k141-53227i,742 <br /> lliuthrotek livxltecSe_. 2012 4-door 16MKt/GEO4GT214041 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> 0 Agricultural/Horticultural 0 Educational 0 Religious 0 Charitable D Cemetery as indicated? <br /> Give detailed description of use,including an explanation if mullale use classifications exist: 7E5 ONO <br /> f Se— G,0vp�i It ` `akS �e_ u�� b y 4L `,d S+4-4e- <br /> % <br /> If No,give percentage of exempt use: <br /> Bcscret of A91^tcia4lxrrzr and S+afc Cr- co AAsetvly use.. 0 Kly . , <br /> kie-bra Slat A)an) o•r Agrtc.44urrc. •tS cc 50I(c-cS <br /> Corporc --tiavt . <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 membersh' or employment based on race,color,or national origin. <br /> sign <br /> #Rayin d rtB vC 4 D <br /> 11/2 <br /> o hs <br /> here o (r-11y 0461 en 308-3E2_Tlitso, ,o ate <br /> I <br /> FOR COUNTY TREASURER RECOMMENDATION • t 7,1-- I <br /> ©'APPROVAL RECEIVED COMMENTS: J t.' "7-" ��' /v"'�'9C' ��� <br /> °aa'i pt9G <br /> El DISAPPRO L � '. <br /> /Signature of County Treasurer • Date <br /> I HALL CO�NT•�r�Ey R COUNTY BOARD OF EQUALIZATION USE ONLY <br /> TRCAGUf1CR 8 CS <br /> �[ GRAND ISLAND NEBRAStCA <br /> Si{APPROVAL COMMENTS: <br /> ❑DISAPPROVAL /� � C <br /> I Au'Rrized •! !1%r! ihe <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stat.§§77-202(1)(c)and(d),and 60-3,185,and 60-3.189 <br /> 96-253-2006 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />