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^—Z-- Application for Exemption FORM <br /> Nebraska Department of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organize lorfs 457 <br /> •To be filed with your county treasurer. <br /> canal •Read instructions on reverse side. <br /> Applicant%Name Type of Ownership <br /> THE SALVATION ARMY <br /> ®Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 818 W THIRD ST HALL <br /> City State Zip Code State Where Incorporated ❑Other(specify): <br /> GRAND ISLAND NE 68801 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION <br /> Title Name,Address,City,State,Zip Code <br /> Corps Otter IArtie c W,a;o.•r. tiles v 1115 JMaat G� Gran"' Zsla•.a fret/en 3 <br /> 6115 pkrr-trGee fit o" Awn. 01 coyly f3tt51}e•.•..rd Ct Gra-n. asLaJ A r eig g0 <br /> AA v.z5. &rant .LI-d-•/Lc4A cad <br /> DESCRIPTION OFTHE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition, <br /> if Newly Purchased <br /> K t--pti oI00 to V Set _NV b/'\t3 33561, D95I56 <br /> CI. tvr-clvfc x2011 1 door Sp .UvI• IGNKRtoeb'BS,3671154 <br /> Glncvrolcic c2OIO Skiatoto 'Va.M IUA1•S(96SAtI345as <br /> trot sa 0 0 9 ee,a,,,„srw•..1 Ca.hustr(FbWtt3SL84DA809Sb <br /> �vr�J ,' ? °t 8 -11-r.04. t FoA17o18wAo tall l <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusNely <br /> ❑AgriculturavHorticufural ❑Educational [Religious 15itLharitable ❑Cemetery as indicated? <br /> Give detailed descrption of use,including an explanation if multiple use cllassififications exist: W\c'6 .s0 . .V.c '- R ES ❑NO <br /> a e r^�•� (y1�0.2 crow, G C.t• 0.Y.6 f.Or•�'• 1N'v+rw: . Y(lt•...45. If No,give percentage of exempt use: <br /> lit�G-3ee d• so.s�`5 5•....c.�t.- s.j c\eusl,rr(4crre..-.ta•LS , --S re-3, G % <br /> ck eta b•a"c.kr .}ow, r CAgeh 4"), -3wr.Inn - . vie a-..5° <br /> -9 C v%r-tiairt"4 .ML's p'J- 3° AC <br /> `r"`1I rider penalties •,- ��That I have-• :mined this application and that a is,to the best of my kno a and belief,true,complete,and coned.I <br /> also declare the ed to sign th,exemption application,and that the organization owning the above-listed property does not discriminate <br /> ' membership. don race,••br,or national origin. <br /> sign <br /> here )) eFOR rps l)0- � \t/I -z,o /5 <br /> A tune T e O 9 Date <br /> 34Y3 90 — Y�r�+r� COON THEEAS,URRE�R,RECOMMENDATION/ � ) s <br /> ErAPPROV'. RECEIVED CO MENTS: �'/""'7""� �� ,t.' • -7 7-.°F•10� <br /> ,�.(.TRfgs, <br /> ❑DISAPPR I AL _ Sal. <br /> NOV L ;�'�5 �• I�- - <br /> .4?-/6 -/-5 <br /> O.Signature of County Treasurer Date <br /> TREASURERS OFFICE FOR ••UNTY BOARD OF EQUALIZATION USE ONLY <br /> GRenu IbLANU,NEBRASKA <br /> [APPROVAL COMMENTS: <br /> ❑DISAPPROVAL i <br /> / <br /> l > � -t Ir,, //A •% 460!✓." <br /> A yf�ized gn. um ate <br /> Nebraska Department of Revenue Authorized by Nob Rev.Slat.§§77-202(1)(c)and(d),and 60-3,185,and 80-3,189 <br /> 96-253-2006 Rev.8-2011 Supersedes 95.253.2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />