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02/04/2016 13:26 3083022494 AMERICAN RED CROSS PAGE 02/02 <br /> , ,tom Application for Exemption FORM <br /> Pt alit <o 7 .,a,aned from Motor Vehicle roe by Qualifying Nonprofit Organizations .457 <br /> •�� •Read innetrircUons your ma/side.urar' <br /> Type or Ownership <br /> Applicant's American arras 14 Nonprofit <br /> gITterican Red Cross CounW Corporation <br /> Street a Other Malting Address Hall _ 0 Other(seedy): <br /> City E Third St Sabi alp Code State Where InOOrporafed <br /> c� <br /> Grand Island NE DC <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF H E NONPROFIT ORGANIZATION <br /> The Naive;Addrem,GN,state,Zip Code (A �/�����II'.3 .. ,.Aar' rS.: <br /> 11.4144••• � / d�� /I,fI�Y� r/1L 713,,rte/ 11 17i lr m�!'eZ' AP.. ri.'f-�i <br /> —WW1!.I, : II vac , Ir. y3L M e. A ' nfai"i%"l f.7 5xt'r l <br /> DESCRIPTION OPINE MOTOR VEHICLES <br /> •Attach an AMMAN sheet,If necessary, <br /> Registration Date Or <br /> Motor Vehicle Make Model Year saSyTpe VeNde ID Number Dam W AoWJeltlan, <br /> s Newj Purchased <br /> CMG <br /> 2015 Terrain SLE2 2GKFLWEK2F6417459 02/0112016 <br /> Na the motor whiles used mxdusNely <br /> Exempt gricltMolooVMYde: as SP:Wated? <br /> ❑AgrddoamYHardeultural ❑Educational ❑RsugWUe ®ChartebW ❑Cemetery <br /> YES ONO <br /> detailed desorption or um,Mang an explenatlon it maple use dsnl cation exist: <br /> Disaster emergency response services if No,ghe percentage of ewdmpt use: <br /> x <br /> under pommies of lax,I declare that I have oxaunlhad this epplIcadon and that it Is,to the bee!Oi my knowledge and beliat bus.Odrapbls,and carted.I <br /> llhodred to eV this exampdon appaoetlon,and that the ot9wiU lOn owning Ihe atw.wfstad property does/nn7ootQ�asysIn illlaala /� <br /> in m tubers ip r em loly a� color,or national origin. Drip' D (O' )l i to <br /> in membership or employment based on race, <br /> Sign litigULLJApiff0- Executive Director 02/01/2016 <br /> here tlxed 9lpetum Tile Date <br /> I FOR COUNTY TREASURER RECOMMENDATION . <br /> Eir‘PROVAL RECEIVEDra MM TS: t i,e...r , I A . 1 . , _; <br /> ❑DISAPP L <br /> FEB 4 2016 A , . % I ._ a .„, , 2 .t ,2l to <br /> Signature or CountYTr:, - �e ,.,, l• <br /> I N411 rtutry FOR COU BOARD OF EOUALJZATION USE ONLY <br /> TREASURERS 01-FleE <br /> GRAND ISLAND NEBRASKA <br /> ❑APPROVAL COMMENTS: <br /> It . <br /> ❑DISAPPROVAL i�a I/j • <br /> ., '/, <br /> thodxed 7-n - Date <br /> ean,ereed by Mane%star 4 fl�10211xd add IM.Odd ead,1e5,err eca.teo <br /> Nebraska 00R a SS d Rcronud <br /> g6dsaaoeC pea SSW gupwyMes%2saese Hsu 54009 PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />