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File with Exemption Application FORM <br /> Your County for Tax Exemption on Real and Personal Property by Qualifying Organizations 4J� <br /> Assessor Read Instructions on reverse side. J <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 /> Platte River Whooping Crane Maintenance Trust, Inc. Hall 2016 <br /> Name of Owner of Property State Where Incorporated <br /> Platte River Whooping Crane Maintenance Trust, Inc. Nebraska <br /> Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number <br /> 6611 Whooping Crane Drive $566,442.00 400229609 <br /> City Stale Zip Code Contact Name Phone Number <br /> Wood River NE 68883 Charles A. Cooper (308) 384-4633 x 116 <br /> Type of Ownership <br /> [JAgricultural and Horticultural Society [I Educational Organization t: Religious Organizalion Charitable Organization Cemetery Organization <br /> Name Title of Officers, Address,City,State,Zip Code <br /> Directors,or Partners <br /> Van E. Korell Chairman AmFirst Bank, N.A., 602 W. "B"St.. McCook, NE 69001 <br /> Thomas J. Dougherty Vice Chair 2973 Zachery Drive, Loveland, CO 80537 <br /> Douglas L. Curry Secretary/Treasurer Erickson &Sederstrom PC LLO, 301 S. 13th St., #400, Lincoln NE 68508 <br /> Legal description of real properly and general description of all depreciable tangible personal property,except licensed motor vehicles: <br /> MARTIN TWP PT SW Y 12-9-11 (116.18 acres). I <br /> ,)EE 31 2015 <br /> Property described above is used in the following exempt category(please mark the applicable boxes): //�HALL C011iti i'y!ASSESSOR <br /> ❑ Agricultural and Horticultural Society ® Educational ❑ Religious ® Charitable ❑ CemeterPRANO ISLAND. NEBRASKA <br /> Give a detailed description of the use of the property: <br /> The Platte River Whooping Crane Maintenance Trust, Inc. ("Crane Trust")is a charitable organization dedicated to protecting and <br /> maintaining critical habitat for Whooping Cranes,Sandhill Cranes, and other migratory birds.The Crane Trust uses the said property <br /> exclusively for this purpose and for related charitable,educational,and scientific purposes.The said property is exempt from taxation under <br /> Neb. Rev. Stat.§77-202(1)(d),among other reasons. <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 pe Iti=s 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. V clare I am du+ authorized to sign this exemption application. <br /> Sign /iii/% ��� President and CEO 12/30/2015 <br /> here Authorized Signature Title Date <br /> Retain a copy for your records. <br /> For County Assessor's Recommendation <br /> ❑ Approval COMMENTS: l.._.'— c�tTJ r� <br /> ❑ Approval of a Portion ` \ ) <br /> AT <br /> Denial \ c �`- Y �. cY`_ <br /> / Signature of my Assessor Date <br /> For County Boa 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: r <br /> i <br /> ❑ Approval of a Portion / SY / er <br /> Denied ,/ur�/ A - <br /> Si•6!ure of t/ my-r?r•Memb r Date <br /> County Clerk:A legible copy of this form showing the final decision of the County 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,Property Assessment Division Authorized by Neb.Rev.Slat.§§77202.01 and 77-202.04 <br /> 96-135-1999 Rev.1-2014 Supersedes 96-135-1999 Rev.7-2012 <br />