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Ale with Exemption Application Your County forTax Exemption on Real and Personal Property by Qualifying Organizations FORM Assessor Read instructions on reverse side. 451 Failure to properly complete or timely file this application will result in a denial of the exemption. Name of Organization County Name Tax Year Platte River Whooping Crane Maintenance Trust, Inc. Hall 2 6 1 Name of Owner of Property _ 216 State Where Incorporated Platte River Whooping Crane Maintenance Trust, Inc. Nebraska Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Pro 6611 Whooping Crane Drive perty Parcel ID Number $524,863.00 400218879 City State Zip Code Contact Name Phone Number Wood River NE 68883 Charles A. Cooper of Ownership (308)384-4633 x 116 ❑Agricultural and Horticultural Society ❑Educational Organization Religious O I ❑ 9 Organization ®Charitable Organization ❑Cemetery Organization Name Title of Officers, Directors,or Partners Address,City,State,Zip Code Van E. Korell Chairman AmFirst Bank, N.A., 602 W. "B"St., McCook, NE 69001 Thomas J. Dougherty Vice Chair 2973 Zachery Drive, Loveland, CO 80537 Douglas L. Curry Secretary/Treasurer Erickson&Sederstrom PC LLO, 301 S. 13th St.,#400, Lincoln NE 68508 Legal description of real property and general description of all depreciable tangible personal property,except licensed motor vehicles: See the attached Exhibit"A." Property described above is used in the following exempt category 9 P 9 ry(please mark the applicable boxes): Be r• 3 1 2015 ❑Agricultural and Horticultural Society ® Educational ❑ Religious ® Charitable ❑ Cemete U V Give a detailed description of the use of the property: X114 NQ(Q(�N' The Platte River Whooping Crane Maintenance Trust, Inc. ("Crane Trust")is a charitable organization dedicated to p,�ro jtethssis� maintaining critical habitat for Whooping Cranes,Sandhill Cranes,and other migratory birds. The Crane Trust uses L he said prope y exclusively for this purpose and for related charitable,educational,and scientific purposes.The said property is exempt from taxation under Neb. Rev. Stat.§77-202(1)(d),among other reasons. All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. Is all of the properly used exclusively as described above? Is the property used for financial gain or profit to either the owner or owner or o ��YES ❑NO ryanization making exclusive use of the property? ❑YES ®NO Is a portion of the property used for the sale of alcoholic beverages? If Yes,state the number of hours per week DYES ®NO Is the properly owned or used by an organization which discriminates in membership or employment based on race,color, or national origin? Under penilfies of law,I declare that I have examined this exemption ❑YES El NO signcomple -1' decl that I a mot application and,to the best of my knowledge and belief,it is correct and y authorized to sign this exemption application. here Authorized signawre President and CEO 12/30/2015 Title Date Retain a copy for your records. I For County� r A�ssessor's Recommendation ID 7 Approval COMMENTS: (, { - k0 _--a, ❑ Approval of a Portion _ Denial ._.• . ' . n / Signa— i County Assessor ` l ,C.-- Date I For County Bo. d of Equalization Use Only 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 laws of the Stale of Nebraska. ❑ Approved COMMENTS: IXApproval of a Portion ,��—a A `X Denied �,%Y,al Ar 7 'rim; jr •*!fl*.+►,-'be- Date County Clerk:A legible copy of this form showing the final decision of the County Board of Equalization must be delivered electronically to the Nebraska Department of Revenue within seven days after the Board's decision. Nebraska Department of Revenue,Property Assessment Division 96-135-1999 Rev,Y2014 Supersedes 96 135-1999 Rev.7-2012 Authorized by Neb.Rev.Stet.§§7F 202.01 and 77-202.04