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J./ <br /> File with Exemption Application FORM <br /> Your County for Tax Exemption on Real and Personal Property by Qualifying Organizations 451 <br /> Assessor Read instructions on reverse side. <br /> Failure to properly complete or timely file this application will result In a denial of the exemption. <br /> Name of Organization County Name TaxYear <br /> CENTRO DE VIDA CRISTIANA HALL 2016 <br /> Name of Owner of Property State Where Incorporated <br /> CENTRO DE VIDA CRISTIANA NEBRASKA <br /> Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number <br /> 1414 E 6TH ST $168,903.00 400058669 <br /> City State Zip Code Contact Name Phone Number <br /> GRAND ISLAND NE 68801 <br /> Type of Ownership <br /> ❑Ayiiuultural and Hudiuullural Sudety ❑Educational Otyauizatiun ®Reliyiuua Otyanimtiun ❑Charitable Organization ❑Cemetery Otyanizatiun <br /> Title of Officers, <br /> Name Address,City,State,Zip Code <br /> ��.��' r7��if Directors,or Partners p • • <br /> �,SPX?o/ <br /> Legal description of real property and general description of all depreciable tangible personal property,except licensed motor vehicles: <br /> LAMBERTS ADD TO THE CITY OF GRAND ISLAND LTS 5&6 BLK 12 <br /> Property described above is used in the following exempt category(please mark the applicable boxes): `r. '�.- e ,µ <br /> ❑ Agricultural and Horticultural Society ❑ Educational IA Religious ❑ Charitable ❑ Cemetery <br /> MAR 2 9 <br /> Give a detailed description of the use of the property: 7� fYl/iR p �/ 206 <br /> HALL= ; ..5:30? <br /> GRAND ISLAND, N'L3?ASi <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? " ES n( NO^ <br /> Is the property used for financial gain or profit to either the owner or owner or organization making exclusive use of the property? DYES N"c/ <br /> Is a portion of the property used for the sale of alcoholic beverages? OYES 02O <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 <br /> Und-r•. (ties of law,I d:.la-that I have examined this exemption application and,to the best of my knowledge and belief,i is correct and <br /> comptet .l .declare that •1{t author' e-to ' this ex lion application. <br /> sign k " /G� .�ea�a..~a,� i4 <br /> J <br /> here ' Authorized Signature Ttle Date <br /> Retain a copy for your records. <br /> For County Assessor's Recommendation <br /> ?Approval COMMENTS: ,� , - — t <br /> ❑ Approval of a Portion <br /> Denial 1 • _ ` <br /> Signature 6 • my Assessor Date <br /> For County Board •f 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: <br /> ❑ Approval of a Portion 4 .• <br /> ❑ Denied / a. 2 I1 <br />• J / 7/,- gna u .ff Co. :. d jmber <br /> 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.Rea Stet.§§71-202.01 and 77-202.04 <br /> 96-135-1999 Rev.1-2014 Supersedes 96-135-1999 Rev 7-2012 <br />