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File with Exemption Application FORM Your County forTax Exemption on Real and Personal Property by Qualifying Organizations 4J Assessor Read instructions on reverse side. J 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 2016 Name of Owner of Property 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 Property Parcel ID Number 6611 Whooping Crane Drive $126,682.00 400218992 City State Zip Code Contact Name Phone Number Wood River NE 68883 Charles A. Cooper (308)384-4633 x 116 Type of Ownership ❑Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization ®Charitable Organization ❑Cemetery Organization Name Title of Officers, Address,City,State,Zip Code Directors,or Partners 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: RECFALDA TWP LTS 10-11 ISL 33-10-10(63.00 acres). R NEC 3 1 2015 Property described above is used in the following exempt category(please mark the applicable boxes): HALL n r x ❑Agricultural and Horticultural Society ® Educational ❑ Religious ® Charitable ❑ Cemetery l 7 L C y J)y�; u ASSESSOR GRAND ISLAND ra1=R i7r As rl Give a detailed description of the use of the property: The Platte River Whooping Crane Maintenance Trust, Inc.("Crane Trust")is a charitable organization dedicated to protecting and maintaining critical habitat for Whooping Cranes,Sandhill Cranes,and other migratory birds.The Crane Trust uses the said property 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 roP e m/used exclusively as described above? ®YES El NO P Is the property used for financial gain or profit to either the owner or owner or organization making exclusive use of the property? ❑YES ®NO Is a portion of the property used for the sale of alcoholic beverages? ❑YES ®NO If Yes,state the number of hours per week Is the property owned or used by an organization which discriminates in membership or employment based on race,color, or national origin? ❑YES ®NO Under pe law,I declare that I have examined this exemption application and,to the best of my knowledge and belief,it is correct and complete.I f tare th am ddy,,�autthoo�rriized to sign this exemption application. Sign ' ' �C_ t President and QFO 12/30/2015 here Authorize Signature Title Date Retain a copy for your records. I For County Assessor's Recommendation I ❑ Approval COMMENTS: 17[ . O Approval of a Pwliuu f — --- - /g(((Denial y� � SC fJC ` `" t Si a reo 1 nty Assessor : . Date I For County Boa 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 State of Nebraska. ❑ Approved COMMENTS: ❑ Approval of a Portion at ❑ Denied SIIIiValatratarr Sig�re of Plc ryBoa 1uT •''-r Date County Clerk:A legible copy of this form showing e 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 Authorized by Neb.Rev.Slat.§§77-202.01 and 77-202.04 99-135-1999 Rev.1-2014 Supersedes 96-135-1999 Res.7-2012