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Sep. 19. 2016'{{12:07P A "7 No. 2605 P. 1 <br /> J ii n-n. t_\ti , - 308 385- 5-75 <br /> ai-n---_-- Application for Exemption FORM <br /> Nebran°aDcj°�""` from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> NuC'• •Te be filed with your countytreas W et.. 457 <br /> •Reed <br /> Inszpehgasynyeypae Jlde <br /> Apperan's Name <br /> . Type of Ovmerd <br /> dp <br /> lri l. O e: eegs i•r tri_gi t a L ( S is led S ❑Nonprofit <br /> Street or Other Meiling Address County Corporation <br /> 2536, ea -L6,.. fie, 14 <br /> cot ❑PINK OPety)1 <br /> City State Zip Cods Siete Mara Incorporated <br /> 6.re.d„,d 13L,.1 N£ 6 446 3 N 6 . <br /> IDENTIFY OPROERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION • <br /> Title Name,Addlees,CTLy,State,by Cade <br /> Gl o.lr.np rN . .ZIM.a. 4«la-1 v. Po 3 x 13 .,. AJL 6 Y 8'0 (4 <br /> I e.._. b- -, it - ost Malta ` ,er rU £ 6 ; : Z <br /> �1 moil _ D _ S 6.116. z • <br /> Cs b o l mac r - ID 144.v. &wit(9••,c! at- ► - 1AlI E ' 7 q e l <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> *Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Melee Model Year BodyType Vah)ok D Number NN of Aequishion, <br /> Newly Purchased <br /> C',lref CGS- .to(r 'r'raak-- 2 444Rc196GFf<61114T1 50-24t** <br /> n ,4erV Sap. ' <br /> Lent Umoi Motor Vehicle: • Are the motor vehicles used exclusively <br /> rk1 ea helmeted? <br /> ❑AgriwllerallNorlkuXural ❑Educational ❑Religious Thereat* ❑Canletefy <br /> Give detailed d,eaeriptan of use,indrding an nptenatkn t mul6pla use classification east <br /> KYES ONO <br /> TrAan /fort heu 0em tut tadts kiE$' 0 <br /> a cl 0No,give pe tage of exempt use! <br /> 1tr A L 't eLIA4l5 CL-',A r&Oidle S1erUecC5 iO4, <br /> For eiy.9l65fi sir, <br /> Under wallas of I l declare thel l hex examined this application and that t b,to the bast d my knowledge end talky We,complete,and correct. <br /> also declare that I am duly authorized to sign this exemption appication,end Mal the organizailon owning the abOVWkted property does not discriminate <br /> in membership or employment based on race,color,or rational origin, <br /> tit sign to x t C Stab . Also inwir, kl'1 . — Data <br /> i_ <br /> here red Si lraXrm <br /> FOR COUNTY TREASURER RECOMMENDATION I <br /> I+"APPRCVAL RECEIVED COMMENTS: 4/.5.5. n1-717 �°' <br /> ❑DISAPPROYAL SEP 1 9 2016 a, 9-R/.—/la <br /> Signature 01 Measurer Date <br /> MMLL wvry 1 y � FOR COUNTY BOARD OF EQUALIZATION USE ONLY I <br /> 1 TRCGSI IRCRS nCCI[- <br /> GRAND ISLAND,NEBRASKA <br /> XAPPROVAI. COMMENTS: , <br /> ❑DISAPPROVAL 6 �O <br /> bed to Dale O �" <br /> Nsorada Otpalmef of Remo Manama by Nab Asa e)al f377.2OP{Iile)and td),and 863,105,and MM3,ONN <br /> 552512x6 Rau.8-2011 auxrwdes 9e253-200e Pm WOOS <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />