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JAN/0 '2017/TUE 04:42 PM Fonner Park FAX No, 308 384 2753 P. 002 <br /> • , gd /7 <br /> ��--2 Application for Exemption FORM <br /> Neuron DepeMra of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> •To be fiMed with your courtly treasurer. 457 <br /> •Read Instructions on reverse side. <br /> Applicant's Name type of Ownership <br /> HALL COUNTY LIVESTOCK IMPROVEMENT ASSOCIATION FONNER PARK Nonprofit <br /> Street or Other Many Address Courtly torpor/On <br /> 700 E STOLLEY PARK RD PO BOX 490 HALL 0 other(specify): <br /> city stale zip Code Stale where Incorporated <br /> GRAND ISLAND NE 68802 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> TNe PRESIDENT wart "--- p6aity MONTE HEHNKE 4019 NORSEMEN AVE GI NE 68803 <br /> 1ST VICE GREG BAXTER 2121 N MONITOR RD GT Ni! 68803 <br /> 2ND VICE STEVE HANSEN 1420 STACRCOACR RD CT NR fRRnI <br /> 3RD VT CE MIKE JAKUROWSICT 1510 S ill ATNE CT NF. 65501 <br /> SECRETARY'.. DAN FOGLAND 4604 LAKESIDE DR Gi NE.68801 <br /> TREASURER RUSS RERUCHA 2024`STAGECOACH RD GI NE 68801 <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Atledt aft additional sheet,if necessary. <br /> Motor Vehicle Make Morel year Uo Date atAonDate or <br /> dyyype Vehicle ID Number Date at Acur thaed, <br /> jh Mir?eh0,04/ 2O/O HNSWry PdnEesstl <br /> �7'on >rs+clS //j"'/n7illfl.9,C,OAHa/YS'9.3' <br /> 11ca- .07o,‘ <br /> Exempt Uses of Rotor Wrecks: M the motor vehicles used exclusively <br /> ®A9dcuhunalortioulturel ❑Educational ❑Retgfoua ®Charitable p Cemetery es Indices/id? <br /> Give detaAad description at use,including an explanation if multiple use caaalicalions exist EYES ❑NO <br /> 4-H ACTIVITIES, COMMUNITY ACTIVITIES, PROMOTIONAL EVENTS OF AN <br /> EDUCATIONAL OR CHARITABLE NATURE, HORSE RACING, AGRICULTURAL EVENTdfNagn°perwMeyeaexamOupe: <br /> INCLUDING THE HALL CO FAIR & NE STATE FAIR & STATE 4-H HORSE SHOW <br /> Underpwylass of law,I declare tot I have eswmkrd this application and that it is,to the best of nylcowledge and ballet true.complete,and correct.I <br /> also declare tat I ern duly authwaed to sign this eiemp000 appimtah•end Matta o,xtlzwion owning the above-listed property does not dleabtla <br /> In membership or empigmtent based on lace,color,or national origin. <br /> sign <br /> CEO 7. 1-16 <br /> here Auttiorizettstnetture BRUCE SWIDART Title Date <br /> t`jl <br /> FOR COUNTY TREASURER RECOMMENDATION ,�/ <br /> PROVAL RECEI Y EOMMENTP 6�'�A'`a n ' , 't.' "` 4F-9C: # 77-4 Q <br /> DISAPPROVA_ <br /> JAN 3 2017 t —y *02 --d <br /> 11`Sgnders of Toseeurer Date <br /> HALL COU <br /> TRCAGt3RCRC Ot ry R CpLINTY 30450 OF EQUALIZATION USE ONLY GRAND ISLAND,NEBRASKA <br /> o APPROVAL COMMENTSt <br /> o DISAPPROVAL <br /> %/ • _7//��✓ et / t 7—/a�7 <br /> Authorized Sigrelure Date <br /> 4 <br /> Nebraska Dapertrronl or&Menu• A thaizS by Neb.P.St* n202(t)(a)and(d),and e0.2,tea,and 504102 <br /> 96283$0%Pm 84011 9upersadaa 9823sa08 hw.SOGe p <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />