Laserfiche WebLink
9o / 7 <br /> Nebraska l Application for Exemption FORM <br /> REVENUE from Motor VehicieTaxes by Qualifying Nonprofit Organizations 457 <br /> •To be.filed with your county treasurer. <br /> nu <br /> •Read Instructions on reverse aide. <br /> Applicant's Name <br /> Type of Ownership <br /> ABUNDANT LIFE CHRISTIAN CENTER ®Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 3411 W FAIDLEY AVE HALL <br /> ❑Omer(specify): <br /> City State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION <br /> TNe t� Name,Address,City,State,Zip Code <br /> Seazor P, -lle p`',�,,� kvh- friar. tAoatll.s( -1n P.aLA)eoa Rd <br /> ta �cu4 atd it (mos3 <br /> ' t cf -Aiwa Po.33 i3rkL _nw - M S t4. Vs' 5!. Gea$'sl m <br /> 6ltD3 <br /> 6 ct ,,ty-alt ALfuntr kcause, Nowak- lido ' 4.r,.w4 hoe A2D (ea, , Ss1a A 62no3 b <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,It necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year , BodyType Vehicle ID Number Date of Acquisition, <br /> if Newly Purchased <br /> H&H 2015 7X16 ENCLOSED TRLR 533TC1621FC243680 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> ❑Agricultural/Horticultural ❑Educational VI Religious ®Charitable ❑Cemetery as Indicated? <br /> Give detailed description of use,including an explanation 8 multiple use_classifications exist:t� 1 RYES ❑NO <br /> 'tt \4.t ii 15 rncp. 1F{ ustan-i�t1YV.`t1 d+4� maUS ' op ..1y1 o cL, Lsu.Tt� as uieLN. <br /> as e0{f ia1p,q�`r 1v ir`'`� OV yef (pa.A'`it,Mt lAAzl 'rRSanxs•1 .Jf, tut Q�§i33, Sack os If No,give percentage of exempt use: <br /> 54' 4:or k+h�i %V timbir up t WM- Co-- �t04, '(Cara 6s beef. u4 % <br /> 'c' ((path bw .41 pro;ecas (Q. raatn3 •AdoLka s ,v-stUe caS oA{S4c <br /> of aur Cvtkrttl-ivi.. <br /> Under penalties of law,I declare mat I have examined this application and that his,to the best of my knowledge and belief,true,complete,and correct.I <br /> also declare that I am duly authorized to sign this exemption application,and that the organization owning the above-listed property does not discriminate <br /> in me ershl• • 'mp based on race,color,or national origin. <br /> sign I. 4 ; a e Q r 11-tl-fit <br /> here Adt °zed' Ski <br /> Date <br /> I FOR COUNTYTREASURER RECOMMENDATION <br /> 44 <br /> S77- �� <br /> ynPROVAL E "IVES: a- <br /> ❑DISAPPROVAL <br /> NOV 17 2016 k of Av -2�/c• <br /> Signat C Treasurer Date <br /> FOR COUNTY BOARD OF EQUALIZATION USE ONLY <br /> HALL COUNTY • <br /> TREASURERS OFFICE <br /> ❑APPROVAL GRAND ISLAND NEBRgS koffs: <br /> ❑DISAPPROVAL / //J <br /> ,u orized ignature Oat. .- <br /> Nebraska Department of Revenue Authorized by Net.Rev.Stat.§§77'202(1)(c)and(d).and 60.3,185,and 80-1189 <br /> 96-253-2006 Rey 8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />