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11/11/2016 12:29 3083822494 AMERICAN RED CROSS PAGE 02/02 <br /> GYU� <br /> I se —�— Application for Exemption <br /> RE_ �nnm.w•o. er FORM <br /> from MotorvehideTaxes by Qualifying Nonprofit Organizations <br /> •To be f led with your county treasurer. 457 <br /> •feed Instructions on remerse side. "R'J <br /> APP6Cantt Kama <br /> Type of Onward <br /> AMERICAN RED CROSS <br /> Street or Other Malting Addross County ®Nonprofit <br /> 404 E THIRD ST HALL <br /> City State Zip Coda State Wham Incorporated ❑Other(specify): <br /> GRAND ISLAND NE 68801 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTNE NONPROFIT ORGANIZATION <br /> Tele . Name,Address,City,Sbae,Zip Code <br /> • '.e V. i b ' I _ !. rl !OD •b G :, D I .;t A NI 5, 0 <br /> �DCkoven i 'D' - II ` ;at. Pk} 0 1 ..a, o. hie L•Afij$ <br /> lrlilr•��+�+.r. a ritard O s CRII r =,•■ • �_:r. ► t ` .- ajg <br /> DESCRIPTION OFTNE MOTOR VEHICLES <br /> •Attach an additional sheet,If necessary. <br /> Motor VehIcl Make Model Year ReelTYpe Veb ID Number • Dateof AutHeftor <br /> Data of Adquhaion. <br /> GMC 2015 TERRAIN SLE2 2GKFLWEKZF5417459 IfNewNiaurchased <br /> DODGE 2013 GRAND CARAVAN 2C4RDG9G4DR771457 <br /> FORD 2009 E-450 1FDXE45P19DA90312 — <br /> Exempt Uses of Motor Wilda: Are the motorvelddee used exclusively <br /> ❑AgdduMsakMonbunurei ❑Educational ❑Religious tJ Chaltteble ❑Cemetery se indicated? <br /> Ohre detailed description of use,Including an explanation if multiple use deaepfoatione moat FIIYES ONO <br /> "Ouse Veh 1 /tic,flctn��eu.�.ed bay A �huma�t�.#�f'I tp�,,.y , �, fit' <br /> keno AA d.G‘aAl#L l tapyrnse, moo "�I9f ..WT�t7 Il - If rue,glee Percentage of exempt use: <br /> WI AV � 80Y iu Iti1S � Db.0.1 n man Pei &Ira - <br /> Under molds:of law,I declare that I have exsnIned this application and that It Is,to the best of my knowledge and bard,true,complete,end coned,t <br /> also docks*that I em duly authorized to egn yss exemption application.and that the organization owning the above-listed property does not discriminate <br /> In membership or employment based on race,color,or national origin. <br /> here rt: A. ,,/' jam,, <br /> here Authorizod8 ►/ ! � `lor'll 11-10 •201i, <br /> �— -_—_Signature 1 Date <br /> I FOR COUNTY TREASURER RECOMMENDATION <br /> El/APPROVAL RECEIVE&MENT& £/& ' wi - ,,Q-tc) � � 477-t°a <br /> 0 DISAPPROVAL i <br /> NOV 1 4 2016 ���le � " � e� /a -at / * <br /> blunt= ty Treasurer bate <br /> MA/I notl J <br /> COUNTY 9OARD OF EQUALIZATION USE ONLY I <br /> TREASURERS OFFICE <br /> GRAND ISLAND,NEBRASKA <br /> ❑APPROVAL COMMENTS: <br /> ❑DISAPPROVAL / ��// <br /> 'P✓e i/� i.e+ . !.er/ ,/ 76 1-/ <br /> oozed !Kure Date <br /> Newmann Oeperbnem or nwenue Aehodaed by Net Pee.Slat,rr 77202(i)(e)and(d),and eoa,tsa,ee%Me6 <br /> 59253-2006 nee 62011 Supersede 90.253.2006 Rev.5 4009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />