Laserfiche WebLink
X6 / 7 <br /> +4^ —� Application for Exemption FORM <br />• Nab l_ska arsement of <br />• <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> • e d filed with your 457 structio o side. <br />• <br /> Applicant's Name Type of Ownership <br /> GRAND ISLAND CENTRAL CATHOLIC SCHOOLS g Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 1200 RUBY AVE HALL Other(specify): <br /> City State ZtpCode State Where Incorporated <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION <br /> Title Name,Address,City,State,Zip Code <br /> Pre 6i deer& result Mueller-&ossbery (509 Wkle �4vL Q,..e. ii/t= (o nu <br /> _5ufxrih6,..4ar 51-eve tSbarn 6 ?RI Ty Cir O.j ,ve 49'O3 <br /> DESCRIPTION OFTHE MOTOR VEHICLES <br /> *Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Veer BodyType - V illsi e)Number. . . .Date of Acquisition. <br /> if N Newly Purchased. _ <br /> CHEVROLET 2017 SUBARBAN 1GNSCGEC4HR125299 <br /> CHEVROLET 2016 SUBARBAN 1GNSCGEC2GR307677 <br /> BLUE BIRD 2007 BUS 1BABNCKA57F240051 <br /> CHEVROLET 2004 EXPRESS VAN 1 GNGG25U041201129 <br /> CHEVROLET 2004 EXPRESS VAN _ 1GNGG25U541194694 <br /> Exempt Uses of Motor Vehicle: �/ Are the motor vehicles used exclusively <br /> ❑AgriculturaVHorticultural 'Educational ❑Religious 0 Charitable ❑Cemetery as indicated? <br /> ng <br /> Give detailed description of use.including an explanation If multiple use classifications exist / . / YES ❑NO <br /> VE.yttck° u,5ltd 'or Mktg ft 54 14 If No,give percentage of exempt use: <br /> rr r ✓✓it �lU 1 <br /> -}-v 5cAoo ( QGtiui4-(to. d <br /> Under penalties of law,I declare that I have examined this application and that it is,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 membership or employment based on race,color,or national origin. <br /> sign Q ( ` 'S„�tertt,d�..d- II -at-/L <br /> here 'Authorized Signe re Title Date <br /> FOR COUNTY TREASURER RECOMMENDATION "y�, -y <br /> �i PPROVAL RECENED^MENT- ,6;;z—" ALGA-- - 5. 77—Gc cr <br /> ❑DISAPPROVAL <br /> DEC 1 2016 e :=� a°tCeo. ' ia-.4--sue <br /> Signature of Co ny Treasurer Dale <br /> ,�:� COUNTY B rARD OF EQUALIZATION USE ONLY <br /> TREASURERS O KA <br /> GRAND ISLAND NEBRAS <br /> ❑APPROVAL COMMENTS: <br /> ❑DISAPPROVAL <br /> • i <br /> thoraed Signature Date <br /> Nebraska Department of Revenue Authorized by Neb.Res.Sta1.§5 77-202(1)(c)and(d).and 60-3.185.and 60-3.189 <br /> 96-253-2006 Res.8-2011 Supersedes 915253-2006 Rev..5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />