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• <br /> 20 / 2 <br /> Nebraska Application for Exemption FORM <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •To be Bbd with your county treasurer. <br /> •Read Instructions on reverse side. <br /> Applicants Name Type of Ownership <br /> OVERLAND TRAILS COUNCIL BOY SCOUTS OF AMERICA j Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 2808 O'FLANNAGAN ST HALL ❑Other(specify): <br /> City Stale Zip Code Stale Where Incorporated <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> The Name,Address,City,Stale,Zip Code <br /> Pr-U-r. tP'rpc iaon4- Mork Mnwr- 39213 0tsHanu3Lrrl Ln., t4¢a.rneu Alt= 1np(34C, <br /> Finn rdd' Tren_st,re r Ron Vnr dornhtr V2Jg Mte.,n-cr. Ave, Cnn-n -A Tsk,r 4 hit. t>FS'6D1 <br /> To r,i.Sonr&4.n ry brunet Plot-.-� l' t°i W.Liwistoa,.1 , 6rn nci=slnr.cli NE ta`6&t l <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year I Body Type Vehicle ID Number Date of Acquisition, <br /> R Newly Purchased <br /> KAUFMAN 2015 TRAILER 5SHFX1424FR000690 <br /> HAULMARK 2014 TRAILER 575682422E11204078 <br /> FORD 1997 CAB-CHASSIS-BOOM 1 FDLF47F2YED03347 <br /> Fast, 19R9 Picrag) 1FT <br /> tf15n11.iCLRi)'15h1r 5l2nle tf4-C+erl <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> ❑AgriculturaVHorticultural Educational ❑Religious ❑Charitable ❑Cemetery as icated7 <br /> Give detailed description of use,including an explanation if multiple use classifications exist: [IVES ❑NO <br /> "-Tr o Ien t trtsczlz5 used Car DJ:La...is (2,9(25-3-4%' r■-o II No,give percentage of exempt use: <br /> Tra_tlen 0-1So use-Cl cot- rhzacsae C_L1l-tut 4-t e' in VCn C La- Cc.mw,.rct{ti.). % <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,We,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,employmetlI based , br,or national origin. �{ ` / G�i/' <br /> sign /1�utttonz S ure f� Title �. &tJG7 -,)D V) /4N IK� <br /> here A Date <br /> FOR COUNTY TREASURER RECOMMENDATION <br /> 7-ao M'APPROVAL COMMENTS: �y y l,S' ' <br /> ❑DISAPPROVAL RECEIVED <br /> ,(°7r �.-e--*.)`-� /— .�=./? <br /> NOV 2 8 2016 Signature of County Treasurer Dale <br /> C+ FOR COUNTY BOARD OF EQUALIZATION USE ONLY <br /> ❑APPROVAL HALL COUNTY <br /> TREASURERS OFFRCII&OMME►ITS: <br /> GRAND ISLAND NEBRASKA <br /> p DISAPPROVAL , <br /> « _ _ .,._i.� _la - % /'Yu/7 <br /> thorized ignakirei Date <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Slat.§§77-202(1)(c)and(d),and 60-0185,and 60-3,189 <br /> 96-253-2036 Ray.8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />