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aoi7 <br /> �a1 Application for Exemption FORM <br /> NabrasbD ernwA al <br /> NUE 1 from Motor Vehicle Taxes by Qualifying Nonprofit Organizations w CJ� <br /> •lb be filed with your eau*Iruesurse. °e <br /> ;Rued Instruptfirms pg revere*tide. <br /> Applicant%Name Type of Ownership <br /> PEACE LUTHERAN CHURCH OF GRAND ISLAND NE INC Nonprofit <br /> cgi <br /> iYroat of Other Wing Address Coen/ Corporation <br /> 1710 N NORTH RD • HALL - D Oche.(spat ty): <br /> City State ....�.,._...'� 2% Cods State Where Ineorporaled <br /> GRAND ISLAND NE 68803 NE <br /> 10ENTiF/OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tats i Nerve.Address,CWA stale,Zip Code <br /> __ ,`_ _____ __. �..:.�..�... ..__d� •yam <br /> t e c taoyltkon 102.tsl2 —_ — <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Atmdt an additional sheet,II nsaesssry. <br /> Registration Dale or <br /> motor Vehicle Yale • • .....ASdciYesf•- -• ••• Dtdyrypt .Dell IdAlagiblOalts <br /> ._If Newly Purchased <br /> . . <br /> MFG ENCLOSED TRAILER 1991 TRAILER 87726 <br /> F.xenpt Ogee of Motor tklacla: Are the motor rebid..used exclusively <br /> ❑AgdmataaHronicaiwnl ❑Ea oatlonal M Retgous ❑Chartable ❑Cemetery as����kidiueted? <br /> Give detailed description of use,anlWMg an eipla a llcn If multiple use <br /> ✓dles`skhkacllals oat YES ONO <br /> �Ot O r-Slke. c'i sad we �ield/A bti PeA« L.L,,rnc& N No,gN.percentage of exempt use: <br /> % <br /> —.~• Under penalties of bw.I declare that I have ammswd this application and that it h.to the bast of my knowledge end begat,ttue,conta end eared.I <br /> also declare that I am duly aelhorl ed It sign this exemption apptkatlen,and that the organization owning Me abCSWted property does not dbdtn5nate <br /> In membership or employment based on rate.coke,or nillahW angle. <br /> sign nk L A//6,. T eASOgEi. is/n/r& <br /> here dsignewre The Date <br /> I FOR COUNTYTRtASURER RECOMMENDATION <br /> APPROVAL RECEIVE®1dMENTS: •e., "' " sp,'`— ,12'5. `F.- '.#7?—a1O� <br /> ❑DISAPPROVA_ <br /> JAN - 32011 / r ��-� /-_. i7' <br /> s �o u tag,- “surer <br /> WM <br /> I us6LCOUNTY R COUNTY BOARD OF EQUALIZATION USE ONLY <br /> TREASURERS OFFICE <br /> GRAND ISLAND,NEBRL�S� <br /> ❑APPROVAL �O .. _. <br /> ❑DISAPPROVAL <br /> ,i • •sd Signature er Date <br /> Nebraska Deponent.talon"* .•• Adoring to Neb.Raa Sat.if 77-202It)(o)MO 00.wd 80518$,and$04105 <br /> 58,253.eWQ nor.e.2011 SWansd.t hm.&32008 Rat}salt <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br /> Td Wd170:TO LTOZ £0 'U?f 100Eteat0£: 'ON XNd : *Dad <br />