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File with Exemption Application FORM Your County for Tax Exemption on Real and Personal Property by Qualifying Organizations 45� Assessor Road Instructions on reverse side. Failure to properly complete or timely file this application will result In a denial of the exemption. Name of Organization County Name Tax Year Platte River Whooping Crane Maintenance Trust, Inc. Hall 2017 Name of Owner of Property State Where Incorporated Platte River Whooping Crane Maintenance Trust, Inc. Nebraska Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number 6611 Whooping Crane Drive $28,611.00 400287129 City State Zip Code Contact Name Phone Number Wood River NE 68883 Charles A.Cooper (308)3844633 x 116 Type of Ownership ❑Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization ®Charitable Organization ❑Cemetery Organization Name Title of Officers, Address,City,State,Zip Code Partners Directors,or Partners Douglas L.Curry Chairman Erickson&Sederstrom PC LLO.301 S. 13th St..#400.Lincoln NE 68508 Craig Thompson Vice Chair do 6611 Whooping Crane Drive,Wood River,NE 68883 Brad Korell Secretary/Treasurer Olsson Associates,601 "F'"St.. Ste.#200.Lincoln, NE 68508 Legal description of real property and general description of all depreciable tangle personal property,except licensed motor vehicles: See the attached Exhibit"A? Property described above is used in the Blowing exempt category(please mark the applicable boxes): ❑Agricultural and Horticultural Society ® Educational ❑ Religious ®Charitable ❑ Cemetery Ohre a detailed description of the use of the property: The Platte River Whooping Crane Maintenance Trust,Inc.("Crane Trust')is a charitable organization dedicated to protecting and maintaining critical habitat for Whooping Cranes,Sandhill Cranes,and other migratory birds.The Crane Trust uses the said property exclusively for this purpose and for related charitable,educational,and scientific purposes.The said property is exempt from taxation under Neb.Rev.Stat.§77-202(1)(d),among other reasons. All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. Is all of the property used mclusivey as described above? ®YES ❑NO Is the property used for financial gain or profit to either the owner or owner or organization making exclusive use of the property? ❑YES ®NO Is portion of the property used or the sale of akohcgc beverages? ❑YES ®NO if Yes,state the number of hours per week Is the property owned or used by an organization which discriminates in membership or employment based on race,color, or national origin?.... ❑YES f NO God- i of law,I declare))hal I have examined this exemption application and,to the bent of my knowledge and belief,it Is correct and compl- -. : iff eclare I am day authorized to sign this exemption application. sign ,147, �� L/ President and CEO 12/28/2016 here '•rized Signature Title Date Retain a copy for your records. For County Assessor's Recommendation ❑ Approval COMMENTS: `Li �lr_-`a • ❑ Approval of a Portion ;^ .yi r-. 1,- V' 7 Denial out Lion 1 r �� ,d� ��l Signature t ou ty- esaor Date For County Boa of Equalization Use Only I declare that to the test of my knowledge and belief,the determination made by the County Board of Equalization is correct pursuant to the laws of the State of Nebraska. ❑ Approved COMMENTS: ❑ Approval of a Portion , [�Denied �lrii it_ a1T/ . .- /L! a ' '_ —wad.( L-7 Signature o County;.,.. •-, .-r rate County Clerk:A legible copy of this form showing the final decision of the County Board of Equalization must be delivered electronically to the Nebraska Department of Revenue within seven days after the Board's decision. Nebraska Department of Revenue,Property Assessment Oision NAheriied by Senates.Sal-§§77-202.01 and 77202.04 9e-135.1999 Rev.1-2014 Supersedes 90-135-1999 Pew.7-2012