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(2013 <br /> ^ -� Application for Exemption FORM <br /> RNe anima r l from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> •Tdfieil your ma Itteesurar. 7 <br /> •Readfi orim MIA*side, <br /> AppheelirnName _.. Type OlOwnerttp <br /> GOODWILL INftUSTRIE$OF$BEATER NEBRASKA,INC. j Nonprofit <br /> Street or Otherlaewnp Address Cotny :Corporation <br /> PO BOX 1063(DOM: 1804 S EDDY ST,GRAND ISLAND NE 68801 HALL <br /> City State Zip Cie State Where Incorporated Olher:IaPeeltYl <br /> GRAND ISLAND NE 68802 NEBRASKA <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERSO!THE NONPROFIT ORGANIZATION <br /> Rile Name,Wee%-CitY:Stele,Zip Code <br /> SEE ATTACHED LISTING <br /> DESCRIPTION OP THE dtOTOR VEHICLES <br /> •Attach eh addi$ottel dheet,U neeessary. <br /> Reglittatbn Dnepr <br /> Motor Vehicle lane Mo64taar BedYlype. Wattle ID Number meat AdqulslUon. <br /> R Meady purchased <br /> SEE ATTACHED:LISTING <br /> Exempt Uses.of MroorVehidet Ara themeterva5k lesetel exclusively <br /> ❑Aprioglenthi0rppilwtel El Educational ❑:Reagbus d*writable 0 Cemetery .esleckelett? <br /> Live detailed:doscdppoh otdee,MOWNnp..asuxplenedon B nnrl ste use class f ens exist ;YES ONO <br /> Used for picking up and taking home clients. Also used for support of clients activities and BNo,ova percentage or exempt use <br /> : <br /> training. Some are used for hauling of donations that support our disability programs. <br /> t o,u-r er 'TAmYl i 14A-eatdEic <br /> 303-a.8q-73g4 itl <br /> Underpenahrotimv,I deaere Meal Bove axammedlhlaepplkagat amt ION ttlA to the best of my knovaedge and SW,Irpe,CORIPl .aM correct.I <br /> etsadechre that I em dufrattNht dto sir INsexamptten aPPINMOn,and that theeremeNttknewNnp the ebove-Ileted prepelydoeshtd trumdmbeta <br /> In merM7etahip-Or etrc4rt sm IThnd on meet aolau orMONT SFOrigIA <br /> sign I/ I <br /> Akita A Q PO <br /> here Authh rf .sig 4 Tee Date <br /> FOR COUNTY TREASURER RECOMMENDATION <br /> ErAPPROVA RECEIVEDCOMME <br /> poISAPP AL DEC 1 3 2017 z4 <br /> SIgha NAeasumr _.. Data <br /> 6 I 1,41.GOu sr Y ;R COU BOARD OF EQUALIZATION USE ONLY J <br /> -7 •D D NEBRASKA <br /> 1PPROVAL COMMENTS: <br /> • <br /> DISAPPROVAL fgt <br /> ilipltrt al Mona- Date <br /> Nebraska CoparlmemaRuvuma mooted by Nab:Rio.Slebg577-2000)t)erid1d),and mates,and somas <br /> 06250.2055 Rev.asol I supersedes e5-251-2008 Rest 5 COW <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />