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pal g <br /> "m'"a`-'Z- Application for Exemption FORM <br /> Nebraska -r--Department of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> lifiummemnts •To be filed with your county treasurer. 1 457 <br /> •Read bwtructions on reverse aide. `!J 7 <br /> Applicant's Name -_.— _--_.__--_ !-We of Ownership <br /> GRAND ISLAND CENTRAL CATHOLIC SCHOOLS <br /> Street or Other Mang Addr®sa i s Nonprofit i County <br /> 1200 RUBY AVE l <br /> HALL <br /> City State Zip Code I State Where Incorporated —4 other{sPeufly): <br /> GRAND ISLAND NE 68803 1 NE ____________ <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tice Name Address.City,Slats,Zip Code <br /> _ PrE s 14_/14– _. • R i n Eu _E1A44+we r I< -411a.XsJgn M `5T n_. __ ___ <br /> 5r19,0 rIrITenr e.r7 - S rve. an —!�'aa ,rah,y - .m -r .`I Ag��, <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach art additional shoat n r edemoty _ . <br /> MoterWthtel[ ,ke M IY r. ° <br /> r ' En VA , i7 ::ice ,e Ito 4; e,x ''•ii3 • :3-(7 <br /> 7,44-", , 2017 SUBARBAN IGNSCGEC4 • 25299 l-43-(7 <br /> v 2(16 SUBARBAN _ !-Gi8-/7 <br /> ,el,fiEa1RD - 2007 BUS - 1BABNCKA57F240051. • f lag-17 <br /> ttinarr 2004 WARN VAN 1GNGG25U041201129 /.-0,3-17 <br /> CHEVROLET 2004 ° c . V t{t, .., 1GNGG25U541194694 — . ..• <br /> _ <br /> Are the motor vehicles used excusivay <br /> o Awt urat'lorfiwrcural Education) 0 Religious 0 Chadmtde 0 Cemetery as indicated? <br /> Give detailed descr plion of use,mclucarg an explanation it mmipfa use classiscatlons exist: i %ES <br /> 3 LI NO <br /> {G f t‘lifq i i <br /> fo II No,give Percentage of exempt use: <br /> oG-riot-f i2At <br /> I <br /> Under penalties of law,I declare that I have examined this application and that It is.to the bed of my knowledge and betel,true.complete,and correct I <br /> also declare then am duly authorized to sign this exemption application.and that the organization owning the above-listed property does not discriminate <br /> in me hip or employment based on race,color,or national wgh. <br /> /sign LG.�_. •Cu t---L In_it.g._-,,1- 1.2- i .J 0 y <br /> here Authorized S4lature Tale Date <br /> L___ - FOR COUNTY TREASURER RECOMMENDATION —J <br /> /� S S "7�`c�o2 EPPROVAL MME ;S: deOle ,t lath-s RECEIVEU <br /> D DISAPPROVAL -'--- ---- ---_—_ <br /> DEC 1 5 2017 �alL-�°% /09-a7-/7 <br /> L ,Sign of C Measurer Date <br /> L anneal!COU Y BOARD OF EGUAUZATION USE ONLY - -- I <br /> -- .--_ —. <br /> TREASURERS OFFICE <br /> 3 APPROVAL .. GRAND ISLAND.NEBR#5t MI ;c. <br /> 0 DISAPPROVAL ' <br /> ;,i. . Ot�i - ._ �e-r.-�_ l L <br /> Aotho, ea Signature Data T----- <br /> Nebraska Oepwtna^r M Revenue <br /> Authorized by Net Rev.Stet.§4 T 2G2f11(01 and(d).end ass,m8a and ebb.tea <br /> PG-233-2006 het 8-2011 Supersedes a8-269-2t06 Re.t-NAa <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />