Laserfiche WebLink
Aug <br /> Application for Exemption FORM <br /> Wheeze Department of <br /> REVENUE from Motor VehicleTaxes by Qualifying Nonprofit Organizations 457 <br /> G •To be filed with your county treasurer. <br /> _.-_--_ __----.-._--._ •Read instructions on reverse aide. <br /> ApplicanYS Name Type of Ownership <br /> MINISTERIO DIOS ESAMOR gi Nonprofd <br /> Street or Other Mating Address 1 County Corporation <br /> 423 W THIRD ST ! HALL <br /> —'!-- —a ❑Othes(specify): <br /> City- --- - State Zip Code !State Where Incorporated <br /> GRAND ISLAND NE 68801 i NE ---._._--_._._._ <br /> I IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTNE NONPROFIT ORGANIZATION <br /> Tine i Warns,Address.City,State,21p Code <br /> tai .f1Y-_inAtika_ 4i4_, 1152_2._. 130,99 e "f,_ Ciat_ryi_._ISletha_ ----ta b'$._a 1—.------------ — <br /> , <br /> I <br /> !I DESCRIPTION OF THE MOTOR VEHICLES <br /> I <br /> •Attach an additional sheet,If necessary. <br /> i j Registration Date or <br /> Motor Vehicle Make I ModelYtar I Body Type I Vehicle ID Number I Date ration Date r _ i rt Nowljr-Parossad.__ <br /> -22.11 -C _-- - BBL. -_ I Le.5a rP. T II?z`1 5ZLi$ftia7z7x- <br /> t I <br /> i I <br /> I <br /> I- — — --I- L______ <br /> Exempt Uses of Motor Vehicle: I Are the motor vehicles used exclusively <br /> I as ixirted? <br /> 0 R rlgAturalMortiwRurel r Educational NI Reagious 0 Ghateble 0 Cemetery , <br /> Give detailed description ol use,including an explanation it mm/unipp�lee use dasstlustiio-nss/exiisC / )y, ? ZYES `NO <br /> E"+ V 5 vl.� 1 ' ' - C! 1 t�` P`- 1 i IIN o.give percentage of exempt use: <br /> 111NSYylNNaf34 A= 1 <br /> I <br /> Under penalties of law.I declare • • Ind this application and that A is,to the best of my imoviedge and belief,true.complete,and correct.I <br /> also declare Matt am duly auth• to sign ih: : :notion application.and the organization owning the above-listed propetty does not discriminate <br /> in membership or ample:man' race. --. national main. 7e a 30g .2_257_ 7 2 97 <br /> r ,� 30g ✓ J <br /> Sign Ai 0 '..,.„.....1 PA s ro 2 1 I-- 20-- 17 <br /> hem Auih'died '.W The Date <br /> •lam -_ Fa` ��.r�qv wp»- FOR COUNTYTREASURER RECOMMENDATION --_- <br /> [YJr+PPROVAL REC� - e /I�c5 S. '•I7�O . <br /> ❑DISAPPROVAL <br /> D - <br /> EC 2 9- 1017---- ------- <br /> Sign ••ol County 1W• Date <br /> TREASUItlp• i5T -e . '• •F EQUALIZATION USE ONLY <br /> ..-_. <br /> -G$AntO-iS • x• i J ----------- '--------'-'--------`---'----'-'---'---• <br /> 'PPROVAL COMMENTS: N... <br /> [-I DISAPPROVAL /-7z87 <br /> or ...0,Signature Oa1a <br /> IV ee+assa Department N f avenue Authorized by Rex.Rev.blob fin-2020)N end 1r11.and 809.180 end wale9 <br /> 90-253-2006 Pee 8-2011 Supe'sedsa 96203-2005 Rev 54009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />