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mov^----z- , Application for Exemption 1 &Mg <br /> Nebraska Depanmeat of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations ! <br /> •To be tiled with your county treasurer. 457 <br /> •Read instructions on reverse side. <br /> Applicant's Name ;Type at Ownership <br /> ABUNDANT LIFE CHRISTIAN CENTER 1 \I�/Narprotit <br /> Street or Other Mailing Address County I / \Corporation <br /> 3411 W FAIDLEY AVE HALL <br /> 0 Other(specify): <br /> City Stare Iry Code State Where Incorporated Ciher(specify): <br /> GRAND ISLAND NE 68803 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tide Name,Address,City.State,rip Code <br /> ', -r L� lr Se, 1� 1� , t l - 11 .I . I . r <br /> M ! h <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year BodyWPe Vehicle ID Number Date of Acquisition, <br /> If Newly Purchased <br /> _ _. _ 2e15 1j4lo L 53%t lb 11 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively -� <br /> 0 AgdcuduradFtorttutural ❑Educational 0 Religious Charitable ❑Cemetery <br /> as indicated? <br /> Give detailed deScripljon r ause.Including an explanation if multiple use classifications exit <br /> 5A YES <br /> .ONO <br /> ittxts `5 aInorma, QA sic l®Na v.,- s Qom Ll. 0.S J�lt <br /> 05 cusdlPterg AP 1 et :441% t ltl s t suit, .s If Na.give Percentage of exempt uss: <br /> m , I- itbs i c % <br /> 1 kA-A• la } M w a�v) S Santis - o <br /> c,, ley Ask% oa Mask INS Under penalties of law,i declare that I have examined this application and that it is,to the best of my knowledge and belief;true,complete,and correct.I <br /> also declare that I am duly authorized to sign this exemption application.and that the organization owning the above fisted Property does not discriminate <br /> in me or-, rt based on race,color.or national origin. <br /> �s <br /> sign t,yl,.. - - 1 _tt Ut?.. <br /> �__._. zed Sig �� -- ---------------- Date <br /> FOR COUNTY TREASURER RECOMMENDATION I <br /> APPROVAL RCEI M EDC.UMMtNTS: . !'°". �yt"i /v.°5'eS. �°�—�L70.�.. <br /> LI DISAPPROVA- <br /> N0V 9 0017 I*Sig ryacti ~3 AQ 49/7 e <br /> I I TALL COUNTY FOR COUNTY BOARD OF EQUALIZATION USE ONLY I <br /> TREASURERS OFFICE <br /> GRAND ISLAND,NEBRASKA <br /> VAPPROVAL VUMMt NTS: <br /> []DISAPPROVAL ' <br /> y_ 8' <br /> nzed Signature Date <br /> Netiaska ospartmM of Revenue Authorized by Neb.Rev.Stat.§§T1.202t1)(c)and(d),and 60-3.185,and 60-3.189 <br /> 96-253-2006 Rev.a-201:Supersedes 96-553.2006 Ray.5.2089 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />