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Mk iIt IV 0 3 2017 <br /> No-breaW De ca. i <br /> Application for Exemption FORM <br /> 1b5*�. �t. E from Motor Vehicle Taxes by with Nonprofit Organizations i 457 <br /> F7GY6 l' G <br /> •Te be filed with your county treasurer. i <br /> ertar>Earr nss "+'nr .Fiaetl ifretnlclions on reverse side. _ <br /> Applxents N:, •T of Ownership <br /> NEBRASKA STATE FAIR BOARD El Noi rom <br /> Street or Other Mailing Address County Corporation <br /> 501 E FONNER PARK RD STE 200 PO BOX 1387 HALL <br /> City ---_—_.-__-- State Zip Code Slate Where incorporated <br /> —i U Other(specmh: <br /> GRAND ISLAND NE 68802 NE I _._—._.__—.._..... <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Title j Name,Address.CR);Sues,rrp Code <br /> _Ss moral.A'a <br /> DESCRIPTION OFTNE MOTOR VEHICLES <br /> *Attach an additional sheet,It necessary. <br /> j Registration Date or <br /> Motor Vehicle Melee i Model Year I Body Type I Vehicle ID Number Date of Acquisition, <br /> t _ _--i---'" _ I . R Newly Purchased _ <br /> SW __--__.-- ; 2.o1z. . .1.__ 1 1.�1?..._—. ' /6crpxYC6l�z2mAp�s .. _-- <br /> tWEVy -[-- 2003 i Macula : {68.670#7-532271o7/f <br /> ENEVy it 20/2 i I/BOOK r SAlkv&CO5Q'2f4 4) <br /> LW SYOA/ 1 2015 i -772/II1.E72 }HVtMzL /12J1FMii17342 i_ <br /> 1 I 1 <br /> ExetnQt Uses of Wax Vehicle: — ------ -- —_-- Are the motor vehicles used exdusrvaiy--- <br /> ` AgnkNfuraWorliatural 0 Educational i�Reiglou6 C:narta4e 0 Cemetery as indicated? <br /> -mot" Give detailed description of use,inducing an explanation if mentiale use classifications exist: <br /> t� '� a 1i i b1'ES ONO <br /> r Vte- Cn1MP0,Yty ve,ya: s trite... used b�/ M�Wx L.cp GTfxtL i-Gtt r 4>oGrp ;1I No,give percentage of exempt use: <br /> o.tnJ G F 4F 4144_ ptwpa scs of oMe tt to wee:61 Gas, Co t•.ve s4 0%ns °AAA ' <br /> p;r tug u+ Supplies . <br /> Under penalties of law,I declare that I have examined this application and that It It to the best of my knowledge and belief,true.complete,and correct I <br /> also dentate Matt am duly authorized to sign this exemption appilcallcn.and that the organization owningthe abovadsted tweedy does not discriminate <br /> in members .or employment based on race,color,or national origin. <br /> / 7• <br /> sign A' " / � �/J. . th/ Id -// <br /> ere mail- -:. -rR'E, re f Date <br /> /(illy �Qrlrn 308-387- •20 <br /> 1 —_._-------._— FOR COUNTYTREEAASS/U�REERR RECOMMENDATION ---_--� <br /> ROVAL CWMMEN-TS: efie— " /04.4-1 �S 77 4O�' <br /> �a <br /> R C IVED <br /> 0 DISAPPROVAL -- ... <br /> /o,4r/7 <br /> NOV 1 4 2017 Signatu a Co My Treasurer Data <br /> — _ — __— —_ FOR COUNT'BOARD OF EQUALIZATION USE ONLY <br /> HALL COUNTY <br /> EJ APPROVAL TREASURERS OFFIf' vyEM S <br /> GRAND ISLAND,NEB ■ i <br /> j DISAPPROVAL , .. <br /> ,!rized Sigr:nhue Date <br /> Nebreaaa Depanmeni K Revenue Authorized by Net Rev.Stat.4477-202f1Kci and(di.and 6.4,l06.and 604.18a <br /> 962532008 Rex 8-22011&serns 2e.2532006 Rev 0-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />