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2,0 <br /> ��'�L—lt� — Application for Exemption FORM <br /> RVENUE I from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> Immantassane •To be prod with youroounly treasurer. 457 <br /> •Reed lnlruoaona on rows*Ode.. <br /> Ap sons-Name _ - Typo ofOwnerehip <br /> l& I eel.. Ottui C� VNanpml% <br /> Street orOther Malang `' county Corporation <br /> i-110 1P • N Of{\j Roace; i`1 i I ❑Other Opeeity): <br /> OilY C rewA \—s1 an r Brat E 3 stall J lneaPa s ad <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTN FERRSOFTHE NONPROFIT/OROANJZARON <br /> To Naoe•Addree4,_Clhs Slate.ZIP Code . .._ _ <br /> G. I. ,r• 2�pai� en ; I tcp <br /> � p7 1 nryas"w ' <br /> HA w b, s r t► pie - t i• e . s.a O.!'S•91.ell sArl0 <br /> DESCRIPTION OPINE MOTOR VEHICLES <br /> •Attach an additional sheet,If necessary. <br /> Registration Ds*or <br /> Yoloryehbb Yaks YodeTYear eodyTyp6 Vahlola ID Number DOH of Acquisition, <br /> I NaW Pureassed <br /> f4163 (i1C,rrodlE° 14100h l fi�\ y_ <br /> XU T»3.� 'S,n1tI 5, as <br /> Exempt Uses of otorVehde: kegs molorvehieleeused exclusively ' <br /> 0 Ai7iaiturnnmreculiaa 0 EdueeUOnel V Religious ❑.Charitable 0 Cemetery aeWhetted? <br /> Gus detailed descriptor;of use,Inducing an explaneaoeI'nualPie Usedaselleeaare exist: )UUYES ONO <br /> Trailer will be Used to haul equipment and materials used to help members fulfill our mission which I No,ghee permutes/of exempt use: <br /> rsto bring the word of Jesus to residents of Grand Island and Hall COImt . A)Peace Lutheran is a <br /> religious organization;B)-thetrailer wilt be used exclusively for religious purposes;C)thetrailer is <br /> not owned or used for finandatgaln or profit to either the owner or users;and DI Peace Lutheran <br /> does not discriminate in membership or employment based on race,color,or national origin. <br /> Underpenalties of t M geow � ' le a d re l aWl end that eNza�rownEg presey and <br /> in nrenPoewhPor maPfol radblued an race,cobs,or natlorW origla <br /> h <br /> 44ECFJVED ` 7/17 CO l `' i <br /> FOR UNTY TH RER RECOMMENDATION <br /> Er-APPROVAL DEC C 2 7cdlWtim RRdvirya ' <br /> ,'S'`S 77 9PEz:v <br /> ❑DISAPPROVAL HALL COUNTY �J ry !rp <br /> TREASURERS EBR �i /R^�+ '/7 <br /> GRAND1URER OFFICE <br /> tuns drowtty Date <br /> l FOR COUNTY BOARD Of EQUALIZATION USE ONLY <br /> de PPROVAL COMMENTS: <br /> 4,..,t_ <br /> ❑DISAPPROVAL ,. .. <br /> AI <br /> ¢-- <br /> Aid• .. d8• .. <br /> $•bream Department of Revenue Amawn:edby Neb.Rev.efel§I.77YOeflxol bad b),aided-as;snaao.a;tas <br /> eassoacosrectierni Busman ssmarev.sam <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />