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■ <br /> ---Z-- Application for Exemption, <br /> Nebraska Department or <br /> REl/ENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations � 7 <br /> •lb be tiled with your county treasurer. <br /> Emiszni •Read Instructions on reverse side. <br /> Applicant's Name 1 Type of ernership <br /> AMERICAN RED CROSS I Y/I Nonprofit <br /> Street or Other Mailing Address County //'\Corporation <br /> 404 E THIRD ST HALL <br /> Other ispeclfyi: <br /> City State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68801 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Title Name.Address City,State,Zip Code <br /> :_nfl'2D CThen A. 02 2ofihctz, a N023M14f-0 M ?I 4• •N A • I, -78-63 -- <br /> Ssile • - VI to A Hat ' __b&t iin]V /�o _ _ <br /> i•-the / • 1t✓ V g �' • - *24 i / .may a , i‘„, , L i .L /. • . r;Q <br /> �: ! 1 I A 441 A _ : , 41 .111: .• 07— WET.4!'tZW .Aaarr, 4 (:.10880 <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary, <br /> Registration Date or <br /> Motor Vehicle Make Model Year BodyType Vehicle ID Number Date of Acquisition. <br /> If Newly Purchased <br /> S�G _ St-62 2G FLW EK2rinitt45q <br /> - al-mss 26 01taii-VAN 9011t 6reG ca-nitiSi _ <br /> .01717 .W_ e460 IF-DYE 45PfgbiF8o3/2 _ <br /> Exempt Uses of Motor Vehicle: --- Are the motor vehicles used exclusively <br /> Agriddtura4Norticultural ❑Educational ❑Religious INChataable 0 Cemetery as indicated? <br /> Give detailed description of use.l cks:ing an explanation If multiple use classifications edst: YES ONO <br /> these- V t'ttc- kS 4Vw Vitt for huwl #U-tunka44 e-F its <br /> 51/1 t . n s c,a!kr re I 1 e CI Ye�Q 4 A^6t pr� _ ! H No.give percentage of exempt use: <br />• <br /> 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 iha;the Organization owning the above-listed property does not clscrimitate <br /> in membership or employment based on race,color,or national origin. <br /> sign _-[ f %— —.. Bete v_t_ji_Y Y i1_Z 0.l 1 <br /> here �Authodzed Signature ture <br /> Title Dale <br /> FOR COUNTY TREASURER <br /> TREASURE R RECOMMENDATION <br /> ��� 'alO..2, <br /> p**,PPROVAL <br /> RECEIVED COMM N'S: £SU*4 Y` — /pIO <br /> 0 DISAPPROV L <br /> NOV 1 4 2017 am' n< or ./4-47- /9' <br /> . Signature of County Treasurer Date • <br /> • ra FOR COU i TY BOARD OF EQUALIZATION USE ONLY <br /> GRAND ISLANDSN FFI ' KA <br /> [KAPPROVAL COMMENTS: <br /> 0 DISAPPROVAL v q� <br /> / <br /> v' ed Signa : , Date <br /> Nehmsaa Department of Rouerue Authorized by Nab.Roy.Stat.§§T1-202(1)6,0)and(di.and 60-ties.end 00-3.189 <br /> 9e-253.2008 Rev.6-201:Supersedes 96.253.2005 Rey.`5-2000 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />