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;Di 1 <br /> wevn---e-- Application for Exemption FORS, <br /> Nebraska Departmen of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •TO be filed with your ur county treasurer. <br /> M - •Read instructions on reverse side. _.__...._.__._._.�- <br /> Applicants Name Type of Ownership <br /> SISTERS OF THE HUMILITY OF MARY Nonprofit <br /> Street or Other Mailing Address I County Corporation <br /> 720 STONEWOOD AVE I HALL <br /> —.+_ 4 ❑Other lspm fiy): <br /> City State Zip Code I State Where Incorporated <br /> GRAND ISLAND NE 68803 i NE __.._--._..__._. <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tide I Name Address.City.State,Zp Cole <br /> S higi Jcial_142; lesidi_ Jrat- - PD <br /> P>y,,._ t3 EVAtai.rt,.en_fet_.JAd fig MAricc__- A- 1A 1 SS- __ <br /> i <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary- <br /> i I Registration Data or <br /> Motor Vehicle Make i Model Year Body Type i Vehicle ID Number i <br /> ._ _._..--to APucq is <br /> y D e..Y. ehwsed <br /> / y2 n 4_1)nr a- <br /> ._.__ <br /> I I <br /> I <br /> I i <br /> 1 <br /> Exempt Uses of Mahar Vehicle: j Are the moor vehicles used exclusively <br /> 0 Agricultural:Horticultural `FI Educational (I Religious [-. indicated? <br /> ('�tAlartafxe ,-'�Cemetery as <br /> Oka detailed description of use,including an explanation if mmtple use classifications exist r ptk-ty ii VES NO <br /> fist car is Usc 4cr Rs+b oral Min;cf 7 d i Sit In -}�t siL <br /> Prcvi Gltn{ 1{dux`I-i./ coia"F"DN Or -f-Iva Ei4e�k+rt^f pr T""`"' ;h 'th 44}- ho.w.cs III No,give percentage of exempt use: <br /> in r) SPr 't-✓✓A I$ 'rOThtr 1�ft.t.st/oart51 -f'Or et��e_p/��H.KtA/IG`�1r raj 1Y' Far 11.c.1.4 pec+1'+ �; <br /> jn L;t..reJ ;Ca I ser✓,"ze sit TYr ReJIyt>Ns Fonc."Txp1•n 6_45scs -eve <br /> gnat alSa' 4o r- ivVee_+iv1) 14-re ntc 2s of GtrSpn5 r-eq.r,rinq <br /> at/Vecac:� , -fccc), St, e-lJ-ter i GpHnsc I il of . TI•ieV14rpr+aef-0I Vc#e, I <br /> t/ <br /> Under penalties of law.t declare that I have examined this application and that a N,to the best of my knowledge and belief,hue,complete,and correct.I <br /> also declare that I am duly authorized to sign this exemption application,and that the organization owning the above-Itsted property does riot discrkninate <br /> in membership or employment based an race,Color,or natural origin. <br /> • <br /> sign // _ u4 !{;a, -124-1-0 ra 1 pi,e rk i51"e r /2 //57a20 <br /> here Morized Signature Title Date <br /> [_.__._ .-__.__---.__._FOR COUNTY TREASURER RECOMMENDATION <br /> E1PPROVA. .t3MMENTS: /g't' ,tZ SS yje"77 4'cca <br /> 0 DISAPPROVAL RECEIVED '-------- - - - ---- ---------------- ------- <br /> DEC 2 1 2017 `—"i9,OC�� /a-ez'7—/7 <br /> - Signature of County Treasurer Date <br /> _ FOR COUNTY BOARD OF EQUALIZATION USE ONLY - . <br /> HALL COUNTY <br /> TREASURERS OFFICE <br /> - PROVAZ GRAND ISLAND.NEBRASt4R1MMLNTS: - _ , <br /> Li DISAPPROVAL <br /> An Signature - Data <br /> Nebraska Department C Revenue r Authodked by Nab.Rev.Stat.§§:740211xc)and(d).and BO-0ta5 and 660159 <br /> 96253•2008 Rea 8-2011 Suaerteoas 0S-2542006 Rev 54009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />