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imien----z—.. Application for Exemption F <br /> REVENUE of <br /> from Motor VehicieTaxes by Qualifying Nonprofit Organizations 457 <br /> •To be tiled with your county treasurer. <br /> •Read instructions on reverse aide. <br /> Applicant's Name Type of Ownership <br /> ST MARYS CATHEDRAUCATHEDRAL DAYCARE 51j Nonprofit <br /> Serest or Other Mailing Address j County Corporation <br /> 112 S CEDAR ST I HALL ❑ails. a <br /> J feciyi: <br /> City State Zip Code i State Where Incorporated <br /> GRAND ISLAND NE 68801 I NE I <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tide 1 Name.Address.City.State,tip Code <br /> _i? sr,�tisi Doxiit _�1�f11 7. -Gsci 1. s long :,M <br /> e. AmS_�-F ich.s 741 f_--.oath S ftMain _._c g.t. 5 anti,iC-------._._:_.. <br /> -i can,ct,re.0 ikt c.km-u s GoIKa. r 075 127tn (2iund slrsncll ye <br /> t <br /> t <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> *Attach an additional sheet,if necessary. <br /> I i Registration Date or <br /> Motor Vehicle Make I Model Year l aodytype Vehicle ID Number Date of Acquisition, <br /> _._—.__—._.._..1. A 0:5: myna — _;_aa1.Cx.l=•zW-1. $3 r�P71,.._._g 17.1.5 -_-_-_ <br /> C I cOno I CirCata nslan (R6)11681 G i1F Yta43731 I 7-/ 13 <br /> I <br /> 1 I ; <br /> I <br /> t , <br /> Exempt Uses of Motor Vehicle: ,�.,5 I Are the motor;shines used exclusively <br /> AgriculturaL9lorec*awral VEducatlor ;]U Religious ❑Charitable ❑Cemetery i as indicated? <br /> T� <br /> Give detailed desctptiorrn__of use,including an explanation if mullets use classifications exist 1 1 ! gYES ❑NO <br /> Pt,M use "roc `-fraospV r'fc 1 on o Y ck Oa to cA st-LO01 Ct 2 I If No,give percentage of exempt use: <br /> ChItaCea� on cick +1,'RS of oft rsc t `froa ortv?hon . MQy • <br /> , ' us-A b,3 Pa( Leh, oc cctzeosor Act sfnIli,cpurporss,�J j <br /> 3 <br /> Under penalties of law,I declare that I have examined this application and that it is,to the best of my knowledge and belief,hue.complete,and correct I <br /> also Cedars that l am duly authorized to sign this exemption application,and that the organization owning the above-tsted property does not disaenatate <br /> In membership or employment bawd on race,color,?national ought <br /> sign J f` °P A.- Pak S'‘br V ID/ 17 <br /> here Jere Authorized Signature ignature Ties Da; <br /> I -_- -__ FOR COU NTYTREASURRER RECOMMENDATION <br /> —__-__---_-�___--_- <br /> —._•_—._I <br /> APROVAL R CEIVE&E a o—RR"EC ,c2,-.-- <br /> -- ✓/(4s$ 77—,90.22_a <br /> 0 DISAPPROVAL <br /> NOV 2 7 2017 Q e ) &a /Q 018/7 <br /> rSignature of County Treasurer Date <br /> COUNTY EOARD OF EQUALIZATION USE ONLY <br /> — — — — — 1A{SURER <br /> 'TREASURERS OFFICE <br /> GRAND ISLAND NEBRASKA <br /> APPROVAL COMMEN:S: <br /> DISAPPROVAL ® ) <br /> • Autho.. ..Signature - Data <br /> Nebraska oepvnmeni M Revenue Ate/treed by Neb.Rev.Star.§§?7-2o20n(c)and(di.and Bennie and 809,189 <br /> 96.283.2005 Rev.8-2011 Supa:sedes 9a-2Ei3-zoos Rev 5.2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />