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go t <br /> amb^----z-- Application for Exemption FORM <br /> Nebraska Department or I <br /> RIEVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •To be tiled with your county treasurer. <br /> ` •Read instructions on reverse side. <br /> Appecanfs Name 'Type of Ownership <br /> ST STEPHENS EPISCOPAL CHURCH i El Nonprofit <br /> Street or Other Mailing Address County f Carpurtrvon <br /> 422 W 2ND ST PO BOX 2317 HALL <br /> Othe,'(sPecifYY <br /> City State Zip Code State Where Incorporated <br /> GRAND ISLAND NE 68802 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tide i Name:Address.City,State,Zip Code <br /> fe tie,l -------1i Q t1r- Rekktr_r FI•Lr_w_S. ;a, S. tilrF SSA c^S'IL Gra_.4 7sls-.J. n!fG88n i.--'-' <br /> Ile c'IVY U Warden i -bekyt-_ se . is a_1 r., ova e-.. E. 6 SP .s- <br /> �2rltla 'S LJ avA ey. -- f-Kcvin It dint a-1v ,'/13re 4/e se •e,d5 e: Ls-"v, &re-.-L SS(a.+-f, NE E tkv3 <br /> Q41`tc.°- 64a s-,Star I Linn- Nuts , /L3l Kend<(1 S* 1 St-Pa.cl, r"€2 LEP73 <br /> DESCRIPTION OPINE MOTOR VEHICLES <br /> •Attach an additional sheet,If necessary. <br /> I I 1 Registration Date or <br /> Motor Vehicle Make Model Year Body Type I Vehicle ID Number I Date of Acquisition, <br /> _ _ _ _ ___ _ __..j,_.__.—._..__...-._._—,—_._._._.-_....1..... it NmroiSPUrcht ....... <br /> F a. eC ta. eru5---------.2-o-e 7--- e.f-docr-.-.-sed a,-.-- -L f AF3s3x�a lFSS r—s�rs[ <br /> ae-& -- <br /> — ---- t I <br /> I i <br /> i <br /> I I <br /> -J _. . - ii <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exciuslveiy <br /> El AgricuiturasHortkukural El Educational 2 Religious 0 Charitable [.j Cemetery as indicated? <br /> Give detailed description description of use,including an explanation if nestipie use classifications exist: RYES ONO <br /> ry-ut-(-c r'II re bb't't5t 191/hhie S o4 rectors Job des ditto, r"`- I d No,gore percentage of exempt use: <br /> iAVE(vzAJ !'fir si,prt-a- 'cn- besets % <br /> Under penalties cf taw.I declare that I have examined this applica"..cn and that it is,to the best of my knowledge and belief,true.complete,and correct I <br /> also declare that tam duly authorized to sign this exemption application.and that the organization owing the above-listed property does not discriminate <br /> in membership or employment based on race.color,or national origin. <br /> sign e / M —ni u 2x d 1,/> // <br /> Author signature d ynn� ',ha, 30& Tull- �9L/ Doe <br /> [. --_--_.----- FOR COUNTY TREAASSSUUeREERR REE.COMMENDATION /_-- --- ----_� <br /> [V APPROVAL COMMENTS: ��" r .tom /''• • • "1.77--a0.02-• <br /> ❑DISAPPROV RECEIVED -'----------------------------'-- <br /> A:9-a i7 <br /> NOV 1 4 2717 l'sigra of 0 ,r�r Date <br /> FOR COU Y BOARD OF EQUALIZATION USE ONLY <br /> HALL COUNTY <br /> ry]APPROVAL GRAND IISLANS O BRAS2 ME ,S: <br /> D v <br /> DISAPPROVAL NEBRASKA eh <br /> 40 I <br /> OP / 7- 1--L_- _' <br /> ed Skgatue �' --- Date <br /> Nabras'xa Dapanmen or Revenue - Authorized by Neb.Rev.Sea-gg 71-202f11(c)and(dl.end 82-3,125.and 60-3.189 <br /> 962512+008 Rev.8-2011 Supersedes$6-253-2006 Rev 5.2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br /> I <br />