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en----z Application for Exemption �MS <br /> Nebraska Doberman:of 1 FORM <br /> REVEruUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations [ 457 <br /> •To be filed with your county treasurer. <br /> •Read instructions on reverse aide. I <br /> Applicant's Name - Typed Ownership <br /> THE SALVATION ARMY t g Nonprofit <br /> Street or Other Mailing Address I County 1 Corporation <br /> 818 W 3RD ST 1 HALL Other(specify): <br /> City .—.^ State Zip Code I Slate%Nhere incorporated <br /> GRAND ISLAND NE 68801 I NE _—._______ <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tide 'Name,Address.My,Stars,Zip Code <br /> _ ees1 r-. -' .0of _ '+tB GY _1O'—K_'4pc.-2as esk _A i°..-.s-- � V _____ <br /> !7Stf- [►:.➢1sTL 1 skd g1 gatd.C _ = is..:!� __ 320 -__._.__.___ <br /> v:soil I re„..c-A <br /> T ik4Fes- tot <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> *Attach an additional sheet,If necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year Body Type I Vehicle ID Number I Date of Acquisition, <br /> -- —._ If NewixPurehased <br /> . _ __ ___ _----_._ _. <br /> rev a 1 . <br /> a) 1 cs oai16AaG14 GSM_13 _._. <br /> 5?S — — _-- <br /> I ..... • • r_...,,,,-.L'. __-VrthAZ c 1. E is b. ; .is . <br /> v-dL 1 ' el ; ru_c_XL. 1f.WrIonWVA 01081 I <br /> cr 0 i L 0 L_�_ 1-;.a l 1e.c LIN mcL081Xem 01 D4171 <br /> Exempt Uses MoiorVehicie: i Are the motor vehicles used exclusively <br /> o AgricukuraL9iorfigrkural fl Educational "1RMigi ius gcharrlab!e Eli Cemetery l as indicated? <br /> Otve detailed descdption of use,Including an explanation if multiple use c assikcations exist: Es 0 NO <br /> G,Aw,cCcS� Ql C.SkIS,aM `t • QV e vkS. ds as-tEA-5, <br /> II No,give percentage of exempt use: <br /> p` 'ct10 , <br /> �rpoa, c-�DkA:,(19y �h� <br /> •4�-rz �� 5 >k <br /> *co_y,s po A ‘0:,2 rt A/ .e.-e-5 orb c\r c- s-mo-5 V.sLM-e...5 <br /> Under penalties law.I I. , :II have examined this application and that a h,to the best of my knowledge and belief,tee.complete,and correct.I <br /> also declare I am duty, -:.to sign this exemption application,and that the organization owning the above-listed property does not discrafmate <br /> in membersh'>or• •based on race,color,or national origin. <br /> sign i . Mgt ' r /f -/3- /7 <br /> here Aah. ,: rc . 0.x°125 oC�(ett nda'3ce/3 90- a 09 Dare <br /> L FOR COUNTY TREASURER�RECOMMENDATION � <br /> PPROVAL , COMMENTS: 4eil'i"�7�'/14-4-- ii,..C.S --lp..a- <br /> 1 0DISAPPROVAL RECEIVED -- - - --'------- ---'-'-----'-'-'--'-----..._._._-_--- <br /> NOV 1 6 2017 It Signature of county Treasurer Date <br /> FOR COI.NTT BOARD OF EQUALIZATION USE ONLY <br /> APPROVF L TRH HALL CO TY COMb ENTS: <br /> GRAND ISLAND,NEBRASKA <br /> CJ DISAPPROVAL <br /> 011111_„,a tier <br /> .Signature ------ - ---- bate - --. <br /> Nebresxa Daparnent of Reranue Authorized by Net Rev.Stt§ 77-202(1)(c)and(di.and®r3,I55.and 60-3,tad <br />• 26-n3-200B Pax 8-2011 Supersedes 98-213-2006 Rev 5.2009 <br />• <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />