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9,614g <br /> istert----c Application for Exemption FORM <br /> Nebraska <br /> REVENUE ENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •To be filed with your county treasurer. <br /> •Read instructions on reverse side. <br /> AI.y-Y.R.RYS Memo Type of Ownership <br /> UNITED VETERANS CLUB HONOR GUARD kJ Nonprofit <br /> Street or Other Mailing Address County Corpora:»on <br /> 1914 W CAPITAL AVE HALL <br /> —; LI Other(eDs y): <br /> City Sate Lp Code I Slate Where Incorporated <br /> GRAND ISLAND NE 68803 i NE ______ <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Tide 1 Name:Address.City;Slate,Zip Cods <br /> __ Chairman_ ._._.1. Mike _Ponte 216-_ E 18th St Grand _Island , NE 68801 -.-._._-_-_-_ <br /> Treasurer •-I Verne Hill 3228 W _18th_ St Grand. Island,-_NE _688.13._,__-._..__._ <br /> ft' _ - . 1. ) . • _ 111 • , • ♦ • • a . 11 t . 11 . 1a 1' 0 : :01 <br /> _- DESCRIPTION OF THE MOTOR VEHICLES <br /> *Attach an additional sheet,B necessary. stration <br /> Motor Vehicle Make 1 Model Year Body TYPe I Vehicle ID Number j Dattee of Acquisition, <br /> __ 1 it Newly Purchased <br /> __.II; orb icon iline _t43590 20141 Van__. __ 1FBSSBL3EDA754.__ . 1/1112Q1Z_ <br /> 1 1 i I <br /> I <br /> — <br /> Exempt Uses of Motor Vehicle: - `----- Are the motor vehicles used exdusivoy —. <br /> as indicated C Agricufiurafillortiailtural 0 Educatioar 0 Religious M Charitable S Cemetery <br /> Give debarred description of use,including an explanation If muit ple use classifications past: i, 1. 'ES 0 NO <br /> Used to transport Honor Guard members to perform iINo,ovepercentagocfexematuse: <br /> 1 military rites at funerals for deceased veterans k <br /> and parades honoring our country . <br /> Under penaltes of taw,I declare that I have examined this application and that it is,to the best of my knowledge and belief,but complete,and correct.I <br /> also declare that 1 em duty authorized to sign this exemption application.and that the organization owning the above-sted property does not disah•.enate <br /> in membership or employment based on race,color,or national origin. <br /> sign 7 Director /1. OY 17 <br /> here Autho 6igrature / Tare Date <br /> l-_- ---__—.__—_ —_ FOR COUNTYTRREEAASSJU.R�ER RECOMMENDATION _ ------i <br /> .APPROVAL ,tin la lvI�� Mrvrtiv rJ: r 14:2-W <br /> ��� �/� �O� <br /> ❑DISAPPROVAL —.— _.__.__----_. ._ _-- ---_ _------ <br /> EY is-°Sr-/ <br /> DEC - 5 2017 /Slgnaw o my Treasurer Date <br /> FOR COUNTY 30ARD OF EGUAUTATION USE ONLY <br /> i - HALL COUNTY . <br /> TREASURERS OFFICE <br /> VAPPROVAL GRAND ISLAND,NEBCGTh&MENT:: <br /> fl DISAPPROVAL 0014 , <br /> % -9:l <br /> Signet _ — . .___--' <br /> t 7 <br /> '7 Date <br /> Nebraska Dapa'.neal M Re erwe Authorized by Na Rev.Stet.§g 172028062 and(re.and 604,185.and 80-3.189 <br /> 964332006 Rem 6-2011$14,.rsedes 98-253-2006 Rev 5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />