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JAN/17/2018/WED 04:48 PM Overland Trails Coun FAX No. 3083823718 P. 001/001 <br /> n_.. Application for Exemption FORM <br /> Nebrathe Department REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> A <br /> •To be filed with your county treasurer. 4 <br /> •Read Ins1tvctions on reverse side. <br /> Applicant's Name Type of Ownership <br /> Overland Trails Council, Boy Scouts of America ®Nonprord <br /> Street or Other Melling Address County Corporation <br /> 2808 O'Flannagan St, PO Box 1361 Hall <br /> City slam zy cads ❑Other(specify): <br /> State Where incorporated <br /> Grand Island NE 68802 NE <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OFTHE NONPROFIT ORGANIZATION <br /> This Name,Address,city.State,Zip Code <br /> President Tim Jacobi,200 W 6th St,Hastings,NE 68901 <br /> Secretary David Plond,1519 W Division,Grand Island,NE 68801 <br /> Treasurer Ron Vonderohe,4218 Michigan Ave,Grand Island,NE 88803 <br /> DESCRIPTION OFTHE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Regialrefon Dew or <br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Dare of Acquisldon, <br /> if Newly Purchased _ <br /> Dodge 2008 Van 108HN44111813172132 1/2008 <br /> Ford 1997 Pickup 1FDLF47F2VED03347 1/2008 <br /> Ford 1989 Pickup 1FTDF15IIIIQB07506 1/2008 <br /> Haulmark 2014 Enclosed Trailer 575GB2422EH204078 1/2008 <br /> Kaufman 2015 Dump Trailer 8SHFX1424F8000890 12008 _ <br /> Exempt Uses of Motor Vehicle: Are the moor vehicles used exclusively <br /> ❑AgriculluraVHodicuitwai Is Educational ❑Religious ❑Charitable ❑cemetery as irdcated7 <br /> Give detailed description of use,InclUdng an explanation If multiple use classifications west ®YES ❑NO <br /> Pickups,trailers, and van used for operations at Camp Augustine. <br /> it No,give percentage or exempt use: <br /> x <br /> Um:eapenalties of ON I declare that I have examined mis application an =• of my knowledge and ballet,true,complete,and correct! <br /> elsfd tare that I am duly authorized to Es!,the exemption applicehan, icon owning the above-listed property does not discriminate <br /> inneriberahi I.• _ ' color,or n�ationalortgin. <br /> G <br /> sign ' � %�� Sr ici3 Vi 7/115 <br /> here Authcr,a Signature The Date <br /> FOR COUNTYTREASU RERRECOMMENDATION J <br /> APPROVAL RECEIVEDAM P - Acs * n/`_ENTS <br /> ❑DISAPPROVAL • <br /> JAN 1 7 2018 <br /> fig (..pt [lliti rfi i luslra .. <br /> unn rnnniry Sigmyre oC6antyTreaeUrer Date <br /> TREASURERS FVEVliNTV E OARD OF EQUALIZATION USE ONLY <br /> ,,mi�ll UMFl vIS r5L.cNB, ,'I U <br /> 4.APPROVAL COMMENTS; <br /> • <br /> ❑DISAPPROVAL <br /> Signar re Date <br /> Nebraska o.partnem M Revenue Authorized by Neb.Rae Slat if 77'202(1)(o)end(d),Dad 504,185,and 664169 <br /> 95-25912668 Rev.8.26x1&ppervades 96'262.200e Res 5-2669 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />