Laserfiche WebLink
File with Exemption Application FORM <br /> Your County for Tax Exemption on Real and Personal Property by Qualifying Organizations 451 <br /> Assessor Read instructions on reverse side. <br /> Failure to properly complete or timely file this application will result in a denial of the exemption. <br /> Name of Organization County Name Tax Year <br /> MARY LANNING MEMORIAL HOSPITAL ASSOCIATION HALL COUNTY P018 <br /> Name of Owner of Property State Where Incorporated <br /> MARY LANNING MEMORIAL HOSPITAL ASSOCIATION NEBRASKA <br /> Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number <br /> 715 N. St. Joseph $ 400271826 <br /> City State Zip Code Contact Name Phone Number <br /> HASTINGS NE 68901 LISA KARR 402-461-5502 <br /> Type of Ownership <br /> ❑Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization ®Charitable Organization ❑Cemetery Organization <br /> Name Title of Officers, <br /> Directors,or Partners Address,City,State,al,Code <br /> Jeff Anderson Chairman 5807 Osborne Drive, Hastings, NE 68901 <br /> Michele Bever Vice Chairman 606 N. Minnesota. Suite 2, Hastings, NE 68901 <br /> C.M. Anderson Secretary P.O. Box 756, Hastings, NE 68901 <br /> Legal description of real property and general description of all depreciable tangible personal property,except licensed motor vehicles: <br /> MEDICAL PARK FOURTH SUB S 258'OF LOT 1 - PERSONAL PROPERTY <br /> 1 <br /> Property described above is used in the following exempt category(please mark the applicable boxes): <br /> ❑ Agricultural and Horticultural Society ❑ Educational ❑ Religious ® Charitable ❑ Cemetery <br /> Give a detailed description of the use of the property. C E p1 <br /> . T(' E D <br /> PERSONAL PROPERTY AT CLINIC JAN 0 2 2018 <br /> HALL rrUirlri n <br /> GRAND '`'ASSESSOR <br /> IS! ANO <br /> All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. �1EBRASKq <br /> Is all of the property used exclusively as described above? III YES ❑NO <br /> Is the property used for financial gain or profit to either the owner or owner or organization making exclusive use of the property? ❑YES ®NO <br /> Is a portion of the property used for the sale of alcoholic beverages? ❑YES [Si NO <br /> If Yes,state the number of hours per week <br /> Is the property owned or used by an organization which discriminates in membership or employment based on race,color, <br /> or national origin? ❑YES ®NO <br /> Under penalties of law,I declare that I have examined this exemption application and,to the best of my knowledge and belief,it is correct and <br /> complet;j s iso declar thr I am duly authorized to sign this exemption application. <br /> hereV tic ! -.✓ .2t. l <br /> A _ Signature Title Date <br /> Retain a copy for your records. <br /> I For County Assessor's Recommendation I <br /> *Approval COMMENTS: 7 cDo . <br /> ❑ Approval of a Portion <br /> ❑ Denial I l ivA 1,n <br /> . <br /> r- � <br /> ignature is;my Ass=war Dah_ <br /> For County Board of Equalization Use Only <br /> I declare that to the best of my knowledge and belief,the determination made by the County Board of Equalization is correct pursuant to the <br /> laws of the State of Nebraska. <br /> 6 Approved COMMENTS: <br /> Ar <br /> ❑ Approval of a Portion ilb• v <br /> ❑ Denied <br /> ' Signa re of C o u n t y:.' . Member Date <br /> County Clerk:A legible copy of this or, showing the final decision of the County Board of Equalization <br /> must be delivered electronically to the Nebraska Department of Revenue within seven days after the Board's decision. <br /> Nebraska Department of Revenue,Properly Assessment Division Authorized by Neb.Rev.Stat.§§77-202 0' and 77-202.04 <br /> 96-135-1999 Rev.1-2014 Supersedes 96-135-1999 Rev.7-20'2 <br />