01/23/2018 - Laserfiche WebLink

Home Browse Search

File with Exemption Application FORM Your County for Tax Exemption on Real and Personal Property by Qualifying Organizations 451 Assessor Read Instructions on reverse side. Failure to properly complete or timely file this application will result In a denial of the exemption. Name of Organization County Name Tax Year Heartland Health Center, Inc Hall 2018 Name of Owner of Property State Where Incorporated Northwest Crossings, LLC Nebraska Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number i 3315 West Capital Avenue $ _ City State Zip Code Contact Name Phone Number Grand Island NE 68803 Kari Wilcox 308-382-4297 x531 Type of Ownership ❑Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization El Charitable Organization ❑Cemetery Organization Name Title of(Officers, Address,City,State,Zip Code Directors,or Partners Teresa Anderson President 1107 N Broadwell Ave, Grand Island NE 68801 Deb Ross Vice President 1137 S Locust Street, Grand Island NE 68801 David Faimon Treasurer 105 N.Wheeler Ave. Grand Island Ne 68801 Legal description of real property and general description of all depreciable tangible personal property,except licensed motor vehicles: personal property Property described above is used in the following exempt category(please mark the applicable boxes): ❑ Agricultural and Horticultural Society ❑ Educational ❑ Religious ❑Charitable ❑ Cemete ry Give a detailed description of the use of the property: RECEIVED DEC 2 6 201// All organizations,except for an Agricultural and Horticultural Society,must complete the following questiordALL G(fUIIIIITY AS S E J�R Is all of the property used exclusively as described above? BRAND.15t hLEBRONS KA Is the property used for financial gain or profit to either the owner or owner or organization making exclusive use of the property? ..OYES ❑NO Is a portion of the property used for the sale of alcoholic beverages? ❑YES ❑NO If Yes,state the number of hours per week Is the property owned or used by an organization which discriminates in membership or employment based on race,color, or national origin? ❑YES 0 N 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 corn te.I alsctdecl that I am duly authorized to sign this exemption application. sign r � Title tirctne; 1>)rec,hr Date i ri here Retain a copy for your records. For County Assessor's Recommendation \\ mendation X Approval COMMENTS: / 7 V "J ��'❑ Approval of a Portion QG. � *s 7 ❑ Denial i y.F�I�xAtfNIY NII. ig�l ure o xaI Asse.C•r Date For County Board of Equalization Use Only I declare that to the best of my knowledge and ballet,the determination made by the County Board of Equalization is correct pursuant to the laws of the State of Nebraska. AApproved COMMENTS: ❑ Approval of a Portion • // / ❑ Denied ' +�"s- /�3 -/8 1.ignatu=of County Member Date County Clerk:A legible copy of this rm s,owing the final decision of the County Board of Equalization must be delivered electronically to the Neb , - - Department of Revenue within seven days after the Board's decision. Nebraska Department of Revenue,Properly Assessment Division Authorized by Neb.Rev.Stet.077-202.01 and 77-202.04 96-135-1999 Rev.1-2010 Supersedes 96-135-1999 Rev.7-2012