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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 Central Nebraska Community Action Partnership(fmrly Centrt Hall County 2018 Name of Owner of Property State where Incorporated Central Nebraska Community Action Partnership Nebraska Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property Parcel ID Number 626 N Street, P.O. Box 509 $93,504.00 400375710 City State Zip Code Contact Name Phone Number Loup City NE 68853 Judy Hughes 308-745-0780 Type of Ownership 9 Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization ®Charitable Organization ❑Cemetery Organization Name Title of Officers, Address,City,State,Zip Code Directors,or Partners Cheryl Holcomb CNCAP Ex.Director P.O. Box 509. Loup City, NE 68853 Judy Hughes Housing Director P.O. Box 509. Loup City. NE 68853 Legal desorption of real property and general description of all depreciable tangible personal property,except licensed motor vehicles: RECEIVED Cairo South Loup Village Second Addition Lots 3 and 4 Block 4 • / DEC 2 6 2017 iddress: /0? Said HALL COUNTY ASSESSOR Property described above is used in the following exempt category(please mark the applicable boxes): (iHAND ISLAND. NEBRASKA ❑Agricultural and Horticultural Society ❑ Educational ❑ Religious ® Charitable ❑ Cemetery Give a detailed description of the use of the property: This property is used for rental housing. We are a nonprofit organization and provide housing opportunities to tow-income individuals and families. n CNCAP was formerly Central Nebraska Community Services. is Y snt a-AY prc ff L bust hC&3 All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. Is all of the property used exclusively as described above? YES ❑NO is the property used for financial gain or profit to either the owner or owner or organization malting exclusive use of the property? ..❑YES 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 whicr discriminates in membership or employment based on race,color, or national origin? OYES is NO Under Hies of law, .:dal: , I have examined this exemption application and,to the best of my knowledge and belief,it is correct and comple . al declare 1•c I am du, ;pi tr.to sign exemption application. sign / Executive Director 12/14/2017 • here Au rized Sig re Title Date Retain a copy for your records. For County Assessor's Recommendation I vv-rust ❑ Approval COMMENTS: k nil + �f _I /1 J t r i •l l 3✓ i :A . ❑ Approval of a Portion L. I eeIL + II t•A 1+• ��r Denial r .� f +a A ignatur ou Assessor Date For County Board of Equalization Use Only 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 laws of the State of Nebraska. Approved COMMENTS: ❑ Approval of a Portion Denied l�i `AQ ti'74 �� .. ,. _ l GC.J Signatur of County r:Member Date County Clerk:A legible copy of thi orm - owing the final decision of the County Board of Equalization must be delivered electronically to the Ne• --- - Department of Revenue within seven days after the Board's decision. Nebraska Department of Revenue,Property Assessment Division Authorized by Neb,Rev.Slat.§§77-20201 and 77-202x4 96-135-1999 Rev.1.2014 Supersedes 96-135-1999 Rat 7-2012