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TO BE FILED WITH ; Exemption Application FORM <br /> YOUR 1 for Tax Exemption on Real and Personal Property by Qualifying Organizations <br /> COUNTY ASSESSOR p Read instructions on reverse side. y 9 451 <br /> Failure to properly complete or tile this application In a timely manner shall result In a disapproval of the exemption. I <br /> Name of Organization C_ /. County County No.,Satt$ Type of Ownership <br /> a ra.nr Isia,�-k S'Aierr+-4'i-�y (kUp.V1�5� I-la i i ]Cdo3$g761 ,l� Nonprofit Corporation <br /> Street or Other Mailing Address k.te,'1 1 Slate Where Incorporated 1 ❑ Other(Specify) <br /> Jp.31_g. She65 3ena s I <br /> City State Zip Code 1 Actual Value Parcel or Location ID Number <br /> GroaaS taiAS Ai , bcs101 1 /Co,3co oc.>38`/71,4 <br /> Legal description of real property and general description of all tangible personal properly,except licensed motor vehicles: /40.102-44.,r S:,e 3 LI a <br /> ITitle of Officers, T--- <br /> Name Directors,or Partners Address,City,State,Zip Code <br /> asr GOA ROSS; P star- Gr 9 ss1 K !38a3 <br /> �¢ (fic� Tr.✓alp; <br /> !ev✓yt _r3� eaa E'c ct 35C T Schroccol c- AU@.&Wc,�-.r9� Jr1ra,-icQ este 617aa3 <br /> - - — Yr- scy.PCP 1€o ox aL SLscLto-t,N <br /> Property described above is used in the following exempt category(please mark the applicable boxes): <br /> ❑Agricullura'iHorticultural Society' 4 Educational g Religious ❑ Charitable ❑ Cemetery <br /> Give a detailed description of the use of the property: over cJ0� 'b_r#ii n3'y S�,r�I -�!aj,� r cL Et re .4o <br /> b }—Qet 3 C'J. rci ti IdiraCi. J <br /> 'AgriculturaVHorticultural Society does not need to complete the following questions. <br /> Is all of the property used exclusively as described above? EI.YES ❑NO <br /> Is a portion of the property used for the sale of alcoholic beverages? ❑YES ®NO If Yes,state the number of hours per week <br /> Is the property owned or used by an organization which discriminates in FBI <br /> membership or employment based on race,color,Or national origin? ❑YES ry 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 /> complete.I also declare that I am duly authorized to sign this exemption application. <br /> sign �. ae5r-ecre ' a-II- IS <br /> here Authorized Sig ure Titte Date <br /> _ <br /> FOR COUNTY ASSESSOR'S RECOMMENDATION <br /> APPROVAL COMMENTS: 1 1 — /7��/i� <br /> G' APPROVAL OF A PORTION —b�—�=�-- �� �// <br /> ASAPPROVAL �n/_ VJb L. / / t t x <br /> 'Sign Co ty ssessor <br /> Datee -j •l <br /> FOR COUNTY BOARD OF EQUALIZATION USE ONLY <br /> I declare that,to the best of my knowledge and belief,the determination hereby made by the County Board of Equalization is correct pursuant <br /> )(APPROVED///��� to the laws of the State of Nebraska. <br /> `� APPROVED COMMENTS: <br /> !�[II, <br /> APPROVAL OF A PORTION <br /> ❑ DISAPPROVED �AiLL�L�L . -z---. / �-. CE I V E D <br /> Signatur•of County:'oar. 'ti''r <br /> Neoraska Department al Revenue Authorized by Neb.Rev.Stet.§VT-202.01 96-t35-1999 Re.?-20W Superseaes 96-'351999 Rev.11-2008 FEB 2 0 2018 <br /> PLEASE MAKE A COPY FOR YOUR RECORDS HALL COUT'i I Y ASSESSOR <br /> GRAND ISLAND. NEBRASKA <br />• <br />