Laserfiche WebLink
elm— Application for Exemption FORM <br /> Nebraska Department of <br /> REVENUE from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •To be tiled with your county treasurer. <br /> =a= •Read instructions on reverse side. <br /> Applicants Name Type of Ownership <br /> Diocese of Grand Island <br /> ®Nonprofit <br /> Street or Other Mailing Address County Corporation <br /> 2708 Old Fair Rd Hall ❑other(specify): <br /> City State Zip Code' State Where Incorporated <br /> Grand Island NE 68803 Nebraska - <br /> IDENTIFY OFFICERS,DIRECTORS,OR PARTNERS OF THE NONPROFIT ORGANIZATION <br /> Title Name,Address,City,State.Zip Code <br /> Bishop Joseph G Hanefeldt Box 1531,Grand Island NE 68802 <br /> Rev Charles L.Torpey 2635 Brennen Lane,Grand Island NE 68803 <br /> Rev Michael McDermott 422 College Drive,Sidney NE 69162 <br /> DESCRIPTION OF THE MOTOR VEHICLES <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition, <br /> if Newly Purchased <br /> Ford 2016 Explorer4x4 1FM5K8DHBGGB79593 03/28/2018 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> A riculturalHorticultural Educational KI Religious Charitable as indicated? <br /> ❑ g' ® g' ® ❑Cemetery <br /> Give detailed description of use,including an explanation if multiple use classifications exist: [g]YES ❑NO <br /> Used exclusively for non-profit religious, educational and charitable purposes <br /> If No,give percentage of exempt use: <br /> °A <br /> Under penalties of law,I declare that I have examined this application and that it is,to the best of my knowledge and belief,true,complete,and correct.I <br /> also declare that 1 am duly authorized to sign this exemption application,and that the organization owning the above-listed property does not discriminate <br /> in membership or employment based on race,color,or national origin. <br /> sign 7/44,1,4— Bishop/President 03/29/2018 <br /> here I AUthoriz d Signature Title Date <br /> FOR COUNTY TREASURER RECOMMENDATION <br /> EG to D f m , ,41,5-,,,C. '77- c2 <br /> [ PPROVAL COMMENTS: <br /> ❑DISAPPROVALMIAR 2 9 2018 <br /> HALL COUNTY /Signatnty Treasurer Date <br /> TNEABJRER3 3rr1CC <br /> I GRAND ISLAND,NEBRASKA FQR COUNTY BOARD OF EQUALIZATION USE ONLY I <br /> 'APPROVAL COMMENTS: <br /> DISAPPROVAL <br /> 411/11 <br /> Autsrgnature Date <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stat.§§77-202(1)lc)and(d),and 604165,and 60-1189 <br /> 96-253-2006 Rev.8-2011 Supersedes 96-253-2006 Rev.5-2009 <br /> PLEASE RETAIN A COPY FOR YOUR RECORDS. <br />