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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 tile this application will result in a denial of the exemption. Name of Organization County Name Tax Year Third City Archers, Inc Hall 2018 Name of Owner of Property State Where Incorporated Third City Archers, Inc Nebraska Street or Other Mailing Address of Applicant Total Actual Value of Real and Personal Property 1 Parcel ID Number 317 N. Elm St $123,635.00 400004852 City State Zip Code Contact Name Phone Number Grand Island NE 68802 Sean McGee 402-658-7326 Type of Ownership ❑Agricultural and Horticultural Society ®Educational Organization ❑Religious Organization ❑Charitable Organization ❑Cemetery Organization Name Title of Officers, Address,City,State,Zip Code Directors,or Partners Sean McGee President 4179 Norwood Dr, Grand Island, NE 68803 Jim Lott Vice President 4176 Hartford St, Grand Island, NE 68803 Dave Walker Treasurer 8751 N. North Rd, Grand Island, NE 68803 _ Legal description of real properly and general description of all depreciable tangible personal property,except licensed motor vehicles: q ORIGINAL TOWN S 99'LT 4&ALL LT 3 BLK 59 MAY 1 S 2018 Former Mead Lumber storage warehouse gutted, remodeled and re-purposed as an indoor archery range HALL C;OUPNTY ASSESSOR r2RANr? !sl alit, vr3RASKA Properly described above is used in the following exempt category(please mark the applicable bares): ❑Agricultural and Horticultural Society ® Educational ❑ Religious ❑Charitable ❑ Cemetery Give a detailed description of the use of the property: The site is used solely for the promotion of the sport of Archery and the development of the skills of Archery for adults and youth.All fees, dues and fundraising efforts go toward the operation, maintenance, and support of the club facility and training activities. No members receive pay. Youth training leagues are held throughout the year and staffed by dub volunteers. All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. Is all of the properly used exclusively as described above? ®YES ❑NO 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 Is a portion of the property used for the sale of alcoholic beverages? DYES ®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 ®NO 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 complete.I also declare that I am duly authorized to sign this exemption application. e sign -j `�__ President May 8, 2018 her•,-ed Signature Title Date Retain a copy for your records. For County Assessor's Recommendation XApproval COMMENTS: ❑ Approval of a Portion r�.l • .�1 ■`may''■pc ❑ Denial �•'�1!•\�i1� � �l- J ■ e'1111a Signature •1 •untyA -ssor 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. da Approved COMMENTS: ''"� ❑ Approval of a Portion lT ❑ Denied l-.� A.G1--N4iv'^ o`"t;. l r _ Si a$6re of -d Member Date County Clerk:A legible copy of Nf'S fore rshowing the tins is.ion of the County Board Equalization must be delivered electronically to the Nebr ska Department of Revenue within seven days after the Board's decision. Nebraska Department of Revenue.Property Assessment Division Authorized by Nee.Rev.Slat.§§77-202.01 and 77-202.04 96-135-1999 Rev.1-2014 Supersedes 96-135-1999 Rev 7-2012