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Application for Exemption FORM <br /> Good Life Great service. from Motor VehicleTaxes by Qualifying Nonprofit Organizations 457 <br /> To be filed with your county treasurer. <br /> wanton narewoa •Read instructions on reverse side. <br /> Name of Organization Type of Ownership <br /> GOODWILL INDUSTRIES OF GREATER NEBRASKA, INC [g Nonprofit Corporation ❑Other(specify): <br /> Name of Owner of Property County Name Slate where Incorporated <br /> RYDER TRANSPORTATION SERVICES HALL NEBRASKA <br /> Street or Other Mailing Address Contact Name Phone Number <br /> PO BOX 1863(DOM:1140 S LINCOLN AVE,GI NE 68801 TAMI NABOWER 308-384-7896 X124 <br /> City State Zip Code Email Address <br /> GRAND ISLAND NE 68802 tnabower @goodwillne.org <br /> Identify Officers,Directors,or Partners of the Nonprofit Organization <br /> Title Name,Address,City,State,Zip Code <br /> SEE ATTACHED LISTING _ <br /> Description of the Motor Vehicles <br /> -Attach an additional sheet,It necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition, <br /> If Newly Purchased <br /> INTERNATIONAL 2014 TRACTOR 3HSDJAPR9EN766985 8!2(2018 <br /> INTERNATIONAL 2014 TRACTOR 3HSDJAPR6EN788216 812/2018 <br /> Exempt Uses:of Motor Vehicle' Are the motor vehicles used exclusively <br /> 0Agriculaual and Horticultural Society [Educational 0Religious ❑Charitable 0Cemetery as indicated? <br /> Give detailed description of use.including an explanation if multiple use classifications exist: tg1 YES 0 NO <br /> Used for hauling/collecting donations that support our disability programs. <br /> If No,give percentage of exempt use: <br /> Under penalties or law,.I declare that I have.examined this exemption application and,to the best of my knowledge and belief;it is correct and complete. <br /> Sign Ia(.1 Qh uy au g zed osign this exemption application. ( FO sl/islfs> <br /> here /Authorized Signal t Title Data <br /> RECEIVED <br /> Fnr,CountyTreasurer Recommendation <br /> �rpproval Comma nts: b Na#ril-a0a' <br /> II <br /> ❑Disapproal AUG 1 5 2018 <br /> 1 . <br /> rn N i/5ignn of Coin rreas,is Datd <br /> H6l 1_ iJ <br /> I TREASURERS OFFICE For C runty Board of Equalization Use Only I <br /> Ghntvu rot-mivv,nERNAORA <br /> Approval Comments: <br /> ❑Disapproval <br /> - - g"Z/'/ <br /> dir <br /> ed Signature Date <br /> Nebresta Department at Revenue Authorized by Neb.Rev.Slat.§§77-202(1)(c)and(d),and 60-3.185,and 50-3,159 <br /> 96-253-2006 Rev.7-2015 Superedes9 6-253-2006Rev.8-2011 <br /> Please retain a copy for your records. <br />