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NEBRASKA- Application for Exemption FORM <br /> Good Life.Great Service. from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> ov...,auve.s,v,sv, <br /> •To be filed with your county treasurer. <br /> •Read instructions on reverse side. <br /> Name of Organization Type of Ownership <br /> HALL CO LIVESTOCK IMPRV ASSN DiNonprofitCorporation ❑Other(specify): <br /> Name of Owner of Property County Name Stale Where Incorporated <br /> HALL CO LIVESTOCK IMPRV ASSN HALL NE <br /> Street or Other Mailing Address Contact Name Phone Number <br /> 700 F. STOT.T.RV PK RD PO BOX 490 TRACY OR BRUCE 308 382 4515 <br /> City State Zip Code Email Address <br /> GRAND ISLAND NE 68802 <br /> Identify Officers,Directors,or Partners of the Nonprofit Organization <br /> nue PRE SIDENT EirieSaalagiaaC STEVE HANSEN 1420 STAGECOACH RD GI. NE 65801 <br /> 1ST VP MIKE JAKUBOWSKI 3510 S BLAINE GI NE 68803 <br /> 2ND VP DAN FOGLAND 4604 LAKESIDE DR GI NE 68801 <br /> 3RD VP RUSS RERUCHA 156 PONDEROSA CT GI NE 68803 <br /> SFC WHITEY RICHARDSON #47 KUESTER LK GI NE 68801 <br /> TREAS DERKE APFEL 1123 W 2ND GI NE 68801 <br /> Description of the Motor Vehicles <br /> •Attach an additional sheet,if necessary. <br /> Registration Date or <br /> Motor Vehicle Make Model Year BodyType Vehicle ID Number Date of Acquisition, <br /> if Newly Purchased <br /> GMC...SIERRA 2018 PICK UP 1G'TU2VEG8JZ325O22 AUG 20, 2018 <br /> Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively <br /> Agricultural and Horticultural Society 0 Educational 0 Religious fl Charitable 0 cemetery as indicated? <br /> Give detailed description of use,including an explanation if multiple use classifications exist ®YES ❑NO <br /> 4-H ACTIVITIES, COMMUNITY ACTIVITIES, PROMOTINAL EVENTS OF AN <br /> EDUCATIONAL OR CHARTIBALE NATURE, HORSE RACING, AG EVENTS INCLUDING If No,glve percentage of exempt use: <br /> HALL CO FAIR, STATE FAIR & STATE 4-H HORSE SHOW % <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 complete. <br /> I also declare that I am duly au r • ..=• - -this exemption application. <br /> sign CEO 8/24/2018 <br /> here Authorized Signature s t r SWI ' Title Date <br /> For County Treasurer Recommendation <br /> ]Approval RECEIvELI mentt: s Pd A1&9 1 71-at?. <br /> ❑Disapproval <br /> AUG z a zoos � � _ <br /> SignaN (burry Treasurer te <br /> For Cour ty Board of Equalization Use Only <br /> MALL UUUNT Y <br /> TREASURERS OFFICE <br /> (Approval GRAND ISLAND,NEBI 4SKA n nenw: jj <br /> ❑Disapproval Ale. <br /> %., / . rill S _ 9.- Y�l� <br /> !1r.'o n � .iii-re" r 4— -- Date <br /> Or <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stet§§77202(1Nc)and(d),and 80-3,185,and 80-3.189 <br /> 98-253.2006 Rev.7-2018 Supersedes 98-253-2008 Rev.8-2011 <br /> Please retain a copy for your records. <br />