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I roil. 1 I ncay. a Nom, Application for Exemption FORM Good Life.Great Service. from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 •To be flied with eovnn.a.OP e.v.au. ' •Read instructions on reverse ide. Name of Organization ee �j 1 ypof Ownership BetcOn Of Wore Se.ek;sk G,,Arct. 2 Nonprofit Corporation 0 Other{specify): Name of Owner of Property p County Name State Where Incorporated S at.toh Cis \A oft U4e%t5'1- C.Ltmect. l-k3\■ NE Street or Other Mailing Address Contact Name Phone Number aSS W. Skate 54. 13'1\\ Row t nd 308- 33-o - as4`I City State Zip Code Email Address Grassi is\ar•4 1JE (08903 bee.con @ too kq't . org Identify Officers,Directors,or Partners of the Nonprofit Organization The Name,Address,City,State,Zip Code Payler — O:r•ee!-or %'r1\ Q. o..4\2,4 %S17. A..da cl-_ G%ra-..d Ss\z4 NE lotto-3 T'.rectal- F11oyA TreFFer 4117' N. CI. vet Kee Ave. Grs..Jlsl...d /kit t.ews O; reciter Srt'♦tron tie Solt ft- Kavwe1 Rd. Greg Ists.J NE 6not tr.ret at" Frani< Set.ne;Jer 1670 cst.Ps4r:sk Ave. des.J Tah...J NE Gates Icy; ret -er Stnay Rode u..1.4.‘a led Ntir../it...4Me G,.ak Irt...J NE is*40 ] • Description of the Motor Vehicles •Attach an additional sheet,if necessary. Registration Date or Motor Vehicle Make ModelYear Bodyrype Vehicle ID Number Date of Acquisition, it Newly Purchased o;a•-e-d (r-end) 1991• % as (n ' yie), 1FUWE30G'iTHB50Noo 9/2s116 Exempt Uses of Motor Vehicle: Are the motor vehicles used exclusively ❑Agricultural and Horticultural Society 0 Educational Religious ❑Charitable 0 Cemetery as indicated? Give detailed description of use,including an explanation if multiple use classifications exist: 1 EYES ❑NO ZY'a..+s tort&Aton p} People to and crow, Ci..wrc-L and C1.....r tt.. re led e d a C}t ,d',-!.; es If No,give percentage of exempt use: 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. sign C - as,. -t. - ) Pa.t,-.. A e .. 9/a G / 18 here ■Authorized Signature Title Date I For County Treasurer Recommendation I F � t rQKr.proval ommeets: „ y .nt UL Ns s sitl 'ao� ❑ Disapproval S E P 2 i 2018 -r.n'I1f^n �1` HALL COUNTY /vigna of County reasu a ate(.71� I IRE 3,22. orrtGE rGRAND ISLAND, EBRAS F r County Board of Equalization Use Only XApproval Comments: o Disapproval I a�.,,-; ; / '2-/37) -•horized Signe ,= Date Nebraska Department of Revenue Authorized by Neb.Rev.Stet§§77202(1)(c)and(d),and 60-3,185,and 60-3,189 96-253-2006 Rev.7-2018 Supersedes 96-253-2006 Rev.8-2011 Please retain a copy for your records.