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Ilf_BRAcafick Application for Exemption <br /> FORM <br /> ,,,,x,„10 rro:a So.vice. from Motor Vehicle Taxes by Qualifying Nonprofit Organizations 457 <br /> •To be Bled with your county treasurer. <br /> a.+•,nin-" •(l•ad instructions on teeme side. <br /> (Nar�.m.�ol Orronlzellm CC Type olOmordgl .._.._...\.__._,. <br /> �7IV11u —. • X1. 9 rIY Mormon'Corpompa, ❑°Mor(wau»: 5L/C.e• ,..1:._ <br /> Name dPnpl of Properly Cooley Name Sato Whom Incorpornled <br /> PO Box 131s1 <br /> __ .-__.__ 140-11 ► •,.•_ .—__....- <br /> SlrodorOeurMa'ngAadeM — Conlaal Name Phone Minims <br /> 6rana I*1 o_r‘a NE__lafi$9L_ __ ___________ <br /> Cey Slnlo Zlp Code Emil Address <br /> identify Officers,Directors,or Partners of the Nonprofit Orranlz.tion <br /> To Nemo.Address.Cay,Slam 20 Coen <br /> R.-s tdcrt* `,rr+.t(Icnbi, 206 W.l'`S+.1}lo4F■ .- NE 1.7(401 —_---` <br /> •g sorc}ya,-y 1' , J••• - • • i •' • : . a <br /> Sr_ca.5btr.r1 F •. Yarettr•a,t r42.18 M,c3„ntr Av. . 6rar,cdT40 gra. NE 011503 <br /> Description of the MotorVehicles <br /> •Attach an additional sheet,If necessity. <br /> apletretlon OOP or <br /> Melor V.l*le ISM Model Met Bodylyp• Vehicle ID Number Dale of Acquleltlon, <br /> B N Purchead <br /> Exempt Uses of Motor VSWde: Are sre molar vahules used elmosiwM <br /> ❑Agndwluro end HonlwauralSotlny QEduNlmnnl ❑Reaglous ❑chauIam. ❑raven a.YseeMed? <br /> Give d-olniied description fcll use,Including an oxplenalon N multiple use clooa�rce`ua,e oche Da YES ONO <br /> {J�.W 0. . C ittp Au tc# 1ne- CO r pu. l 1 r d T..r p '1•ro a kr •. •No,gee age di exempt use <br /> eneaased 4rcakr. J �J x <br /> UW2d occ tarp -coy- pu_ t .4 r enc.losgd r0. <br /> + 1er 4&- <br /> t u.n it buetness . <br /> ..: .. tl1 I hem Mamawd Iles exemption appllctlon and.to we best d my kn wledge end belle4il Scorrocl andcomplelo. <br /> .le t1am du ', .••so Mgn da•exemption appamYd,sign kerne <br /> �.here T�Ut>3� FYtrolt�tVe tf]-l4-Ijf a 91proale Tile Gale <br /> For County Treasurer Recommendation <br /> m, l!� ; E31en$t per NSSit 77-aOa <br /> Approval 1 F:,s;S x S mments: <br /> .mw am�lYr <br /> ❑Disapproval <br /> OCT 2 c 2018 HU. ._.i .t ../ li, ' I:I.,_ r ryJ. /o'aale <br /> Signewr• 1 Count'Treasurer i Dale <br /> I For Count r Board of Equalization Use Only <br /> HALL COUNTY <br /> TRFASJREPS OFFICE <br /> 'Approval GRAND:SLVND,NEBfj,^y- <br /> ❑Disapproval e/a 7,_ ,,/-y <br /> tired c-t ,e eau • <br /> 9-253- 04 RameNdA.MIe AWw4eep N.oea.BleL;411 2e1(1N4 and lal.Wee T,lae,tad eel,1N <br /> W)Ne.ypee a...).4e1N SWwseesege.tep300•aer,e.2e11 <br /> Please retain a copy for your records. <br />