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7 ,°\ <br /> A_ Application Application for Exemption I FORM <br /> Good Life.Great Service. from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> •To be filed with your county treasurer. A 57 <br /> .....•••••....•,..• •Read instructions on reverse side. `t <br /> Name of Organization Type of Ownership <br /> FIRST PRESBYTERIAN CHURCH I3 Nonprofit Corporation ❑Other(specify): <br /> Name of Owner of Property County Name State Where Incorporated <br /> HALL NE <br /> Street or Other Mailing Address • Phone Number <br /> 2103 W ANNA ST ,tz' i�,_�I -A 5o8 -3.,.Z c 9 3 0 <br /> City State Zip Code Email Address <br /> GRAND ISLAND NE 68803 .2,Syfier ® / iresL . o r- <br /> 1 <br /> I.- tit, O +- , Di - t• . P. t - •f t - N• • oft O •. i .t • <br /> Till- <br /> t � . �r.1%� : .ri71/_ �� r"! !f/A_ssa%J�-rL'/l1/1J <br /> r �� / <br /> r___ AD • ' _ . G g U) ,1 W, it <br /> • i o/ <br /> 1 Description of the Motor Vehicles <br /> •Attach an additional sheet,if necessary, <br /> Registration Date or <br /> Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition, <br /> it Newly Purchased <br /> e a <br /> LQ�� 1V9 titl.e-1112 /aAHG<39J.Sk /065go41 <br /> Mali. 2o00 .//9 I/4 •lid,/ xgrs F/o/!o )(Alf oal5.3`f <br /> Exempt Uses of Motor Vehicle: -Are the motor vehicles used exclusively <br /> ❑Agricultural and Horticultural Society ❑Educational Religious ❑Charitable ❑Cemetery as indicated? <br /> Give detailed description of use,including an explanation if multiple use classifications exist: ,�• gi YES ❑NO <br /> t �,7'(� '-c%�"" nt.i.✓"—-4- /x• If No,give percentage of exempt use <br /> (-6 <br /> Under penalties of law,I declare that I have exam ned this exemption application and,to the best of my knowledge and belief,it is correct and complete. <br /> I also..'tare that I am dul thor ed to sign this exemption application. <br /> Sign sii1r", to ' <br /> 7,e yta.,c�e Q 7 Y /2-//—/c� <br /> here prized ignature T le Date <br /> p.�, For County Treasurer Recommendatiioonn�- !�+� ! <br /> � Wproval a pal e6. meets: tom'^' N`� ` � l-ao 0� <br /> F ; EI EDl <br /> ❑Disapproval <br /> r 27"8 .•I. J I�d�/� <br /> Signature of .•1 ty Treasurer <br /> H ALL COUNTY Date <br /> Approval <br /> For Court Board of Equalization Use Only <br /> TREA:UREPS OFFICE <br /> GRAND isLA NESAp; },,,tom. /// <br /> 111]Disapproval <br /> / <br /> 'AI / --X_____---- /-2/ S? 1 k <br /> 'Auth. ized •n- re Dat <br /> r <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stat.W 77202(1)ic)and Id,and 60-3,185,and 60-3.189 <br /> 96-253-2006 Rev.7-2018 Supersedes 96-253-2006 Rev.8-2011 <br /> Please retain a copy for your records. <br />