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A Application for Exemption a�� <br /> f�ICQ�Arct4 <br /> �� from Motor Vehicle Taxes by FORM <br /> Good Lire,Great service. y Qualifying Nonprofit Organizations <br /> a„„,,,,,„,o,s,,,„w <br /> •TO be filed with your county treasurer. A 57 <br /> •Read Instructions on reverse side. YJ <br /> Name of Organization j <br /> Type of Ownership <br /> GIRL SCOUTS SPIRIT OF NEBRASKA ®Nonprofit Corporation ❑Other(specify): <br /> Name of Owner of Properly County Name State Where Incorporated <br /> GIRL SCOUTS SPIRIT OF NEBRASKA HALL NE <br /> Street or Other Mailing Address Contact Name Phone Number <br /> 2121 S 44TH STREET JODI M. PREWITT 800-695-6690 <br /> City State Zip Code Email Address <br /> OMAHA NE 68105 jprewitt@girlscoutsnebraska.org <br /> Identify Officers,Directors,or Partners of the Nonprofit Organization <br /> Tine Name,Address,City,State,Zip Code <br /> CEO FRAN MARSHALL,2121 S 44TH STREET,OMAHA,NE 68105 <br /> Description of the Motor Vehicles <br /> 'Attach an additional sheet,if necessary. <br /> Motor Vehicle Make Model Year Registration Date or <br /> 9odylype Vehicle ID Number Date of AcquisNlon, <br /> IRON CANOE TRAILER 1980 TRAILER 316445 if Newly Purchased _ <br /> Exempt Uses of Motor Vehicle: - _ <br /> Am the motor vehicles used exclusively <br /> ❑Agricultural and Horticultural Society ❑Educational 0 Religious ®Chadtable 0 Cemetery as indicated? <br /> Give detailed description of use,including an explanation if multiple use classifications exist: ®YES ❑NO <br /> TRANSPORT GIRLS AND ADULTS TO EVENTS AND CAMPS. TRANSPORT <br /> EQUIPMENT AND CAMPING EQUIPMENT, PURCHASING FOOD FOR GIRL SCOUT II No,give percentage of exempt use: <br /> EVENTS. <br /> U ••r pe •hies of t w,l declare• •t l have. :.min.. •.exemption application and,to the best of my knowledge and belief,it is correct and complete. <br /> I also'sclera at l- `mly a ,. ..••to sign tU.. •- .f••-rf.n application. <br /> sign rM �y (� <br /> here Autlwtlzetl Mn Fore l_� • Title CFAO Date <br /> `(10q t a)(J` <br /> ,,itce� For County Treasurer Recommendation �7 r] `vl <br /> LVJ 9pproval Comments: AAA, k �75 ? iaor- <br /> tt❑�Disapproval ���t/f ���� <br /> s DIAL Tre asulO Lx/ tkg <br /> Date <br /> For County Board of Equalization Use Only <br /> ❑Approval Comments: <br /> ❑Disapproval a - <br /> tar - / '''- <br /> Aulh sized i. . ore � <br /> Date <br /> f / <br /> Nebraska Department of Revenue <br /> 96253-2006 Rev.7-2018 Supersedes 96-253-2008 Rev.6-2011 Authorized by Nab.Rev.Stat.g4 77-202(1)(c)and DO,and 60-3,185,and 60-3,189 <br /> Please retain a copy for your records. <br />