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' Application for Exemption <br /> 9O * <br /> Good Life.Great Service <br /> from Motor Vehicle Taxes by Qualifying Nonprofit Organizations FORM <br /> ,E,•„�E„•....Ewvc •To be filed with your county treasurer. A 5 <br /> •Read instructions on reverse side. 457 <br /> Name of Organization Type of Ownership <br /> IGLESIA DE DIOS EBENEZER N Nonprofit Corporation ❑Other(specify): <br /> Name of Owner of Property County Name State Where Incorporated <br /> HALL NE <br /> Street or Other Mailing Address Mentact Nam one Nu..ber <br /> 502 E CAPITAL AVE PO BOX 486 , , tQ ,A k c <br /> City State Zip Code Email Address (� ' <br /> GRAND ISLAND NE 68802 \0D\�.St(�,t�IL�1E7,��1, (IQ\° e m _ • [0cn <br /> Identify Officers,Directors,or Partners of the Nonprofit Organization J Y,� <br /> Title , Address.City,State,Zip de <br /> Co <br /> Qv r - 1A i\ . s t1^ Cr \S\l.r . v . f ' .. <br /> [dC� ; tr r _ 'Ti. ' a=i1T�tiisat lIMMIS �1!� al- <br /> Description of the Motor Vehicles <br /> •Attach an additional sheet,If necessary. <br /> Motor Vehicle Make Model Year Body Type Registration Date or <br /> Y yP Vehicle ID Number Date of Acquisition, <br /> If Newly Purchased <br /> Exempt Uses of Motor Vehicle: I Are the motor vehicles used exclusively <br /> ❑Agncultural and Horticultural Society ❑Educational IN-Religious ❑Charitable ❑Cemetery as indicated? <br /> -�Giiivv\etdettailleed description of se,DA an\,),,M explannaatiion if ultiple u class{iificati e s: !��{ ,`t.,, (/�� r YES ❑NO <br /> f t S \IONc),l`� DA 0 n 4 1p ,P 3 ai ' give percentage P <br /> ` If No. ive percenta a of exempt use <br /> tb L\tt\ifl ,, DM I) loAc k \kUXIO lk \J Ci <br /> 7 <br /> Um e - of law,I declare tha a - amined this exemption application and,to the best of my knowledge and belie(it is correct and complete. <br /> I alsedecla .a -m d,v:uthor - t. :.- this exemption application. <br /> sign .111.1b here Authoriz-,-.natur --- 1 LIMY D?j- 14- 70, 1 , <br /> Title Date <br /> For County Treasurer Recommendation <br /> q I <br /> iLl'•proval . .�, It f.., Lommeits: IJI�.Lfap , pa qv. <br /> ❑Disapprova <br /> DEC 18 I X 1 .1 . _.•i. I. r . 1�11A1a <br /> Signa Trott County Trees -r Date <br /> For County Board of Equalization Use Only <br /> MALL COUNTY <br /> TREASURERS OFFICE <br /> Approval GRAND ISLAM;,NEBfL1$lKa.,,,„a„tS: <br /> ['Disapproval <br /> 771 <br /> S g a ='- ' e I f it <br /> Aut • zed Sitt - — - <br /> _ s.t <br /> j <br /> Nebraska Department of Revenue <br /> 96-253-2006 Rev.7-2018 Supersedes 96-253-2006 Rev.8-2011 Authorized by Neb.Rev.Slat.§§77-202(1)(c)and(0),and 60-3,185,and 603,:89 <br /> Please retain a copy for your records. <br />