Laserfiche WebLink
2c>CP <br /> NSA- I Application for Exemption I FORM <br /> Good c,e ,ea1<e, ;Ce from Motor Vehicle Taxes by Qualifying Nonprofit Organizations <br /> •To be filed with your county treasurer. <br /> 457 <br /> DEPARTMENT OE•EVEsu. •Read instructions on reverse side. <br /> Name of Organization Type of Ownership <br /> BEACON OF HOPE BAPTIST CHURCH ©Nonprofit Corporation ❑Other(specify)- <br /> Name of Owner of Property County Name State Where Incorporated <br /> 5z n4t HALL NE <br /> Street or Other Mailing Address Contact Name Phone Number <br /> 2525WSTATE gt,\\ CRowka-Ae/ <br /> 3 o 370 - S'Sy <br /> City State Zip Code Email Address <br /> GRAND ISLAND NE 68803 beacen @ Ira ohg\ _ org <br /> Identify Officers,Directors,or Partners of the Nonprofit Organization <br /> Title Name.Address,City.t State.Zip Code <br /> fzas}or/D:rector j t311 <br /> . Re:, 1511 A..eta Get-4 ,:tix...d M a (e 4.z.,.:-'1 i <br /> De tee V-0r Stiaro-.. CIcree,5s S'0 1l Fv. Itee_r..e R4. Gra- + d" <br /> Oie ( c4A� y O Ts): 1 Nr. 6E�Ji <br /> r„_te teL r es al21v 36}D 5i-. (�e�vl-ek Rue Gra..O( rsi..,,e/• ms 6'eiti3 <br /> Wen-toe Se.nck ft cele. uvatd IB II GrA..d rile-cl flue 6rt,.rl TT Iz-.)r Alf 6Eeci3. <br /> l�,rec (-dr �d Tre P --e <br /> 4 17 f). Cl.e toe< e G s di I<�I t till 6 f•603) <br /> -script.-Toff tie Moto:Vehicles —1 <br /> •Attach an additional sheet,it necessary. <br /> Registration Date or ZS Skit <br /> Motor Vehicle Make Model year Body Type Vehicle ID Number Date of Acquisition, poke <br /> D zxnenel /Fd-d 199te 13uS 1 FDlee-30aL o/ewly goi <br /> TkkB SbYoO to/ca/aoiE <br /> Exempt Uses of Motor Vehicle: �-/� Are the motor vehicles used exclusively <br /> ❑Agricultural and Horticultural Society ❑Educational l7gtleligious ❑Charitable Ill Cemetery as indicated? <br /> Giv _ including an explan tion if multiple use classi0 Lions e C a.� C<+.-try WYES ❑NO <br /> '•�• 4 t-a.� 55 45 Kc- .•s ve \ <br /> 40 1-r&rt Nk top 1e_ +0 and. t or Churt,h ct.C$ It fits <br /> Sjtx 0, a5 S~,„dey Scl-ew11 C-h•A ck- yDwk-L iCl.lt9L-. . `"—t� !N"^���"•"'L II NO,give percentage of exempt use: <br /> Pe;-iNet t- s Ct.•r•� Cz^.e ouo,p.& c vw Srsu�\ei� o-41'�1Sj VVaS t 6ilat <br /> C)u to sl /lcia- Fe)toe.+i-Ie 1 B..-1-1.,)Lsdtc et.J-t•--5 / _ (_M1 SL.--+ c.- try eL.,rJ- <br /> Aekl.tky or c i .'-j, Wit art a SOIG3 7-2-SL at-.4.$ et-..t.-cL <br /> 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. <br /> I also declare that I am duly authorized to sign this exemption application. < <br /> sign aji <br /> here I Authorized Signature Tide / I e 9 <br /> . Date <br /> For County Treasurer <br /> Recommendationn -1-7-a7Vd1 proval RECEf Y ECfmment : 1 UioJ# <br /> [7, Disapproval <br /> I lA/J31K 1 <br /> DEC132018 [t_ f.m,: 1„ / <br /> Signature W <br /> nature of Cou Treasurer Date <br /> IIALLCOUNPy For Cow ty Board of Equalization Use Only <br /> �j TREASURERS OFFICE <br /> AAA roval GRAND ISLAND,NEBRASKA <br /> 7� PP Gurrnnetns: <br /> ❑Disapproval aW�1e <br /> / Aut .rized Sigr r e / <br /> Nebraska Department of Revenue Authorized by Neb.Rev.Stat.§§77,202(t)(c)and Id),and 60-3,185,and 60-3.199 <br /> 96-253-2006 Rev.72018 Supersedes 96-253-2006 Rev.8-2011 <br /> Please retain a copy for your records. <br />