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File with Your County Exemption Application FORM Assessor on or for Tax Exemption on Real and Personal Property by Qualifying Organizations �51 Before December 31 Read instructions on reverse side. Failure to properly complete or timely file this application will result In a denial of the exemption. Name of Organization County Name Tax Year GOODWILL INDUSTRIES OF GREATER NEBRASKA, INC, HALL 2026 • Name of Business if Different than Organization State Where Incorporated NEBRASKA ' Name of Owner of Property Value of Real Property Value of Personal Property Parcel ID Number GOODWILL INDUSTRIES OF GREATER NEBRASKA, INC. $7e.5, - $ , ./. , - Street or Other Mailing Address of Applicant Contact Name Phone Number PO BOX 1863 Tami Nabower 308-384-7896 City State Zip Code Email Address GRAND ISLAND NE 68802-1863 accountspayable@goodwillne.org __ Type of Ownership ❑Agricultural and Horticultural Society ®Educational Organization ❑Religious Organization ❑Charitable Organization ❑Cemetery Organization Title of Officers, Address,City,State,Zip Code Name Directors,or Partners SEE ATTACHED • Legal description of real property and general description of all depreciable tangible personal property,except licensed motor vehicles: I SEE ATTACHED PERSONAL PROPERTY , 2130 DIERS AVE GRAND ISLAND NE 68803 Property described above Is used in the following exempt category(please mark the applicable boxes): ❑Agricultural and Horticultural Society ® Educational ❑ Religious ❑Charitable ❑ Cemetery Give a detailed description of the primary use of the property and any other uses of the property: , 4,M. :.. _ _ ,- Warehouse holds donated Items for store resale. Used for training, education&employment programs inclUcfing Tetail operations,developmental disabilities and behavioral health community support for clients/participants with mental disabilities. All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. Is all of the property used exclusively as described above? ®YES ❑NO Is the property used for financial gain or profit to either the owner,the owner or organization making exclusive use of the property,or private individuals?❑YES 1'.i NO Is a portion of the property used for the sale of alcoholic beverages? ❑YES ®NO If Yes,state the number of hours per week Is the property owned or used by an organization which discriminates in membership or employment based on race,color,or national origin?... ❑YES ®NO Under p nettles 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 also declare that I ty authorized to sign this exemption application. sign �� "�` e6:0 !Z112/25 here 'Authorized ignature Title Date Retain a copy for your records. i For County Assessor's Reco oimeridaatiori ❑ Approval COMMENTS: ❑ Approval of a Portion ❑ Denied pate Signature of County Assessor For County Board of Equalization Use Only Approved If the County Board's determination is different from the County Assessor's recommendation,an explanation Is required. ❑ Approval of a Portion ❑ Denied I deq��I re that to the best rrowle6 a andpelLet.the determination made by the County Board of Equation' rrect,ptdf th State,ot Nebraska.• f 9 l0 5 C �, `( ' Sign lure o du Bd d Mem er Date County Clerk:A legible copy of this fonvshowing the final decision of the County Board of Equalization must be delivered electronically to the Nebraska Department of Revenue within seven days after the Board's decision. Nebraska Department of Revenue,Property Assessment Division Authorized by Neb.Rev.Slat.St 77.202.01 and 77-20204 96-135-1999 Rev 8-2021 Supersedes 96-135-1999 Rev.3-2020