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File with Your Application for Exemption FORM County Treasurer from Motor Vehicle Taxes by Qualifying Organizations 457 •Read instructions on reverse side. Name of Organization Tax Year Value of Motor Vehicles Peace Lutheran Church / 2026 8000 , Name of Owner of Property County Name State Where Incorporated Angela Mueller Church Hall Nebraska Street or Other Mailing Address Contact Name Phone Number 1710 N North Road Angela Mueller (308) 384-5673 City State Zip Code Email Address Grand Island NE 68803 amueller@peacegi.org Type of Ownership: �, ❑Agricultural and Horticultural Society ❑ Educational CI Religious ❑ Charitable ❑ Cemetery ❑ For-profit Nursing Facilities Charitable Organizations:Motor Vehicle described above is used in the following exempt category(please mark the applicable boxes): ❑ Agricultural and Horticultural Society ❑ Educational 0 Religious ❑ Charitable ❑ Cemetery Charitable and For-Profit Organizations,please answer the following: If No,give percentage of exempt use: Are the motor vehicles used exclusively as indicated?(see instructions) ❑ YES ❑ NO For-profit Nursing/Assisting Living Facilities,please select the applicable box: What percentage of occupied beds have been provided to ❑ Nursing Facility Skilled Nursing Facility ❑Assisted-Living Facility medicaid beneficiaries over the most recent three-year period? Name Title of Officers, Address,City,State,Zip Code Directors,or Partners Brian Quandt President 4450 N Quandt Rd,Grand Island, NE.68803 Barrett Hahn Treasurer 4222 Indianhead Rd, Grand Island,NE.68803 Angela L Mueller Director of Operations 2821 Dallas Avenue,Grand Island,NE.68803 Description of the Motor Vehicles •Attach an additional sheet,if necessary. Registration Date or Motor Vehicle Make Model Year Body Type Vehicle ID Number Dafe of Acquisition if Newly Purchased Ford F150 1994 Pickup 1FTEF14N3RLA77926 MFGTRLR 1991 enclosed NET1074169 Give a detailed description of the use of the motor vehicle: Pickup-Hall landscaping supplies, move set designs from storage shed and purchase repair items locally Trailer-Serve meals at church events, outreach events and mission events 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. I also declare that I am duly authorized to sign this exemption application. sign Aiweetcv Director of Operations 2/27/2026 here ,Authorized Signature Title Date i I ICEIVED For County Treasurer Recommendation Approval Comments: EXEMPT PER NSS#77-202 ❑Denial ir,AR 3 2026 ( ' g l."14.04C,tr HALL COUNTY ,L�(:�( �•k.�' `�� 4 6 1at Lc, TREASURERS OFFICE ign_nalilhfffe of County Treasurer at GRAND ISLANn,NEBGASKA For County Board of Equalization Use Only XApproved If the County Board's determination is different from the County Treasurer's recommendation,an explanation is required. ❑ Denied I declare.that to the best o n knowled nd belief,the determination made by the County Board of Equaliz n is correct pur t to e I of the State of Nebraska. /I/ / ,614 /.31y/1(3, Sig re o ounty Bo d Member 1 ate Rev.7-2024 Authorized by Neb.Rev.Stat.§§77-202(1)(c)and(d),and 60-3,185,and 60-3,189 Please retain a copy for your records.