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".M.0 ,,l,.ok P&.. <br /> File with Your County Exemption Application "\ z\-z L FORM <br /> Assessor on or for Tax Exemption on Real and Personal Property by Qualifying Organizations <br /> Before December 31 Read Instructions on reverse side. 45♦ <br /> 1 <br /> Failure to properly complete or timely file this application will result in a denial of the exemption. <br /> Name of Organization County Name Tax Year <br /> FRIENDSHIP HOUSE INC HALL 2026 <br /> Name of Business if Different than Organization State Where Incorporated <br /> NEBRASKA <br /> Name of Owner of Property Value of Real Property Value of Personal Property Parcel ID Number <br /> FRIENDSHIP HOUSE INC $300,000 $250,000 0400068885 <br /> Street or Other Mailing Address of Applicant Contact Name Phone Number <br /> 406 W KOENIG ST CHERYL WASSON 308-675-3345 <br /> City State Zip Code Email Address <br /> GRAND ISLAND NE 68801 cwasson@thefriendshiphouse.net <br /> Type of Ownership <br /> ❑Agricultural and Horticultural Society ❑Educational Organization ❑Religious Organization ®Charitable Organization ❑Cemetery Organization <br /> Name Title of Officers, <br /> Directors,or Partners Address,City,State,Zip Code <br /> Tara Lesiak Executive Director Clarks, NE <br /> Jim Truell President Grand Island, NE RECE1` <br /> Sandra Beroaren Secretary Grans Island, NE <br /> Legal description of real property and general description of all depreciable tangible personal property,except licensed motor ygriclels2 6 2025 <br /> PACKER & BARR'S FIFTH ADD LT 2 UCCII.. <br /> S-T-R: 0-11-9 HALL COUNTY ASSESSOR <br /> 610 N DARR AVE GRAND ISLAND NE 68803 GRAND ISLAND, NEBRASKA <br /> Property described above is used in the following exempt category(please mark the applicable boxes): <br /> ❑ Agricultural and Horticultural Society ❑ Educational ❑ Religious ® Charitable ❑ Cemetery <br /> Give a detailed description of the primary use of the property and any other uses of the property: <br /> Halfway house for adult males. <br /> All organizations,except for an Agricultural and Horticultural Society,must complete the following questions. <br /> Is all of the property used exclusively as described above? ®YES ❑NO <br /> 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 ®NO <br /> Is a portion of the property used for the sale of alcoholic beverages? D YES ®NO <br /> If Yes,state the number of hours per week <br /> Is the property owned or used by an organization which discriminates in membership or employment based on race,color,or national origin?... ❑YES ®NO <br /> Under p nalties of law, I declare that I have examined this exemption application and,to the best of my knowledge and belief,it is correct and <br /> complete/ als 'declare that I am duly authorized to sign this exemption application. <br /> sign tDIRECTOR OF ADM SERVICE 12/26/25 <br /> here I jddrize ignature Title Date <br /> Retain a copy for your records. <br /> For County Assesso ' eco ends ion <br /> VI Approval COMMENTS: _L/� C/—� <br /> '.proval of a Portion <br /> wp t ..r�. '. ' <br /> /0.1 - <br /> 0 Denied <br /> ' Signature of CountA'sbssot; . . i „ .„ Date <br /> For County Board of Equalization Use Only <br /> ❑ Approved If the County Board's determination is different from the County Assessor's recommendation,an explanation is required. <br /> ❑ Approval of a Portion <br /> Denied <br /> I c re that to the est my k ledge and belief,the determination made by the County Board <br /> y-71-a a <br /> of a zatiyn is c rre t rs t e we <br /> y�te of Nebraska. <br /> ig ature 6f Co y' oard Member Date <br /> County Clerk:A legible copy of this fo( showing the final decision of the CountyBoard of Equalization <br /> must be delivered electronically to the Nebra a Department of Revenue within seven days after the Board's decision. <br /> Nebraska Department of Revenue,Property Assessment Division Authorized by Neb.Rev.Stat.§§77-202.01 and 77-202.04 <br /> 96-135-1999 Rev.8-2021 Supersedes 96-135-1999 Rev.3-2020 <br />