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for Exemption , File with Your ApplicationFORM o County Treasurer from Motor Vehicle Taxes by Qualifying Organizations � 457 •Read Instructions on reverse side. Name of Organization Tax Year Value of Motor Vehicles GOODWILL INDUSTRIES OF GREATER NEBRASKA, INC. 2026 30,000 Name of Owner of Property County Name State Where Incorporated HALL NEBRASKA Street or Other Mailing Address Contact Name Phone Number PO BOX 1863 TAMI NABOWER (308)384-7896 City State Zip Code Email Address GRAND ISLAND NE 68802-1863 tnabower@goodwillne.org Type of Ownership: ❑Agricultural and Horticultural Society Q Educational ❑ 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 0 Educational ❑ 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) E 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 SEE ATTACHMENT Description of the Motor Vehicles •Attach an additional sheet,if necessary. Registration Date or Motor Vehicle Make Model Year Body Type Vehicle ID Number Date of Acquisition If Newly Purchased FORD 2020 TRANSIT 250 1 FTBR2C87LKA34571 4/23/2026 . Give a detailed description of the use of the motor vehicle: Used for the hauling and collecting of donations that support our disability programs. Under penalties of law,I declare t : I have examined this exemption application and,to the best of my knowledge and belief,it Is correct and complete. I also. lare that I am.my au oriz:.to sign this exemption application. sign ice, i ../ a �o� a‘ here Authorized tgnature Title Date RECE D For CSunty Treasurer Recommendation I b ij EXEMPT PER NSS#77-202 A.•royal Commens: • Denial APR 2 3 2026 l`i7 Gt-LheYdeJ HALL COUNTY L(it LPL /' i�� U TREASURERS OFFICE V Signature of County Treasurer Date'""�' GRAN ICI ANn NEBRASKO I-or County Board of Equalization Use Only Approved 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 my wiedge and belief,the determination made by the County Board of Equal Lion is correc p uan the laws of the State of Nebraska. Sig ature of County oard Membecte//1/4S Rev.7-2024 Authorized by Neb.Rev.Stat.§§77-202(1)(c)and(d),and 60-3,185,and 80-3,189 Please retain a copy for your records.