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DocuSign Envelope ID: 39C14A36-747B-40C0-A57E-222EC8D2C574
NE
Dodge2012
Henry Schultz, 5240 La Salle, Lincoln, NE 68516Secretary
2C4RDGDG9CR179242
2018 Van Passenger
402-474-6890
Dodge
68430
Bill Cummins, 9620 South 30th St., Lincoln, NE 68516
January
Keith Plummer
NE
1050 Saltillo Road
Potentate
2011
Roca
Participate in parades, promote Shriners Hospitals and Shrine activities, transport Shrine patients and their families to Shriners Hospitals for Children.
Dodge
2016
2018January
2D4RN5DG2BR6296719
January
Sesostris Shrine Holding Company
Treasurer
D d
WagonDodge
X
2C4RDGBG4JR180234
Lancaster
January
2C4RDGCG0GR354484Wagon
WagonVan Passenger
Dodge
January
2C4RDGBG2JR134319
Richard Eggerling, 5554 Chancery Rd., Lincoln, NE 68521
Hospital Vehicle Listing
Vehicle Make Model Year Body Type Vehicle ID License # Name ValueDodge 2011 Wagon 2D4RN5DG2BR6296719 2542 Hospital-Columbus 29955Dodge 2012 Wagon 2C4RDGDG9CR179242 2543 Hospital-Charcoal 25750Dodge 2018 Van Passenger 2C4RDGBG4JR180234 2204 Hospital-Norfolk 28937Dodge 2018 Van Passenger 2C4RDGBG2JR134319 2205 Hospital-Granite 28437
DocuSign Envelope ID: 39C14A36-747B-40C0-A57E-222EC8D2C574
Registration Vehicle Listing
Vehicle Make Model Year Body Type Vehicle Id License # Name ValueDodge 2016 Wagon 2C4RDGCG0GR354484 2544 Charcoal 26945Dodge PU 1976 Pick Up D14BE6S254436 2545 Keystone Kops 0Chevrolet 2003 Dr Ext Cab 2GCEC19T0311803 2546 Gray General 12995Chrysler 2010 town/Country 2A4RR5D16AR137474 2548 Silver General 27893
DocuSign Envelope ID: 39C14A36-747B-40C0-A57E-222EC8D2C574
Registration Listing - Trailers
Vehicle Make Model Year Body Type Vehicle ID License # Name ValueHome Made Trailer 1980 2 wheel utility 2W0MINH000002861 XPJ 984 Temple 750Home Made Trailer 1986 2 wheel utility 621 TRLR XPJ 985 RR Trailer 1500Home Made Trailer 1999 2 wheel utility 4X8 none XPJ 975 Grill 1000Home Made Trailer 2003 5X8 Trailer none XPJ 993 Calliope 12000Home Made Trailer 2011 8X16 2 wheel none XPJ 994 Keystone Kops 750Carry On Trailer 2000 5X10 2 wheel Trlr 4YMUK1012YH031481 XPJ 988 Football Float 585Carry On Trailer 2007 Utility 4YMUL14167M043985 XP J989 Hillbilly Model T 1310Continental 2001 Utility 4X4TSE41X1N019404 XPJ 990 Rit Divan 3000Home Made Grill Trlr 2008 2 wheel #790 none XPJ 991 Temple 2000Aluma Utility Trailer 2017 Utility 1YGUS1019HB156386 XPI 743 Hospital Float 1470
DocuSign Envelope ID: 39C14A36-747B-40C0-A57E-222EC8D2C574
DocuSign Envelope ID: 157C1140-C2EF-40F5-9BB3-1F8FBB24B371
NEBRASKA
FEB 2019
CHAIR TRUSTEE
1FDXE45S85HB19856
LANCASTER
MARGARET STYLES
MARGARET J STYLES, 3200 CENTER STREET, LINCOLN, NE 68503
2015
LINCOLN 68504
20051FB2X2YM1FKA72400
NE
T 350
PASTOR
X
MOUNT ZION BAPTIST CHURCH
REV. DR. MICHAEL W. COMBS, 2501 SOUTH 76TH STREET, LINCOLN, NE 68506
FORD
CHARLES ROBINSON, 6121 AYLESWORTH, LINCOLN, NE 68505
402-770-24213301 NORTH 56TH STREET
E 450
FEB 2019
VEHICLES ARE USED ONLY FOR CHURCH SERVICES AND ACTIVITIES.
TREASURER
FORD
MOUNT ZION BAPTIST CHURCH
DocuSign Envelope ID: 4D042947-E973-4FA0-BA9E-9B6EA2041921
Susan McIntosh Kriz, 2601 N 48, Lincoln, NE 68504
Lancaster
NE
We use this van to take art classes to schools and other locations in the community and to transport art for our gallery.
2008
Executive Director
4024668692
Ford
LUX Center for the Arts NE
Lincoln
Sherri Daubert, 9121 Pioneer Court, Lincoln, NE 68520
Susan McIntosh Kriz
1FTNE24W88DB12955
68504
2601 North 48th Street
E-250
Board Chair
02/04/2010
LUX Center for the Arts
X
DocuSign Envelope ID: 3C976E7E-86ED-43EA-A19A-B130D058AFA2
X
4615 Orchard St
Steve Semke 3901 S 78th St Lincoln Ne 68506
Lincoln / Lancaster County Habitat for Humanity
NE
Pick up 1/18/2019
Lincoln
Josh Hanshaw
NE
1st Vice President
2012
Lancaster
Treasurer
President
Secretary
Dodge
Matt Kasik 7140 Hampton Rd Lincoln, NE 68506
68503
Vicki Obrecht 2990 S 40th St Lincoln, NE 68506
402-480-6196
Michaella Kumke 4107 S 20th St Lincoln Ne 68502
3C6LD5ATXCG162166
Non Profit homebuilder & mortgage lender for low-income families.
DocuSign Envelope ID: 56F9926F-EA79-465D-A6C1-0AB8E18F6B04
NE
DIRECTOR
BOARD MEMBER
Vehicle is used for AdventSource business purposes only. This would include transportation of employees, officers and board members to and from Lincoln and Omaha airports, the running of business related errands and transport of employees to and from company related functions, conventions and events.
2005
BRAD FORBES 5120 PRESCOTT AVE LINCOLN NE 68506
X
68506
ALEX BRYANT 9705 PATUXENT WOODS DR COLUMBIA MD 21046DARRYL HUENERGARDT 3001 RIDGEGATE RD LINCOLN NE 68516
LINCOLN
FREESTAR
402-486-8813
BOARD PRESIDENTJUDY GLASS 5120 PRESCOTT AVE LINCOLN NE 68506
BRUCE GRIFFITH
FORD 2FMZA052295BA28302
LANCASTER
ADVENTSOURCE INC
NEBRASKA
02/20/2018
CHIEF FINANCIAL OFFICER
ADVENTSOURCE INC
5120 PRESCOTT AVENUE
DocuSign Envelope ID: BB8CDF96-0959-46BA-A61B-0A5CE0A77E9E
TreasurerSusie Carlson; 2407 N 76th St., Lincoln, NE 68507
NE
Van
Van is used to transport children and adults to various religious activities and events.
Lancaster Nebraska
1FBNE31L05HB00257
First Evangelical Covenant Church
Ford
Lincoln
Chair Person
X
6024 L St
2005
68510
Bob Timme; 4911 S 67th, Lincoln, NE 68516
2-21-06
DocuSign Envelope ID: C5ACA100-E4DC-4AB6-896B-1CD79097EA51
1500 S 70th Street, Suite 201
Lincoln
Melanie Roberts
1GNDV33L16D191074
X
2006
68506
4 Door Van
Provide education presentations, training and information to the public in regards to Alzheimer's disease and other forms of demetia. Also used to get staff and items to and from fundraising events for the Alzheimer's Association.
Alzheimer's Association
Development Director
Toyota Camry
Sharon Stephens, 11711 Arbor Street, Suite 110, Omaha, NE 68144
2/2018
Lancaster
Erinn Drouin, 1500 S 70th Street, Suite 201, Lincoln, NE 68506
402-260-7910
2005 4 Door Van
Programs Director
Executive Director
NE
X
NE
Clayton Freeman, 11711 Arbor Street, Suite 110, Omaha, NE 68144
2004
Chevy Uplander5GADV33L75D180220Buick Terraza
2/20184T1BE32K34U9361794 Door Sedan2/2018
NEBRASKA-Good Life. Great Service.
DEPARTMENT OF REVENUE
Application for Exemptionfrom Motor Vehicle Taxes by Qualifying Nonprofit Organizations
•To be filed with your county treasurer.• Read Instructions on reverse side.
FORM
457Name of Organization
L-mcoin C-hns+i^n Scihyp IType of Ownership
Nonprofit Corporation || Other (specify):
Name of Owner of Property County Name
LahC^kfrState Where Incorporated
Street or Other Mailing Address
5801 Scwh ^Hih &te+Contact Name
Vikki PoWt'rPhone Number
^2-4^-A'W x 221City
UncolhState
t^eZip Code
I^S6ibEmail Address
Vi'kki. P£)WC>-^> im^oln c^nS-h'An^,r^_2tIdentify Officers, Directors, or Partners of the Nonprofit Organization
Title Name, Address, City, State, Zip Code
PrcsiJti^ - NWlc C^Cif;(J i,.^S ^ht,£ Co^t-h bnCnln Nfc (p852^-ihttS l-O^h UnCiiln Nt; toS'32^
C1U6^ TlArnbi.'Try Circle LiHfuin, AJ£ k's5Zfc\;,(, Pr.'s.itW Tudd Hol/ilp
rnftS.krtr Aftioti l^irs^ba.nl<.& l6'-f6 SkMl9lAlr<>^ U-hp LirKyli?/f^l; If^^olp
Description of the Motor Vehicles•Attach an additional sheet, if necessary.
Motor Vehicle Make
Thr,W(^
Model Year
2004'
Body Type
i3L(^
Vehicle ID Number
I T'7y74^2SM;fcfc^37
Exempt Uses of Motor Vehicle:
Q Agricultural and Horticultural Society [^Educational |_| Religious Q Charitable [-] Cemetery
Give detailed description of use, including an explanation if multiple use classifications exist:
TnoiSpr?n o(- chi^^n d^ ^^oo/ ^ ^Iwol fic^Vihes
,^>.
^. .^
Registration Date orDate of Acquisition,if Newly Purchased
i-2-2mcj
Are the motor vehicles used exclusivelyas Indicated?
[YES Q NO
If No, give percentage of exempt use:
.%
Underpenalties of laWr+d^clare (hat I hfive examined this exemption application and, to the best of my knowledge and belief, it is correct and complete., l(a|^o declare fjiat I am [duly a^thorj^pdji^ign this exemption application.signj^^lam^tho^^exemptionapplication-
here ^ Authorized Signature L-/^C'hv'^S ^P^'-^rT/-
Titlei-IO-U;^
Date
For County Treasurer Recommendation
{^Approval
Q Disapproval
Comments:
-^?-/^
Date
For County Board of Equalization Use Only
Q Approval
Q Disapproval
Comments:
> Authorized Signature Date
Nebraska Department of Revenue96-253-2006 Rev. 7-2018 Supersedes 96-253-2006 Rev. 8-2011
Authorized by Neb. Rev. Slat. §§ 77-202(1)(c) and (d), and 60-3,185, and 60-3,189
Please retain a copy for your records.
\LEBRA&KA-|3ood Life. Great Service.
;HUE
Application for Exemptionfrom Motor Vehicle Taxes by Qualifying Nonprofit Organizations
•To be filed with your county treasurer.• Read instructions on reverse side.
Name of Organization
CenterPointe, Inc.Name of Owner of Property
CenterPointe, 1c.Street or Other Mailing Address
2633 P StreetCity State Zip Code
Lincoln NE 68503)
Type of Ownership . - ...
|X| Nonprofit Corporation |] Qther (specify):
County Name
Lancaster.-'
Contact Name
Kristi McDonald
FORM
457specify):
State Where Incorporated
NEPhone Number
402-475.8717Ext.131
Email Address
Identify Officers, Directors, or Partners of the Nonprofit OrganizationTitle
Topher Hansen
Tami Lewis-Ahrendt
Pat Meyer
Name, Address, City, State, Zip Code
CEO 2633 P Street, Lincoln, NE 68503
COO 2633 P Street, Lincoln, NE 68503
CFO 2633 P Street, Lincoln, NE 68503
Description of the Motor Vehicles•Attach an additional sheet, if necessary.
Motor Vehicle Make
See Attached Document
Model Year Body Type Vehicle ID Number
Exempt Uses of Motor Vehicle:
Q Agricultural and Horticultural Society |_] Educational Q Religious |^| Charitable || Cemetery
Give detailed description of use, including an explanation if multiple use classifications exist:
Transportation for clients to AppointmentsTransportation of goods to program locationsMaintenance
Registration Date orDate of Acquisition,if Newly Purchased
Are the motor vehicles used exclusivelyas indicated?
g] YES Q NO
If No, give percentage of exempt use:
.%
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 glsq.declare t)iat I am^ufy aythsrizeiiKp sign this e^em^ion application.
S19n ^f\A?Jr (k ^ {^X^\2W\ _ Director of Administrative Services \-~<§"'ZQ 1 c\here ^ Y Title Date
For County Treasurer Recommendation
.Approval
D Disapproval
Comments:
'̂^^L ^L ,'-23-^,Signature of County Treasurer Date
For County Board of Equalization Use Only
Approval
D Disapproval
Comments:
> Authorized Signature Date
Nebraska Department of Revenue96-253-2006 RBV. 7-201 S Supersedes 96-2S3-2006 Rev. 8-2011
Authorized by Neb. Rev. Stal. §§ 77-202(1)(c) and (d), and 60-3,185, and 60-3,189
Please retain a copy for your records.
^\-)
Make Model Year Color License Plate VI N FacilityLancaster County
Ford
T.ailer
Trailer
Ford
\ Ranger Super!2-WheellOft
|2-Wheel Utility Trailer
1 Econoline Wagon E350 SUP
Ford
Ford 15 Pass
Dodge
Ford
;Econoline Wagon E350 SUP
iEconoline Wagon E350 SUP
G rand SXT Caravan
Econoline Wagon E350 SUP
2003
2008^
20192000200620132016
Tan 2046 1FTZR45E43PB14944 Maintenance
Black XPJ353 4YMUL10178M017208 ; Maintenance
Black
Green
White
White
Gray
White
Gray
XNY980UGV047
UGV045UGV048
12475IUGV046
4RWBU1417KH023129 i Maintenance
1FBSS31L9YHB28235 'Outreach
1FBNE31LX5HA99958 MidPointe
1FBSS3BL4DDB02058 Adult Resi.
2C4RDGCG6GR3706901FBSS31SX2HB36097
Adult Resi.
MidPointe
Douglas County
Dodge
Dodge
'Grand SE
Caravan Grand SE
Ford Transit T-350
Silver 1728
Gra7 ^1729White UGN144 1FBZX2YM1FKA72462 CFM-
