EFTA00192584 OFFICE COPY Form 8868 (Rev. December 2004) Department of the Treasury Internal Revenue Service # Application for Extension of Time To File an Exempt Organization Return OMB No 1545-1708 ▶ File a separate application for each return. • If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box. • If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form). Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868. Part I Automatic 3-Month Extension of Time Only submit original (no copies posted) Part I Automatic 3-Month Extension of Time—Only submit original (no copies needed) Form 990-T corporations requesting an automatic 6-month extension—check this box and complete Part I only . ► All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns. Partnerships, REMICs, and trusts must use Form 8736 to request an extension of time to file Form 1065, 1066, or 1041. Electronic Filing (e-file). Form 8868 can be filed electronically if you want a 3-month automatic extension of time to file one of the returns noted below (6 months for corporate Form 990-T filers). However, you cannot file it electronically if you want the additional (not automatic) 3-month extension, instead you must submit the fully completed signed page 2 (Part II) of Form 8868. For more details on the electronic filing of this form, visit www.irs.gov/efile.
Type or print File by the due date for filing your return. See instructions.Name of Exempt Organization The C.O.U.Q. FoundationEmployer Identification number 13 3996471
Number street and room coordinates, the P.O. box instructions.
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
Check type of return to be filed (file a separate application for each return):
☐ Form 990☐ Form 990-T(corporation)☐ Form 4720
☐ Form 990-BL☐ Form 990-T(sec. 401(a) or 408(a) trust)☐ Form 5227
☐ Form 990-EZ☐ Form 990-T(trust other than above)☐ Form 6069
☑ Form 990-PF☐ Form 1041-A☐ Form 8870
- The books are in the care of ▶ Harry Beller. Telephone No. ► FAX No. ▶ - If the organization does not have an office or place of business in the United States, check this box . ► ▶ * If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) ___. If this is for the whole group, check this box ▶ . If it is for part of the group, check this box ▶ and attach a list with the names and EINs of all members the extension will cover. 1 I request an automatic 3-month (6-months for a Form 990-T corporation) extension of time until October 15, 2006, to file the exempt organization return for the organization named above. The extension is for the organization's return for: ▶ calendar year 20 ... or ▶ tax year beginning March 1, 2005, and ending February, 2006. 2 If this tax year is for less than 12 months, check reason: □ Initial return □ Final return □ Change in accounting period 3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits. See instructions $ 37,767 b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit $ 12,767
c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions$25.000
Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions. For Privacy Act and Paperwork Reduction Act Notice, see Instructions. Form 8868 (Rev 12-2004) Cat No. 27916D EFTA00192585 EFTA00192586 EFTA00192587 EFTA00192588 EFTA00192589 EFTA00192590 EFTA00192591 EFTA00192592 EFTA00192593 EFTA00192594 EFTA00192595 EFTA00192596 EFTA00192597 EFTA00192598 EFTA00192599 EFTA00192600 EFTA00192601 EFTA00192602 EFTA00192603 EFTA00192604 EFTA00192605 EFTA00192606 EFTA00192607 EFTA00192608 EFTA00192609 EFTA00192610 EFTA00192611 EFTA00192612 EFTA00192613 EFTA00192614 EFTA00192615 EFTA00192616 EFTA00192617 EFTA00192618 EFTA00192619