EFTA00192620 OFFICE COPY Form 8868 (Rev April 2007) Department of the Treasury Internal Revenue Service # Application for Extension of Time To File an Exempt Organization Return ▶ File a separate application for each return. OMB No 1545-1709 • 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). If you are filling for an Additional (not automatically 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 R868. Section 501(c) corporations required to file Form 990-T and requesting an automatic 6-month extension—check this box and complete Part I only All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Electronic Filing (e-file). Generally, you can electronically file Form 8868 if you want a 3-month automatic extension of time to file one of the returns noted below (6 months for section 501(c) corporations required to file Form 990-T). However, you cannot file Form 8868 electronically if (1) you want the additional (not automatic) 3-month extension or (2) you file Forms 990-BL, 6069, or 8870, group returns, or a composite or consolidated Form 990-T. Instead, you must submit the fully completed and signed page 2 (Part II) of Form 8868. For more details on the electronic filing of this form, visit www.irs.gov/efile and click on e-file for Charities & Nonprofits.
Type or print File by the due date for filing your return See instructionsName of Exempt Organization THE C.O.U.Q. FOUNDATION, INC.E
Number, street, and room or suite no. If a P.O. box see 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. - 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 section 501(c) corporation required to file Form 990-T) extension of time until October 15, 2017, 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 ..., 20 ... 06 ..., and ending ... February 28 ..., 20 ... 07 ... 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.3a$8,000
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.3b$18,872
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.$0
3c
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. Cat No 27916D EFTA00192621 EFTA00192622 OFFICE COPY Page 2
Part IIAdditional (not automatic) 3-Month Extension of Time. You must file original and one copy.
Type or print
File by the extended due date for filing the return. See instructions.
Name of Exempt Organization
THE C.O.U.Q. FOUNDATION, INC.
Employer identification number
Number, street, and room or suite no. if a P.O. box see instructions
c/o GEORGE V. DELSON ASSOCIATES,
For IRS use only
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-PF □ Form 1041-A □ Form 6069
□ Form 990-BL □ Form 990-T (sec. 401(a) or 408(a) trust) □ Form 4720 □ Form 8870
□ Form 990-EZ □ Form 990-T (trust other than above) □ Form 5227
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
• The books are in the care of HARRY BELLER
Telephone 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 is for.
4 I request an additional 3-month extension of time until JANUARY 15 20.08
5 For calendar year ..., or other tax year beginning. MARCH 1 20.06, and ending FEBRUARY 28 20.07
6 If this tax year is for less than 12 months, check reason: □ Initial return □ Final return □ Change in accounting period
7 State in detail why you need the extension CERTAIN INFORMATION NECESSARY FOR A COMPLETE AND ACCURATE RETURN IS NOT YET AVAILABLE
8a 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.8a$ 8,000
c Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, rf required, deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions.
☐We have approved this application Please attach this form to the organization's return.
☐We have not approved this application However, we have granted a 10-day grace period from the later of the date shown below or the due date of the organization's return(including any prior extensions). This grace period is considered to be a valid extension of time for elections otherwise required to be made on a timely return.Please attach this form to the organization's return.
☐We have not approved this application.After considering the reasons stated in item 7,we cannot grant your request for an extension of time to file.We are not granting a 10-day grace period
☐We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested
☐Other...
DirectorBy:
Alternate Mailing Address. Enter the address if you want the copy of this application for an additional 3-month extension returned to an address different than the one entered above.
Type or printName
Number and street (include suite, room, or apt. no.) or a P.O. box number
City or town, province or state, and country (including postal or ZIP code)
Form 8868 (Rev 4-2007) EFTA00192623 EFTA00192624