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2003-253H
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2003-253H
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Last modified
11/22/2016 11:57:59 AM
Creation date
9/30/2015 6:47:47 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/23/2003
Control Number
2003-253H
Agenda Item Number
7.D.
Entity Name
Boys & Girls Club of IRC Inc.
Subject
Children's Home Society of Florida Independent Living Program
Children's Services Advisories Grant Contract
Archived Roll/Disk#
3207
Supplemental fields
SmeadsoftID
3409
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Form 8868 Application for Extension of Time To File an <br /> (December M) Exempt Organization Return OMS No 1545.1 "9 <br /> Dqmw#Whw" now" sem ► FUe a separate application for each return <br /> • If you are filing for an Automatic 3-Month Extension complete only Part I and check this box ► <br /> • If you are filing for an Additional (not automatic) 3 Month Extension complete only Part II (on page 2 of this form) <br /> Note Do not complete Part 11 unless you have already been granted an automatic 3-month extension on a previously Med <br /> Form 8868 <br /> Pert J1 Automatic 3 Month Extension of Time — Only submit original (no copies needed) <br /> Note Form 990-T corporations requesting an automatic &month extension — check this box and complete Part l only ► ❑ <br /> IU other corporations (including Form 990 C /Jeers) must use Form 7004 to request an extension o/ tone to Ice income tax returns <br /> Partnenshps REMICs and trusts must use Form 8736 to request an extension of time to fide Form 1065 1066 or 1041 <br /> Type or Name of Exempt Organization Employer Ideritificotion number <br /> print THE CHILDREN S HOME SOCIETY OF FLORIDA 59 - 0192430 <br /> File by the Number street and room or suite no If a PO boa, see instructions <br /> d1° date forMing P O BOX 10097 <br /> return sesee City town or post office state and ZIP code For a foreign address see instructions <br /> instructions JACKSONVILLE FL 32247 - 0097 <br /> Check type of return to be filed (file a separate application for each return) <br /> ® Form 990 ❑ Form 990-T (corporation) ❑ Form 4720 <br /> ❑ Form 990-BL ❑ Form 990•T (sec 401 (a) or 408(a) trust) ❑ Form 5227 <br /> ❑ Form 990 EZ ❑ Form 990 T (trust other than above) p Form 6069 <br /> ❑ Form 990• PF ❑ Form 1041 A ❑ Form 8870 <br /> • If the organization does not have an office or lace of business in the United States check this box ► ❑ <br /> • If this is for a Group Return enter the organr ation s four digit Group Exemption Number (GEN) If this is <br /> for the whole group check this box ► ❑ if it Is for part of the group check this box ► ❑ and attach a list with <br />the names and <br /> EINs of all members the extension will cover <br /> 1 I request an automatic 3-month (6 month for 990 T corporation) extension of time until FEBRUARY 15 20 <br /> to file the exempt organization return for the organization named above The extension is for the organization s return for <br /> ► ❑ calendar year 20 _ or <br /> ► ® tax year beginning JULY 1 20 0 0 and ending JUNE 30 20 01 <br /> 2 If this tax year is for less than 12 months check reason ❑ Initial return ❑ Final return ❑ Change in accounting <br />period <br /> 3a If this application is for Form 990-BL 990 PF 990-T 4720 or 6069 enter the tentative tax less any <br /> nonrefundable credits See instructions $ <br /> b If this application is for Form 990-PF or 990-T enter any refundable credits and estimated tax payments <br /> made Include any prior year overpayment allowed as a credit S <br /> c Balance Due Subtract line 3b from line 3a Include your payment with this form or If required deposit <br /> with FM coupon or if required by using EFTPS (Electronic Federal Tax Payment System) See <br /> instructions <br /> $ <br /> Signature and Verification <br /> Under penalties of perjury I declare that 1 have examined ttrs form including accompanying schedules and statements and to the best of my knowledge <br /> and belief it is true <br /> correct and complete and that I am sworaed to prepare finis form <br /> Signature ► PTitle ► C Date No <br /> For Paperwork Reduction Act Notice sea Instruction Form 8868 (12 2WO) <br /> MA <br /> SIF FE09056F 1 <br />
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