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Form 8868 Application for Extension of Time To File an <br /> (December theTreasury Exempt Organization Return <br /> Department of the TOMB No. 1545-1709 <br /> Internal Revenue Service ► File 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 /> . . . . . . . . . . . . . ► ❑ <br /> • If you are filing for an Additional ( not automatic) 3 -Month Extension , complete only Part 11 (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 riled <br /> Form 8868, <br /> Part. I Automatic 3 -Month Extension of Time — Only submit original ( no copies needed ) <br /> Note : Form 990- T corporations requesting an automatic 6-month extension — check this box and complete Part 1 only . . . . ► ❑ <br /> All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns. <br /> Partnerships, REMICs and trusts must use Form 8736 to request an extension of time to file Form 1065, 1066, or 1041 . <br /> Type or Name of Exempt Organization <br /> Employer identification number <br /> print HIBISCUS CHILDREN ' S CENTER 59 - 2632361 <br /> File by the Number, street, and room or suite lte­no. If a P. O . box, see instructions . <br /> due date for P . O , BOX 305 <br /> filing your <br /> return. See City, town or post office, state, and ZIP code. For a foreign address , see instructions . <br /> instructions. JENS EN BEACH , FL 34958 <br /> Check type of return to be filed (file a separate application for each return ) : <br /> ❑X Form 990 ❑ Form 990-T (corporation) ❑ Form 4720 <br /> ❑ Form 990- BL ❑ Form 990-T (sec. 401 (a) or 408(a ) trust) E] Form 5227 <br /> ❑ Form 990-EZ ❑ Form 990-T (trust other than above) ❑ Form 6069 <br /> ❑ Form 990-PF ❑ Form 1041 -A ❑ Form 8870 <br /> • If the organization does not have an office or place of business in the United States , check this box . . . . <br />. . . . . . . . . . . . . . ► ❑ <br /> • If this is for a Group Return , enter the organization '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 1 request an automatic 3-month (6- month , for 990-T corporation) extension of time until FEBRUARY 17 , 20 03 <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 /> ► ❑X tax year beginning JULY 1 20 01 <br /> — , and ending JUNE 30 , 20 02 . <br /> 2 If this tax year is for less than 12 months , check reason : ❑ Initial return ❑ Final return ❑ Change in <br />accounting 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 /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ <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 . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . $ <br /> c Balance Due. Subtract line 3b from line 3a . Include your payment with this form , or, if required , deposit <br /> with FTD coupon or, if required , by using EFTPS ( Electronic Federe1- , o menfS� stem} See <br /> instructions <br /> Signature and Verification $ <br /> Under penalties of perjury, 1 declare that I have examined this f including accompanying schedules and statements, and to the best of my knowledge <br /> and belief, it is true, <br /> correct, and complet thorized to pr is m_ <br /> Signature ► / � QD V <br /> Title ► PA nn Date ► 11 / 11 / 02 <br /> For Paperwork Reduction Act Notice, see Instruction <br /> Form 8868 (12-2000 ) <br /> ISA <br /> STF FED9056F . 1 <br />