Form
990.T
(and proxy tax under section
For calendar year 2005 or other tax year beginning
See separate
Departmentof the Treasury
Internal RevenueService
Check box
if
A 0 address
chanqed
6 Exempt under section
0
0
0
0
)
Name
of organization
University
(
0
Check
of Northern
box
6033( e»
--Q!/'Qt- _,2005, and ending
if name
) (
408(e)
0
220(e) Type
408A
0
530(a)
125 Gilchrist
changed
and
D Employeridentification number
see instructions.)
(Employees'
trust,seeinstructions lor BlockD
Iowa
onpage
7,)
42 6004333
E Newunrelatedbus. activitycodes
:
Hall
(See instructions for Block E on page 7,)
City or town, state, and ZIP code
529(a)
C Book value of all assets F
Cedar
Group
Falls,
exemption
711300
IA 50614-0009
number
@O5
--Q'-Q-- - ,20 -Q--
instructions.
Print or Number,street, and room or suite no. (If a P.O. box, see page 7 of instructions,)
501(
at end of year
OMS No. 1545-0687
Exempt Organization Business Income Tax Return
(See instructions
722320
for Block F on page 7.)
0 Other trust
0 501(c) trust
0 401 (a) trust
0 501(c) corporation
399,496.242
G Check organization type
H Describe the organization's primary unrelated business activity. ~ Promoting Performing Arts and similiar events
I Duringthe tax year, was the corporationa subsidiary in an affiliated group or a parent-subsidiarycontrolled group?
~ 0 Yes III No
If "Yes," enter the name and identifying number of the parent corporation, ~
Telephone number ~ ( 319
J The books are in care of ~ Gary B Shontz
.
Unrelated Trade or Business Income
1ab
2
3
4a
D
organizations
(ScheduleF). . . . , . . . . . . .
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
(6) Expenses
2,469,904
1,589,423
880,481
Gross
receipts
sales
2,469,904
Less returns
and or
allowances
c Balance ~
1c
Cost of goods sold (Schedule A, line 7) . .'.
. . , . 2
Gross profit. Subtract line 2 from line 1c.
. , . . . . 3
Capital gain net income (attach Schedule D). . . . . . 4a
b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797)
c Capital loss deduction for trusts.
, . . . . . . . .
5 Income(loss)from partnershipsandS corporations(attachstatement).
6
Rent income (Schedule C). , . . . . . . . . . .
7 Unrelated debt-financed income (Schedule E) . . . . .
8
Interest, annuities, royalties, and rents from controlled
9
I
(A) Income
4b
4c
5
6
7
307,480
446,385
138,905
8
Investment income of a section 501(c)(7), (9), or (17)
organization (Schedule G) , . . . . . . . . . . 9
Exploited exempt activity income (ScheduleI) . . . . . 10
Advertising income (ScheduleJ). . . . . . . . . . 11
Otherincome(Seepage9 of the instructions-attachschedule.) 12
Total. Combine lines 3 through 12. . . . . . . . . 13
1,326,866
307,480
1,019,386
Deductions Not Taken Elsewhere (See page 9 of the instructions for limitations on deductions.)
(Except for contributions, deductions must be directly connected with the unrelated business income.)
Compensation of officers, directors, and trustees (ScheduleK). . . .
. .
. .
. . .
. .
Salariesandwages. . .
Repairsandmaintenance.
Baddebts. . . . . .
Interest(attachschedule).
.
.
.
.
.
.
.
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,
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.
14'
. 15
. 16
. 17
. 18
Taxes
andlicenses. . . . . . . . . . . . . . . . . . . . . . . . . . .
19
Charitablecontributions(Seepage11of theinstructionsfor limitationrules.) . . . .,
Depreciation
(attachForm4562). . . . . . . . . . . . . . lli I
54,593
20
Less depreciation claimed on Schedule A and elsewhere on return.
Depletion.
407,558
25,131
480
54,593
122a
. . . . . . . . . . . .
Contributions to deferred compensation plans.
Employee benefit programs.
. . .
Excess exempt expenses (Schedule I) .
Excess readership costs (Schedule J) .
Other deductions (attach schedule).
.
Total deductions. Add lines 14 through 28 .
Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13
Net operating loss deduction (limited to the amount on line 30) . . . . . . . , . .
Unrelated business taxable income before specific deduction. Subtract line 31 from line 30.
Specific deduction (Generally $1,000, but see line 33 instructions for exceptions.).
. . .
Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line
32, enter the smaller of zero or line 32.
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Cat. No. 11291J
874,287
1,362,049
(342,663)
(342,663)
34
Page
Form 990- T (2005)
2
Tax Computation
Organizations Taxable as Corporations. See instructions for tax computation on page 13.
35
Controlled group members (sections 1561 and 1563)-check here D. See instructions and:
a Enter your share of the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order):
(1) I$
I I (2) $
I I (3) 1$
1
I
1
b
Enter organization's share of: (1) Additional 5% tax (not more than $11,750)
(2) Additional 3% tax (not more than $100,000).
. . . . . . . . .
l!
l!
c Incometax on the amount on line34. . . . . . . . . . . . . . . . . . . . ~ I35c
36 Trusts Taxable at Trust Rates. See instructionsfor tax computationon page 14. Incometax on
the amount on line34 from: 0 Tax rate schedule or 0 Schedule D (Form1041). . . . . ~ 36
37 Proxy tax. See page 14 of the instructions. . . . . . . . . . . . . . . . . . ~ 37
38
38 Alternativeminimumtax.
. . . . . . . . . . . . .
39
39 Total. Add lines37 and 38 to line35c or 36, whicheverapplies.
Tax and Payments
40ab Other
Foreigntax
credit(corporations
ttach
Form1118;trusts
credits
(See page 14 of athe
instructions.)
. . attach
. . Form1116)
. . . . .. 140a
40b
c General business credit-Check here and indicate which forms are attached:
d
e
41
42
43
44a
b
c
d
e
1
0Credit
Form 3800 0 Form(s) (specify) ~ . -for prior year minimum tax (attach
140C
40d
-- -- -- -- -- -- --
Form 8801 or 8827)
.
Total credits. Add lines 40a through 40d.
Subtract line 40e from line 39 . . . .
Othertaxes.Checkif from: 0 Form42550 Form86110 Form8697
0
Form88660 Other(attachschedule)
Total tax.Add lines41 and42 . . . . . . .
Payments: A 2004 overpaymentcredited to 2005.
2005 estimated tax payments. .
44a
44b
44c
44d
44e
Tax deposited with Form 8868 .
Foreign organizations-Tax paid or withheld at source (see instructions)
Backup withholding (see instructions).
. . .
Other credits and payments:
0 Form 2439
0
45
46
47
48
49
-- --
0
Form 4136
Other
Total
~
1441
Total payments. Add lines 44a through 44f. . . . . . . . . . . . . . . . . . . 45
Estimatedtax penalty (See page 4 of the instructions.)Check ~ 0 if Form 2220 is attached
46
Tax due. If line 45 is less than the total of lines 43 and 46, enter amount owed.
. . . . . ~ 47
Overpayment. If line 45 is larger than the total of lines 43 and 46, enter amount overpaid.
. ~ 48
Entertheamountofline48youwant: Creditedto 2006estimatedtax ~
Refunded~ 49
Statements Regarding Certain Activities and Other Information (Seeinstructions on
At any time during the 2005 calendar year, did the organization have an interest in or a signature or other authority
a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
over
If "Yes," the organization may have to file Form TD F 90-22.1. If "Yes," enter the name of the foreign country
here ~ -..
- -- - --.. - -. -.. - - - - - - -. - -.. -.. -. - - - - - - -- - -. - -. - -. -- - -- - - -. -.. - -.. -. - - - - - - - - - - - -. - -. - -. - - - - -2
During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? .
If "Yes," see page 5 of the instructions for other forms the organization may have to file.
Enterthe amount of tax-exempt interest receivedor accrued duringthe tax year ~ $
Schedule A-Cost of Goods Sold. Enter method of inventory valuation ~ Cost
3
1
2
3
Inventory at beginning of year.
Purchases.
. . . . ..
Cost of labor.
. . . ..
1
2
3
0
1,245,351
395,957
4a Additionalsection 263A costs
(attach
schedule).
.
.
..
b Other costs (attach schedule).
5 Total. Add lines 1 throuqh 4b.
Part I, line2.
4a
4b
5
8
1,641,308
51,885
6 Inventory at end of year.
7 Cost 01 goods sold. Subtract line
6 from line 5. Enter here and in
. . . . . . .
Do the rules of section
1
7
I
1,589,423
263A (with respect
to
I Yes I No
property produced or acquired for resale) apply
to the organization?
Under penalties of perjury. I declare that I have examined this return. including accompanying schedules and statements. and to the best of my knowledge and belief. it is true.
Sig n
Here,.
correct.
ili..
I
and complete.
Declaration
of
is based on all information
Preparer's
of which preparer
has any knowledge.
Ih..Controller/Secretary/Treasure
,.
Signature of officer
Paid
Preparer's
Use Only
reparer (other than taxpayer)
r.l
')..1.
Date
Title
Date
~
May the IRS discuss this return with
thepreparershownbelow(see
instructions)?
0
Ves
0
No
Preparer's SSN or PTIN
signature"
Firm's name (or
yours if self-employed),
address, and ZIP code
~
Form
990- T (2005)
Page3
Form 990-T (2005)
Schedule C-Rent Income (From Real Property and Personal Property Leased With Real Property)
(See instructions on page 17.)
1 Description of property
(1) PERFORMING
ARTS CENTER
(2) UNI DOME
(3) OTHER
(4)
2 Rent received or accrued
(b) From real and personal property (ifthe
percentage of rent for personal property exceeds
50% or if the rent is based on profit or income)
3 Deductions directly connected with the income in
columns 2(a) and 2(b) (attach schedule)
(1)
214,292
125,977
(2)
199,295
150,478
(3)
32,798
31,025
(a) From personal property (ifthe percentage of rent
for personal property is more than 10% but not
more than 50%)
(4)
Total
Total
446,385
Total income. Add totals of columns 2(a) and 2(b). Enter
Total
deductions. Enter
here and on page 1, Part "
here and on page
line 6, column (8).
Schedule
1, Part " line 6, column
E-Unrelated
(A)
..
.
Debt-Financed
1 Description of debt-financed
307,480
Income (See instructions on pace 17.\
3 Deductions directly connected with or allocable to
debt-financed property
2 Gross income from or
allocable to debt-financed
property
property
(a) Straight line depreciation
(attach schedule)
(b) Other deductions
(attach schedule)
7 Gross income reportable
(column 2 x column 6)
8 Allocable deductions
(column 6 X total of columns
3(a) and 3(b))
Enter here and on page 1,
Part " line 7, column (A).
Enter here and on page 1,
Part I, line 7, column (8).
(1)
(2)
(3)
(4)
4 Amount of average
acquisition debt on or
aliocable to debt-financed
5 Average adjusted basis of
or allocable to
debt-financed property
(attach schedule)
property (attach schedule)
6 Column 4
divided by
column 5
(1)
%
(2)
%
(3)
%
(4)
%
Totals.
Total
dividends-received
Schedule F-Interest,
deductions
included
in column
8
Annuities, Royalties, and Rents From Controlled Organizations (See instructions on page 18.)
Exempt
1 Name of Controlled
Organization
2 Employer
Identification Number
Controlled
3 Net unrelated income
(loss) (see instructions)
Orqanizations
4 Total of specified
payments made
5 Part of column (4) that is
included in the controlling
organization's gross income
6 Deductions directly
connected with income
in column (5)
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7 Taxable Income
8 Net unrelated income
(loss) (see instructions)
9 Total of specified
payments made
10 Part of column (9) that is
included in the controlling
organization's gross income
11 Deductions directly
connected with income in
column (10)
(1)
(2)
(3)
(4)
Add columns 5 and 10. Enter
here and on page 1, Part I,
line 8. column (A).
Totals
Add columns 6 and 11. Enter
here and on page 1, Part "
line 8. column (6).
.
Form 990- T (2005)
Page4
Form 990- T (2005)
Schedule Q-Investment
Income of a Section 501(c)(7), (9), or (17) Organization
(See instructions on page 19.)
3 Deductions
directiy connected
(attach schedule)
2 Amount of income
1 Description of income
5 Total deductions
and set-asides (col. 3
plus col. 4)
4 Set-asides
(attach schedule)
~
@
£!
(4)
Enter here and on page 1,
Part I, line 9, column (A).
Totals.
Schedule
. . . . . . ..
I-Exploited
Exempt Activity Income,
Enter here and on page 1,
Part I, line 9, column (8).
Other Than Advertising
Income
(See instructions on page 19.)
1 Description of exploited activity
2 Gross
unreiated
business income
from trade or
business
3 Expenses
directly
connected with
production of
unrelated
business income
Enter here and on
page 1, Part I.
line 10, col. (A).
Enter here and on
page 1. Part I,
line 10, col. (B).
4 Net income
(loss) from
unrelated trade
or business
(column 2 minus
column 3). If a
gain, compute
cols. 5 through 7.
5 Gross income
6 Expenses
attributable to
column 5
from activity that
is not unrelated
business income
7 Excess exempt
expenses
(column 6 minus
column 5. but not
more than
column 4).
~
@
£!
(4)
Totals.
. .
. .
. .
I
Enter here and
on page 1,
Part II, line 26.
. . ..
Schedule J-Advertising Income (See instructionson page 19.)
Income From Periodicals Reported on a Consolidated Basis
7 Excess
2 Gross
1 Name of
periodical
3 Direct
advertising
income
advertising costs
4 Advertising
gain or (loss) (col.
2 minus col. 3). If
a gain, compute
cols. 5 through 7.
5 Circulation
income
6 Readership
costs
readership costs
(column 6 minus
column 5, but not
more than
column 4).
~
@
£!
(4)
Totals (carry to Part II, line (5))
Income
. ..
From Periodicals
Reported
on a Separate
Basis
(For each periodical
listed in Part II, fill in
columns 2 through 7 on a line-by-line basis.)
~
@
£!
(4)
(5) Totals from Part I
Totals, Part II (lines 1-5) .
Schedule
...
K-Compensation
Enter here and on
page 1, Part I,
line 11, col. (A).
of Officers,
I
Enter here and
on page 1,
Part II, line 27.
Enter here and on
page 1, Part I,
line 11, col. (B).
Directors,
and Trustees
2 Title
1 Name
(See instructions
on paJe 20.)
3 Percent of
4 Compensationattributable to
time devoted to
unrelated business
business
%
%
%
%
Total. Enter here and on page 1, Part II, line 14
.
..
Form 990- T (2005)
University of Northern Iowa
Unrelated Business Income Tax
Form 990-T
Other Deductions line 28
Travel
General Supplies
Postage and Shipping
Business Meals and Entertainment
Dues and Subscriptions
Insurance
Rents/Leases
Telephone
Printing/Duplicating/AV/Photography Services
Computer Supplies
Purchased Services
Administrative Overhead
Advertising
Utilities
Miscellaneous
Other:
990 Schs sales svcs 06sch line 28
4,783
34,564
840
588
332
5,779
2,720
4,387
2,414
169
17,607
705,347
71,607
23,150
874,287
2/14/200710:58 AM
~orm
4562
OMB No. 1545-0172
Depreciation and Amortization
(IncludingInformationon Listed Property)
(Rev. January 2006)
Departmentof the Treasury
~ See separate instructions.
Internal Revenue Service
Name(s) shown on return
~@O5
Attachment
Sequence No.
~ Attach to your tax return.
Identifying
Business or activity to which this form relates
University of Northern Iowa
FORM 990-T
Election To Expense Certain Property Under Section 179
Note: If you have any listed property, complete Part V before you complete Part
1 Maximumamount.Seethe instructionsfor a higherlimitfor certainbusinesses.
2 Total cost of section 179 property placed in service (see instructions) .
3 Thresholdcost of section 179 property before reduction in limitation
4 Reduction in limitation.Subtract line 3 from line 2. If zero or less, enter -0- .
5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less,enter -0-. If marriedfiling
separately,see instructions
42-6004333
I.
1
2
3
4
$105,000
$420,000
5
(e) Elected cost
(b) Cost (business use only)
(a) Description of property
67
number
6
Listed property. Enter the amount from line 29 .
. L1
Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7.
Tentative deduction. Enter the smaller of line 5 or line 8. . . . . . . . . . .
7
8
9
.
.
.
.
.
.
9
10 Carryover of disallowed deduction from line 13 of your 2004 Form 4562 . . . . . . . . 10
11 Businessincomelimitation.Enterthe smallerof businessincome(notlessthanzero)or line5 (seeinstructions) 11
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11. . . 12
13 Carryover of disallowed deduction to 2006. Add lines 9 and 10, less line 12 ~
Note: 00 not use Part /I or Part 11/below for listed property. Instead, use Part V.
~
[Ji
Special Depreciation Allowance and Other Depreciation (Do not include listed
14
15
Special allowance for certain aircraft, certain property with a long production period, and qualified NYL
or GO Zone property (other than listed property) placed in service during the tax year (see instructions)
Property subject to section 168(f)(1) election.
. . . . . . . . . . . . . . . .
16
Other depreciation (including ACRS)
. .
. . .
. . .
. . .
. . .
,
. .
. .
4
15
. . 16
H!
7,148
MACRS Depreciation (Do not include listed property.) (See instructions.
Section A
MACRS deductions for assets placed in service in tax years beginning before 2005 .
If you are electing to group any assets placed in service during the tax year into one or more
general asset accounts, check here
. ~ D
Section B-Assets
Placed in Service During 2005 Tax Year Using the General Depreciation
17
18
(a) Classification of property
I
(b) Month and
year placed in
service
(e) Basis for depreciation
(business/investment use
only-see instructions)
19a
b
c
d
e
f
g
h
3-year property
5-year property
7-year property
10-year property
15-year property
20-year property
25-year property
Residential rental
property
i Nonresidential real
property
I (e) Convention
25 rs.
27.5 yrs.
27.5 yrs.
39 yrs.
Section C-Assets
MM
MM
MM
MM
(f) Method
System
(g) Depreciation deduction
S/L
S/L
S/L
S/L
S/L
Placed in Service During 2005 Tax Year Using the Alternative Depreciation System
20a Class life
b 12-year
c 40-year
Summary
d
() ReCo~ery
peno
12 yrs.
40 yrs.
MM
S/L
S/L
S/L
..
21
22
Listed property. Enter amount from line 28 .
Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21.
Enter here and on the appropriate lines of your return. Partnerships and S corporations-see instr.
23
For assets shown above and placed in service during the current year,
enter the portion of the basis attributable to section 263A costs
For Paperwork Reduction Act Notice, see separate instructions.
21
22
54,593
23
Cat. No. 12906N
Form
4562
(2005) (Rev. 1-2006)
Form 4562 (2005) (Rev. 1-2006)
~
Page
2
Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and
property
used for entertainment,
recreation,
or amusement.)
Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only
24a, 24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.
Section A-Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)
24a
Do you have evidence to support the business/investment use claimed?
(c)
(a)
Business/
Type of property (list
h ' 1ft
)
ve ICes irS
Yes
0
No
24b
(e)
, for d
,
'
asls
epreC ,allon
B(b
t
t
USlness/ Inves men
use only)
(d)
investment
use
percentage
0
Cost or other
b '
aSls
If "Yes," is the evidence written?
(f)
(g)
Recovery
'd
peno
C
(h)
Method/'
t
onven Ion
25
Special allowancefor certain aircraft,certain property with a long production period, and qualified NYL or GO Zone
property placed in serviceduring the tax year and used more than 50% in a qualifiedbusinessuse (see instructions)I 25
26
Pcopert,
ooeOI mo'e 'hao 5T
27 Pcoperty00""150%°' Ie"
28
29
10a q~rifj""
r a q"'''~IO
booloe"
Yes
0
No
(i)
lecte d
Et
179
sec Ion
cost
§
001'
booloe" ooe
Depreciation
d d
t'
e uc Ion
0
1
~
1
Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1.
Add amounts in column (i), line 26. Enter here and on line 7, page 1.
Section B-Information on Use of Vehicles
28
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person.
If you prCNida:i vehides to your €ITpioyees,
30
31
32
33
34
35
36
first
Cf1S\/o.€r
Total business/investmentmiles driven
duringthe year(do not includecommuting
miles) .
Totalcommutingmilesdrivenduringtheyear
the qJ€Stions in Soction C to see ITyou meet an exception to ccrrPeting
(a)
Vehicle 1
(b)
Vehicle2
(c)
Vehicle3
(d)
Vehicle4
this sectiCXl fa' those vehides.
(f)
Vehicle 6
(e)
Vehicle 5
Total other personal (noncommuting)
miles driven.
Total miles driven during the year. Add
lines 30 through 32
Was the vehicle available for personal
use during off-duty hours?
Was the vehicle used primarily by a
more than 5% owner or related person?
Is another vehicle available for personal
use?
Section C-Questions
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
for Employers Who Provide Vehicles for Use by Their Employees
Answerthese questionsto determine if you meet an exception to completing Section B for vehicles used by employeeswho are
not more than 5% owners or related persons(see instructions).
37
38
39
40
41
Yes
Do you treat all use of vehicles by employees as personal use? .
'
Do you provide more than five vehicles to your employees, obtain information from your employees about
the use of the vehicles, and retain the information received? .
Do you meet the requirementsconcerningqualified automobiledemonstrationuse? (See instructions.)
Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.
Amortization
Amortization of costs that begins during your 2005 tax year (see instructions):
I
43
44
(d)
Code
section
(c)
Amortizable
amount
(b)
Date amortization
begins
(a)
Descriptionof costs
42
No
Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting,
by your employees? .
Do you maintaina written policy statementthat prohibits personaluseof vehicles,except commuting, by your employees?
See the instructions for vehicles used by corporate officers, directors, or 1% or more owners
I
t
Amortization of costs that began before your 2005 tax year.
Total. Add amounts in column (t). See the instructions for where to report.
(e)
Amortization
period or
percentage
t
(f)
Amortization for
this year
143
r44
Form
4562
(2005) (Rev. 1-2006)
Form
8868
(Rev.December
2004)
co~~
Application for Extension of Time To File an
Exempt Organization Return
Departmentof the Treasury
InternalRevenueService
.
.
OMB No. 1545-1709
~ Rle a separateapplicationfor each retum.
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 filing for an Automatic
Do not complete PartII unless you have already been granted an automatic 3-month extension on a previously filed
Automatic 3-Month Extension of Time-Only submit original (no copies needed)
III
Form 8868.
Fonn 990-T corporations requesting an automatic 6-month extension-check this box and complete Part I only.
.
0
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 Form8736 to request an extensionof time to file Form 1065, 1066, or 1041. .
Electronic Filing (e-file). Form 8868 can be filed electronicallyif you want a 3-month automatic extensionof time to file one of the
returnsrioted below (6 months for corporate Form990-T filers). However,you cannot file it electronicallyif 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 electronicfiling of this form, visit www.irs.govlefile.
Type or
~r~dy:r for
Nameof ExemptOrganization
University of Northern Iowa
Number, street,androomor suiteno. If a P.O.box.seeinstructions.
125 Gilchrist Hall
~~~t~s.
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
print
Filebythe
I
Employer:identification number
42 : 6004333
Cedar Falls, IA 50614-0009
Check type of return to be filed (filea separate application for each return):
Form 990
III Form 990-T (corporation)
0 Form 4720
0 Form 5227
0
0 Form990-BL
0 Form990-EZ
0 Form990-PF
0 Form990-T (sec. 401(a)or 408(a)trust)
0 Form990-T (trustother than above)
0 Form1041-A
. Thebooksare in the care of ...-.Gary:B.
Shontz
-u .-u._u.
-. --u...
u
u.
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0
0
-. -..
Form 6069
Form 8870
._uu
Telephone No. ... L.~.~~...L~!~~~1~
FAXNo. ... L_~~.~...L~?~:~~~~........_........
If the organization does not have an office or place of business in the United States, check this box
uu
.
... . . . . ~
. If this is for a Group
0
Return, enter the organization's four digit Group Exemption Number (GEN)
. If this
is for the whole group, check this box ... 0 . If it is for part of the group, check this box ~ 0
and attach a list with the
namesandEINsof all memberstheextensionwillcover.
1
.
I request an automatic 3-month (6-months for a Form 99Q-T corporation) extension oftime until J!:~!}!~!Y. .1.~.
- ,20 .Q?,
exempt organization return for the organiZation named above. The extension is for the organization's return for:
... 0 calendar year 20... or
... III tax year beginning
~~-'y'.1
, 20 ~~, and ending
uA~~!!.~~
, 20 9_~.
to file the
u
2
If this tax year is for less than 12 months, check reason:
0 Initialretum 0
Final return 0 Change in accountingperiod
3a If this application is for Form 990-BL, 990-PF,990-T, 4720, or 6069, enter the tentative tax,
nonrefundable credits. See instructions.
less any
. . . . . . . . . . . . . . . . . . . . . ~
b If this application is for Form 99o-PF or 990- T, enter any refundable credits and estimated tax payments.
/
made. Includeany prioryear overpayment allowed
asa credit. . . . . . . . . . . . . .
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
~
0
0
0
instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
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.
Cat No. 27916D
For Privacy Act and Paperwork Reduction Act Notice, see Instructions.
Form 8868 (Rev. 12-2004)
Form8a68 (Rev.12-2004)
Page 2
. Ifyou are filingfor an Additional (not automatic) 3-Month Extension, complete only Part II and check this box. . ~
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
. If youarefilingfor anAutomatic 3-Month Extension, complete only Part I (on page 1).
Additional not automatic
3-Month Extension of Time-Must
Type or
print
Name of Exempt Organization
File by the
extended
due date for
filingthe
return. See
instnJctions.
Number, street, and room or suite no. If a P.O. box, see instructions.
File Ori inal and One Co
0
.
Employer identification number
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
I
.
Check type of return to be filed (File a separateapplicationfor each return):
0 Form 990-T (sec.401(a)or 408(a)trust)
0 Form 99O-BL
0 Form 990-T (trust other than above)
0 Form 990-EZ
0 Form 1041-A
0 Form 990-PF
0 Form 4720
STOP:Do not complete Part .. if you were not already granted an automatic 3-month extensionona
0 Form 5227
0 Form 6069
0 Form 8870
0 Form 990
. Thebooksareinthecareof ~
TelephoneNo. ~ t
previouslyfiledForm8868.
n'_""""n'''''_''_''''''''''''_'nn.',
>
FIV<
No.~ L
L
oo
oo...n_..
. If the organizationdoes 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'sfour digit Group ExemptionNumber (GEN)
If this is
for thewholegroup,checkthis box ~
D. If it is for part of the group, check this box ~.
0
0 andattacha list withthe
namesand EINsof all membersthe extensionis for.
4
I requestan additional3-month
extensionof timeuntil
5
6
Forcalendaryear
, or other tax yearbeginning
m
If this tax year is for less than 12 months, check reason:
7
State in detail why you need the extension
u... -
.---." u
---.."
,
--00'
000'000'_"'000"_""'_--000'''_000,20
mn
,20m..'
0 Initial return 0
and ending
.20......
Final return 0 Change in accounting period
000-00000000
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Sa If this application is for Form 99O-Bl, 99O-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
instructions.
. . . . . . . . . . . . . . . . . . . . . ~
nonrefundablecredits. See
b If this application is for Form 990-PF,990-T, 4720, or 6069, enter any refundablecredits and estimated
tax payments made. Include any prior year overpayment allowed as a credit and any amount paid
. . . . . . . . . . . . . . . . . . . . . . . . . . ~
previouslywithForm8868
c Balance Due. Subtract line 8b from fine Sa. 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.
$
Signature and Verification
Under penalties of perjury, I dectare that I have examined
it is We, correct. and complete, and that I am authorized
~
.Signatle~ ~a..
0
0
0
0
0
this form. including accompanying
to prepare this fonn.
TItle ~
schedules
and statements,
and to the best of my knowledge
Controller
Date~
and belief,
l\~
Notice to Applicant-To Be Completed by the IRS
We have approved this application. Please attach this form to the organization's retum.
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 retum Qncludingany prior extensions). This grace period is considered to be a valid extension of time for eJections
otherwise required to be made on a timely retum. Please attach this fann to the organization's return.
We have not approved this appI"lCation.After consideringthe reasons stated in item7, we cannot grant your request for an extensionof time
.
to file.We are not grantinga 10-day grace period.
We caMot consider this applicationbecause it was filedafterthe extended due date of the return for which an extensionwas requested.
Other.. -..
00
--- ...u
n..'.'_'"''''
--
.".--'--.'00'-_-
--,u,,,,,,,--,
By:
Director
-
AltemateMailing
Address
Enter the address if you want the copy of this application
returned to an address different than the one entered above.
Date
for an additional
3-month
extension
. Name
Type or
print
Number and street fmcludesuite, room. or apt. no.) or a P.O. box number
City or town, province or state, and country fmcluding postal or ZIP code)
Form 8868 (Rev.12.2004)