Return of Private Foundation F..990-PF OMB No 1545-0052 or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Department of the Treasury 2010 The foundation may be able to use a copy of this return to satisfy state repo , 2010, and ending Fnr r_alondar year 2010_ or tax year beainnina G Check all that apply' ,20 U Final return Initial return of a former public charity Address chap a Initial return H Amended return Name change A Employer Identification number Name of foundation 23-2903172 THE NEW MILLENNIUM CHARITABLE FOUNDATION Room/suite Number and street (or P.O box number If mail is not delivered to street address) B Telephone number ( see page 10 of the instructions) (215) P.0 BOX 1529 D BOCA RATON, FL 33429-1529 I Is. Foreign organ iz ations , check here E Accrual Accountin g method X Cash -----------❑ Other (specify) (Part 1, column (d) must be on cash basis) Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column a (see pa g e 11 of the instructions)) (a) Revenue and expenses per books Contributions 2 Check ^ 3 Interest on savings and temporary cash investments 4 Dividends and interest from securities 262. 262. 6,442. 6,442. - Capital gain net income (from Part IV , line 2) Net short-term capital gain Income modifications 9 10 a Gross sales less returns = _c 219 ^ == ', - =F 3 219 . . . . . . . . . • • • ^ _ -_ - - - - -- -. ' -. - , (d) Disbursements for chartable purposes ( cash basis only) ';AT CH, 1 - ATCI-1` 2'- • - = z -. G a Net gain or (loss) from sale of assets not on line 10 b Gross sales pace for all 3,400. assets on l ine 6 a 8 ^ ❑ .• b Net rental income or (loss) 7 . If the foundat ion is ina60 - month termination under section 507(b)( 1)(B), check here r-s - -- 0 fls , grants , etc, , received ( attach schedule) the foundation is not required to d a tt ac h S ch B 1 under section 507 (b)(1)(A), shed, here F (c) Adjusted net income (b) Net investment income ^ If p rivate foundatron status was terminated S a Gross rents . . . . . . . . . . . . . . . . . y ^ omtest, check hero and sited c on,putawn ^X F a i r mar k e t va l ue o f a ll asse t s a t en d of year (from Part ll, col (c), line 1,106,809. 16) ^ $ at , 2. Foreign organizations meebng the Section 501 ( c 3 exem P t private foundation Other taxable p rivate foundation Section 4947 ( a )( 1 ) nonexem p t chartable trust a of organizationH Check type I 990-4244 C tIf epu^eaapplication is City or town, state, and ZIP code - - - • • • • and allowances a b Less Cost of goods sold , c Gross profit or (loss) (attach schedule) . . . 11 Other income (attach schedule) 12 Total. Add lines 1 throu g h 11 13 Compensation of officers , directors, trustees, etc. 14 Other employee salaries and wages 15 Pension plans , -employee benefits ' 6,923. 6,923. 0 . . . . , , . , , 16 a Legal fees! (attach schedule)'_ ; w- , b Accounting fees (attach schedule) AT C 3 a X W I ' V; c Other profes onal fees (attach schedule) Interest . 18 Taxes ( attach schule ) ( see page 14 of the instructions), 19 Deprectatton (attach•schedule) and depletion' 20 Occupancy 21 - ' , Punting and publications 23 , . . . . . . . . Other expenses (attach schedule) ATCH. 9 24 Total operating and administrative expenses. ,0 22 Add lines 13 through 23 a 0 0 ^t ^J .. A!1G . ^. 17 , ._.-,; Travel , conferences , and meetings , . . 0. 0. 8,700. r Contributions , gifts , grants paid 26 Total expenses and disbursements . Add lines 24 and 25 Subtract line 26 from line 12 27 a Excess of revenue owr expenses and disbursements 10. 8,710. , , . . . , , . 25 10. 10 53,500. "_- - 62,210. - SM7617 1301 _ 10. 0 . 0 0. 53, 500 53, 500 --__ -55 r 287. -- _- - u b Net Investment Income (if negative, enter -0-) = - c Adjusted net Income d neg ative, enter -0-). For Paperwork Reduction Act Notice, see page 30 of the Instructions. 0E14101000 __ V 10-7.2 - - _ _ 6, 913. JSA 732532 _ -- _ __ _ _ = - - u Form yyu - rr (Zulu) PAGE 1 1G1 23-2903172 Form 990-PF (2010) Attached schedules and amounts In the descri p ti o n column s hould b e f o r e n d -o f-year amounts only (See instructions ) ® B a l ance Sh ee t s (a) Book Value End of year (b) Book Value 226, 116. 829, 988. 1 2 Cash - non-interest-bearing . . ..... .. ....... Savings and temporary cash investments ......... 3 Accounts receivable ^ ----------------------- 4 Pledges receivable No. 5 Grants receivable 6 Receivables due from officers, directors , trustees , and other Paae2 Beginning of year (c) Fair Market Value 3, 906. 418, 703. 3, 906 463, 219. 578,208. 639,684, Less- allowance for doubtful accounts ^ ----------------------Less allowance for doubtful accounts ^ _ _ _ _ _ _ _ _ _ _ _ _ _ , , , , , , , , , , , , , , , , disqualified persons (attach schedule) (see page 15 of the Instructions) 7 Other notes and loans receivable (attach schedule) Less allowance for doubtful accounts ^ __ ___ __ 8 Inventories for sale or use _ 9 Prepaid expenses and deferred charges . . . . . . . . . . , Q 10 a Investments - U S and state government obligations (attach schedule) • b Investments - corporate stock (attach schedule) ATCR 5.. c Investments - corporate bonds (attach schedule) . . . . . . . . 11 12 13 14 Investments - land. buildings. and equipment basis Less accumulated depreciation (attach schedule ) Investments - mortgage loans ^ -' ^ ----------------------------------- Investments - other (attach schedule) , , , , , , , Land, buildings , and ,;. equipment basis ^ -- -------------Less. accumulated deprecation III,, (attach schedule) -------------------- 15 Otherassets(descnbe 16 Total assets (to _ . . . . . . . . . . . . . . . . = = ; .., ,. _ w _ :: ,' __ ^' : ;`. , ^ -------------------- ) be completed by all filers - see the instructions Also, see page 1, item 1) 17 Accounts payable and accrued expenses 18 Grants payable 1, 056, 104. 1, 000, 817. 1, 106, 809. =4-. ,,,,,,,,,,,,,,,,,,,,,,, 19 Deferred revenue 20 Loans from officers, directors, trustees, and other disqualified persons 21 Mortgages and other notes payable (attach schedule) 22 Other liabilities (describe 23 Total liabilities (add lines 17 through 22) , , , , , , , , , , , , , , , , , , , , , '' ?F = ^ - - -- - - - -- -------- -- 0. Foundations that follow SFAS 117, check here ^ and complete lines 24 through 26 and lines 30 and 31. aa) 24 25 m 26 LL 0 27 Unrestricted . . . . . . . . . . . . . . . . . . . . . . . . . Temporarily restricted , , , , . . . . . . . , Permanently restricted , , , , , , , , , , , , , , , , , , , , Foundations that do not follow SFAS 117, check here and complete lines 27 through 31. 10. Capital stock, trust principal, or current funds 4 28 Paid-in or capital surplus, or land , bldg ,and equipment fund U0 29 Retained earnings, accumulated income , endowment , or other funds 30 Total net assets or fund balances (see page 17 of the 31 Total liabilities and net assets/fund balances (see page 17 Z instructions) . . . . . ................. of the instructions) 1,056,104. 1,000,817. 1, 056, 104. 1,000, 817. 1, 056, 104. 1, 000, 817. - - - " - '_- _ - _ UMM Analysis of Chan g es in Net Assets or Fund Balances I Total net assets or fund balances at beginning of year - Part II, column (a), line 30 (must agree with end-of-year figure reported on prior years return) , , , , , , , , , , , , , , , , , , , , , , , , , 2 Enter amount from Part 1, line 27a 3 Other increases not included in line 2 (itemize) ^ --- - --- -- -------------------- -------• • .. • • ... , • . • • • . • • • • . • • • .... . 4 Add lines 1, 2, and 3 _ _ _ _ _ ___ 5 Decreases not included in line 2 (itemize ) ^ 6 Total net assets or fund balances at end of year (line 4 minus line 5 ) - Part II column (b ), line 30 1 2 1, 056, 104 . -55,287. 3 4 5 1, 000, 817. 6 1,000,817. Form 990-PF (2010) JSA 051420 1 000 SM7617 1301 V 10-7.2 732532 PAGE 2 Form 990.PF (2010) 23-2903172 Page 3 Capital Gains and Losses for Tax on Investment Income (b) How re acquired D;° P P" () a List and describe the kinds () of property sold ( a g., real estate , 2-sto ry buck warehouse, or common stock , 200 shs MLC Co ) to b (c) Date acquired (mo, day , yr) jd) Date sold lino day, yr ) SEE PART IV SCHEDULE c d e (e) Gross sales price (1) Depreciation allowed (or allowable) (9) Cost or other basis plus expense of sale ( h) Gain or (loss) ( e) plus (f) minus (g) a b c d e Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (I) F M V as of 12/31/69 U ) Adjusted basis as of 12/31/69 (I) Gains (Col (h) gain minus col (k), but not less than -0-) or Losses ( from col (h)) (k) Excess of cot (i) over col Q), if any a b c d e If gain, also enter in Part I, line 7 } 2 { If (loss), enter -0- in Part I , line 7 3 Net short-term capital gain or (loss) as defined in sections 1222( 5) and (6) If gain, also enter in Part I , line 8, column ( c) (see pages 13 and 17 of the instructions) If loss), enter -0- in Part I, line 8 . ................................. 3 Qualification Under Section 4940 (e) for Reduced Tax on Net Investment Income (For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income ) 2 Capital gain net income or ( net capital loss) 219. If section 4940(d)(2) applies, leave this part blank. Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? ❑ Yes Q No If "Yes ," the foundation does not qualify under section 4940 (e). Do not complete this part. I Enter the appropriate amount in each column for each year, see page 18 of the instructions before making any entries Base penod years Calendar year (or tax year beginnmg in) 2009 2008 2007 2006 2005 Adjusted q uali ^( n)9 distributions Disinbution ratio (col (b) divided by col (c)) Net value of nonchantable use assets 1,067,954. 1,121,686. 1,142,285. 1,180,310. 1,182,081. 60,000. 61,257. 62,409. 62,131. 64,057. 0.056182 0.054612 0.054635 0.052640 0.054190 Total of line 1 , column (d) Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the ....... .. number of years the foundation has been in existence if less than 5 years 2 0.272259 3 0.054452 4 Enter the net value of nonchantable-use assets for 2010 from Part X, line 5 4 1,065,235. 5 Multiply line 4 by line 3 5 58,004. 6 Enter 1% of net investment income ( 1% of Part I, line 27b) 6 69. 7 Add lines 5 and 6 7 58, 073 . 2 3 . ............. . . ... . . . . . . . . . . . . . . . . ... ... , , , , . , ..... . . . . ....... . .... . ...... . .. . . . . . .... . 53,500. 8 Enter qualifying distributions from Part XII, line 4 If line 8 is eaual to or greater than line 7 . check the box in Part VI . line 1b . and comDlete that D art usina a 1% tax rate . See the Part VI instructions on page 18 JSA Form 990-PF (2oto) 8 0E1430 1 000 SM7617 1301 V 10-7.2 732532 PAGE Page 4 23-2903172 990-PF (2010) instructions) or 4948 see page 18 of the 4940 4940 (e), 4940 (a), ( b), Income ( Section IUMM Excise Tax Based on Investment 1a Exempt operating foundations described in section 4940(d)(2), check here Date of ruling or determination letter b Domestic foundations that and enter "N/A" on tine I ^ - ------ ----- (attach copy of ruling letter If necessary - see Instructions ) meet the section 4940(e) here 10- ❑ and enter 1% of Part I, line 27b c All other domestic foundations enter 2% of line 27b Part I, line 12, col (b) requirements in Part V, check - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 4 enter -0. If zero or less, line 4 line 3 Subtract from Investment on Income . Tax based 5 . . . . . . . . . . . . Credits/Payments 6 391. 6a a 2010 estimated tax payments and 2009 overpayment credited to 2010 0. 6b b Exempt foreign organizations-tax withheld at source 0. 6c c Tax paid with application for extension of time to file (Form 8868) d Backup withholding erroneously withheld . . . . . . . . . . . . . . . . . Total credits and payments Add lines 6a through 6d . . . . . Enter any penalty for underpayment of estimated tax Check here 7 8 6d 69. 3 4 0. 69. 5 - w _ ._... >_ ❑ if Form 2220 is attached . . . . . . . . . . . . . . . . . . . . . ^ 8 9 ^ 10 , , , , 322. Refunded 391. 7 . . . . . . . . . . . . . . . . . . . Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed Overpayment If line 7 is more than the total of lines 5 and 8, enter the amount overpaid Enter the amount of line 10 to be Credited to 2011 estimated tax ^ 9 10 11 - 2 . Add lines 1 and 2 3 - - Exempt foreign organizations enter 4% of Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-) 2 69 . 1 322. 11 MMY" Statements Reg ardin g Activities 1a Yes During the tax year , did the foundation attempt to influence any national , state, or local legislation or did it . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . participate or intervene in any political campaign? b Did it spend more than $ 100 during the year ( either directly or indirectly) for political purposes ( see page 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . of the instructions for definition )? lb, 1a or attach a detailed description of the activities and copies of any materials 'Yes' answer is to If the c d published or distributed by the foundation in connection with the activities Did the foundation file Form 1120 -POL for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No 1a X 1b X 11c X 2 1= X Enter the amount ( if any ) of tax on political expenditures ( section 4955 ) imposed during the year ( 2) On foundation managers ^ $ ^$ (1) On the foundation e Enter the reimbursement (if any ) paid by the foundation during the year for political expenditure tax imposed ^ $ Has the foundation engaged in any activities that have not previously been reported to the IRS? If "Yes," attach a detailed description of the activities on foundation managers 2 3 , , , , , , , , , , , , , , Has the foundation made any changes, not previously reported to the IRS, in its governing instrument , articles of incorporation , or bylaws , or other similar instruments ? If 'Yes," attach a conformed copy of the changes . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Did the foundation have unrelated business gross income of $1 , 000 or more during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . for this year? . . Form 990-T tax return on filed a If "Yes , " has it to . . . . . . . . . . . . . . . . . Was there a li q uidation , termination , dissolution , or substantial contraction during the year? 5 6 3 X 4a 4b X 5 X 6 X If "Yes,"attach the statement required by General Instruction T Are the requirements of section 508 ( e) (relating to sections 4941 through 4945 ) satisfied either • By language in the governing instrument, or • By state legislation that effectively amends the governing instrument so that no mandatory directions that 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conflict with the state law remain in the governing instrument? Did the foundation have at least $5 , 000 in assets at any time during the year? If 'Yes,' complete Part 11, col (c), and Part XV 8a Enter the states to which instructions ) ^ the foundation reports or with which it is registered ( see page 19 7 X 86 _ X of the -------------------------------------- b If the answer is "Yes" to line 7 , has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate ) of each state as required by General Instruction G'If "No , " attach explanation . . . . . . . . . . . . . . . . . 9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942 )( 3) or for calendar year 2010 or the taxable year beginning in 2010 ( see instructions for Part XIV on page 27)? If "Yes , " complete PartXIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4942 (1)(5) 10 Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names and addresses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 9 10 X Form 990-PF (2010) iSA 0E1440 1 000 SM7617 1301 V 10-7.2 732532 PAGE 4 Page5 23-2903172 orm 990-PF (2010) TWITIFT Statements Re g ardin g Activities (continued) 12 At any time during the year , did the foundation , directly or indirectly , own a controlled entity within the . . . . . . . . . . . . . . . . . . meaning of section 512 ( b)(13)? If "Yes," attach schedule ( see page 20 of the instructions ) before contract applicable insurance Did the foundation acquire a direct or indirect interest in any 13 August 17 , 2008? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Did the foundation comply with the public inspection requirements for its annual returns and exemption application ? 11 11 X 12 X 13 X po^_----N/A-------------------- ------------------------------------- -----------215-990-4 24 9 p The books qre in care of ^ PAUL ROSENBERG --------------------- Tele hone no ^ ----------------------p. 33432--- - - - - -----ZIP+4 RATON, FL Located at --------------------- ------------ Section 4947 ( a)(1) nonexempt chantable trusts filing Form 990- PF in lieu of Form 1041 - Check here . . . . . . . . . . • • • • • • • • ^ . . . . . . . . . . . . . . . . . . ^ 15 and enter the amount of tax-exempt interest received or accrued during the year Yes No At any time during calendar year 2010 , did the foundation have an interest in or a signature or other authority X 16 over a bank , securities , or other financial account in a foreign country? . . . . . . . . . . . . . . . . . . . . . . . . . . . If "Yes," enter _, TD F for Form 90-22 1 See page 20 of the instructions for exceptions and filing requirements Websiteaddress 14 15 16 the name of the forei g n coun try ^ Statements Regardin g Activities for Which Form 4720 May Be Re q uired I Yes Fil e F orm 4720 if an y item is checked In the "Yes" column , unless an exception applies. 1 a During the year did the foundation ( either directly or indirectly) (1) Engage in the sale or exchange , or leasing of property with a disqualified person? . . . . . . . . (2) Borrow money from , lend money to, or otherwise extend credit to (or accept it from) a No No Yes X X Yes X No disqualified person? . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . (3) Furnish goods , services, or facilities to (or accept them from ) a disqualified person? . . . . . . . . disqualified person? of, expenses a reimburse the (4) Pay compensation to, or pay or available for of either make any person (or disqualified or assets to a income (5) Transfer any Yes the benefit or use of a disqualified person )? . . . . . . . . .. . . . . . . '°. . . . . . . . . . . (6) Agree to pay money or property to a government official? ( Exception . Check " No" if the foundation agreed to make a grant to or to employ the official for a penod after termination of government service , if terminating within 90 days ) . . . . . . . . . . . . . . . . ❑ Yes ❑ No ❑ Yes No b If any answer is "Yes" to ta(1 )-(6), did any of the acts fail to qualify under the section 5 3 4941 ( d )- 3 or in a cur rent notice re g ardin g disaster assistance (see page 22 Organizations relying on a current notice regarding disaster assistance check here . . c Did the foundation engage in a prior year in any of the acts described in 2 ❑ Yes = :f 1b . . . . . . . . . . . . ^ la, other than excepted acts , that were not correc t e d b e f ore th e first da y of the tax y ear be g innin g in 2010? . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxes on failure to distribute income (section 4942 ) ( does not apply for years the foundation was a private operating foundation defined in section 4942 (1)(3) or 4942(j)(5)) 1c X - - . ` ❑ Yes O No If "Yes"list the years b Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2) (relating to incorrect valuation of assets ) to the year' s undistributed income? ( If applying section 4942 ( a)(2) to all years listed , answer " N o " an d a tt ac h statement - see p a g e 22 of the instructions) . . . . . . . . . . . . . . . . . . . . . . c If the provisions of section 4942 ( a)(2) are being applied to ; . '.. .. No exceptions described in Regulations . . . .. . . . . . of the instructions ) ? a At the end of tax year 2010 , did the foundation have any undistributed income ( lines 6d and 6e, Part XIII ) for tax year ( s) beginning before 2010? . . . . . . . . . . . . . . . . . . . . . . . . . No 2b any of the years listed in 2a, list the years here - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - 3a Did the foundation hold more than a 2% direct or indirect interest in any business enterprise No ❑ Yes at any time during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b If "Yes ," did it have excess business holdings in 2010 as a result of ( 1) any purchase by the foundation or persons after May 26 , 1969, (2 ) the lapse of the 5-year penod ( or longer penod approved by the Commissioner under section 4943 (c)(7)) to dispose of holdings acquired by gift or bequest, or (3) the lapse of to determine if the the 10-, 15-, or 20 -year first phase holding period ? (Use Schedule C, Form 4720, disqualified foundation ha d excess b us iness h o ldin g s in 2010 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Did the f oun d ation inves t d uring the y ear an y amount in a manner that would j eopardize its charitable purposes ? b Did the foundation make any investment in a pnor year (but after December 31, 1969 ) that could j eopardize its charitable ouroose that had not been removed from eo aril before the first da y of the tax year be g innin g in 2010? . 3b 4a X 4b X X Form 990-PF (2010) JSA 0E14501 000 SM7617 1301 V 10-7.2 732532 PAGE 5 onn 990-PF (2010) 23-2903172 UNURM Statements Regarding Activities for Which Form 4720 Ma y Be Re q uired (continued) 5a During the year did the foundation pay or incur any amount to (1) Carry on propaganda , or otherwise attempt to influence legislation ( section 4945(e))? Page 6 ❑ Yes II No Yes X No . Yes LX No ❑ Yes No ❑ Yes a No (2) Influence the outcome of any specific public election ( see section 4955 ), or to carry on, - directly or indirectly , any voter registration drive? (3) Provide a grant to an individual for travel, study , or other similar purposes ? , , , , , , , , , , , , (4) Provide a grant to an organization other than a chartable, etc , organization described in - section 509 (a)(1), (2), or ( 3), or section 4940 (d)(2)? (see page 22 of the instructions ) , -_-- , (5) Provide for any purpose other than religious , charitable , scientific , literary , or educational purposes , or for the prevention of cruelty to children or animals? b , , , , , , , , , , , , , , , , , If any answer is "Yes" to 5a ( 1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations section 53 4945 or in a current notice regarding disaster assistance (see page 22 of the instructions)? Organizations relying on a current notice regarding disaster assistance check here c . . . X 5b , , , , , , , , , , , , , , , ^ UX - If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the tax because it maintained expenditure responsibility for the grant ? , , , , , , , , , , , , , , , , , , , ❑ Yes ❑ No If "Yes,' attach the statement required by Regulations section 53 4945-5(d) _ 6 a Did the foundation , during the year , receive any funds, directly or indirectly , to pay premiums = on a personal benefit contract ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Did the foundation , during the year, pay premiums , directly or indirectly , on a personal benefit contract? ❑ Yes I I No , , , , , , , , , , X 6b If "Yes" to 6b, file Form 8870 7a At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction ? ❑ Yes a No , 7b b If "Yes ," did the foundation receive any proceeds or have any net income attributable to the transaction? SMM Information About Officers, Directors , Trustees, Foundation Managers, Highly Paid Employees, = and Contractors T List an officers, afrectors, trustees, tounaation mana gets ana tnefr coin ensauon (see (c) Compensation (b) Title, and average a Name and address () I F not paid , enter hours per week -0-) devoted to position ------------------------------------ATTACHMENT 6 a e LL of the mstructlons . (d) contnbutrona to (e) Expense account, employee benefit plans other allowances and deferred oom ensaoon 0. 0. 0 ------------------------------------------------------------------------------------------------------------2 compensation of five highest-paid employees (other than those included on line 7 - see page 23 of the instructions). If none. enter "NONE" (a) Name and address of each employee paid more than $50,000 b Title , and avers a ( ) per week 9 devoted position Po ( c) Compensation (d) Contributions to employee benefit plans and deferred comp ensation ( a) Expense account, other allowances NONE ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Total number of other employees paid over $50,000 .^ Form 990-PF (2010) JSA OE 1460 1 000 SM7617 1301 V 10-7.2 732532 PAGE 6 Form 990-PF (2010) 23-2903172 Information About Officers , Directors , Trustees , Foundation Managers , Highly Paid Employees, Page 7 and Contractors (continued) Five nt nest- ata inae p enaent contractors Tor s rotesslonai services see p a ^ e 2a of the instructions ) . IT none , enter ° NUNt. " (a) Name and address of each person paid more than $50 , 000 (b ) Type of service (c) Compensation NONE --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------. ^ Total number of others receivin g over $50,000 for p rofessional services NONE Summary of Direct Charitable Activities List the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc 1 I Expenses N/A ----------------------------------------------------------------------------------------------------------------------------------------------------- ----- --- ----- -- ---- - - -- - -- -- -- -- - -- - --- -- -- -- - - -- - - -- - - - - - -- - - ---------------------- ------------- ----- - - -- -- - - - - - - - -- - - -- - - - - --- -- - --- - - ------- ------------------ -------------- 4 ----------------------------------------------------------------------------------------------------------------------------------------------------- Summa of Pro g ram-Related Investments ( see pag e 24 of the instructions) Amount Describe the two largest program- related investments made by the foundation during the tax year on lines 1 and 2 I NONE ----------------------------------------------------------------------------------------------------------------------------------------------------- 2 ----------------------------------------------------------------------------------------------------------------------------------------------------- All other program-related investments See page 24 of the instructions 3 NONE ----------------------------------------------------------------------------------------------------------------------------------------------------- Total. Add lines 1 throu g h 3 ^ Form 990-PF (2010) JSA OE1465 1 000 SM7617 1301 V 10-7.2 732532 PAGE 7 Form 990-PF (2010) 23-2903172 Page 8 Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see page 24 of the instructions.) Fair market value of assets not used (or held for use) directly in carrying out chantable, etc , I purposes: 2 3 4 5 6 I 2a b c 3 4 5 6 7 Average monthly fair market value of securities ,,, , , , , , , , , , , , , , , , , , , , , , , , , , , , , Ia lb Average of monthly cash balances , , , , , , , , , , , , , , , , , , , , , , , , , , , Ic Fair market value of all other assets (see page 25 of the instructions) , , , , , , , , , , , , , , , , Id Total (add lines 1 a, b, and c) , , , , , , , , , , , , , , , , , , , , , , , Reduction claimed for blockage or other factors reported on lines 1 a and le . ...... 1c (attach detailed explanation ) 2 Acquisition indebtedness applicable to line 1 assets 3 Subtract line 2 from line ld . . ... ..... .... ............... .ater .amount, see page 25 of Cash deemed held for chantable activities. Enter 1 1/2 % of line 3 (for gre. 4 the instructions) 5 Net value of noncharitable -use assets . Subtract line 4 from line 3. Enter here and on Part V, line 4 6 Minimum investment return . Enter 5% of line 5 Distributable Amount (see page 25 of the instructions ) ( Section 49420 )( 3) and (I)(5) private operating foundations and certain foreign organizations check here ^ [] and do not complete this part.) . a b c d e ........... .. 1 Minimum investment return from Part X, line 6 ........... .. 69. .' .,, 2a Tax on investment income for 2010 from Part VI, line 5 2b Income tax for 2010 (This does not include the tax from Part VI) 2c Add lines 2a and 2b ... .............. . .... 3 Distributable amount before adjustments Subtract line 2c from line 1 4 , , , , , ,,, , , ,, ,, , , , ,,, , , Recoveries of amounts treated as qualifying distributions 5 Add lines 3 and 4 ..... . .. ........ . 6 Deduction from distributable amount (see page 25 of the instructions) Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, ..................................... .. 1 7 1,081,457. 0. 1, 081, 457. 0. 1,081,457. 16,222. 1,065,235. 53,262. 53,262. 69. 53,193. 53,193. 53,193. Qualifying Distributions (see page 25 of the instructions) 1 a b 2 3 a b Amounts paid (including administrative expenses) to accomplish chantable, etc , purposes Expenses , contributions, gifts, etc - total from Part I, column (d), line 26 , , , , , , , , , , , , , Program-related investments - total from Part IX-B Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, purposes Amounts set aside for specific charitable projects that satisfy the ,,,, , , , , , , , , , , , , , , , , , , , , Suitability test (prior IRS approval required) , , , , , , , , , , , , , , , , , , , , , , , Cash distribution test (attach the required schedule) , , , , .Ia 1b etc., 2 , , , 0. 0. 0. 4 Qualifying distributions . Add lines 1a through 3b Enter here and on Part V, line 8, and Part XIII, line 4 5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income. 5 69. , , , , , , , , , , , , , , , ,,, , , Enter 1% of Part I, line 27b (see page 26 of the instructions) 6 53,431. Adjusted qualifying distributions . Subtract line 5 from line 4 , , , , , , , , , , , , , , , , , , , , Note : The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for the section 4940(e) reduction of tax in those years 6 , , , 3a 3b 53, 500 . 0. 4 53,500. Form 990-PF (2010) JSA OE1470 1 000 SM7617 1301 V 10-7.2 732532 PAGE 8 Page9 23-2903172 Form 990-PF Income (see page 1 Distributable amount for 2010 (a) Corpus Part XI, from (b) Years prior to 2009 (d) 2010 (c) 2009 53, 193. line 7 .................... Undistributed income , if any , as of the end of 2010 2 Enter amount for 2009 only a b Total for prior years 20 07 0 8 .20 . .20 06 Excess distributions carryover , if any, to 2010 5, 839. From 2005 3 a b From 2006 4,853. From 2007 6,477. d From 2008 5, 659. c e From 2009 {'r _ - 6, 639. ...... Total of lines 3a through e If _ :. .... ;_ _ _ 29,467 . • , , , , , • , • • • Qualifying distributions for 2010 from Part XII , 4 line4 ^ $ a Applied to 2009 , but not more than line 2a b _ 53,500. ;. • , Applied to undistributed income of prior years (Election required - see page 26 of the Instructions ) . . . . . _ c Treated as distributions out of corpus (Election required - see page 26 of the instructions) , . d Applied to 2010 distributable amount e 5 3 07 • - = : `I -- - - =- 7 -•- - _ - _ 9 instructions ) ................ . Excess distributions carryover to 2011 . 10 Analysts of line 9 _ . " ' i. V . il - --_ =; - T' _ -- - _ n ' 5,839 . - - - 23,935. Subtract lines 7 and 8 from line 6a Excess from 2006 ;}- -- Excess distributions carryover from 2005 not applied on line 5 or line 7 ( see page 27 of the a = _ - instructions) 8 _ - Taxable Subtract line 6c from line 6b amount - see page 27 of the instructions e Undistributed income for 2009 Subtract line 4a from line 2a Taxable amount - see page 27 of the instructions . . . . . . . . . . . . Undistributed income for 2010 Subtract lines 4d and 5 from line 1 This amount must be distributed in 2011 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b )( 1)(F) or 4942 ( g)(3) (see page 27 of the AF _ d f = 29, 774 • a Corpus Add lines 3f , 4c , and 4e Subtract line 5 Subtract income b Prior years' undistributed line 4b from line 2b c Enter the amount of prior years' undistributed _. income for which a notice of deficiency has been issued , or on which the section 4942 ( a) tax has been previously assessed . . . . . . . . . . . =,• 53,193. r ` , , , Remaining amount distributed out of corpus Excess distributions carryover applied to 2010 (If an amount appears in column (d), the same amount must be shown in column (a)) Enter the net total of each column as indicated below 6 :, 4,853. b Excess from 2007 6,477. c Excess from 2008 . . 5,659. d Excess from 2009 . , . e Excess from 2010 . . . 6,639. 307. - _ _• _ _ _ --- =_ _ - "- . _-- - --_ - _-_ Form 990-PF (2010) JSA OE1480 1000 SM7617 1301 V 10-7.2 732532 PAGE 9 Form 990-PF (2010) 23-290317 2 Page 10 UT&WA Private O peratin g Foundations see p a g e 27 of the instructions and Part VII-A, question 9) I a If the foundation has received a ruling or determination letter that it is a private operating foundation , and the ruling is effective for 2010, enter the date of the ruling b 2a . . . . . . . . . , ^ Check box to indicate whether the foundation is a private operating foundation described in section Enter the lesser of the adjusted net income from Part or the minimum Investment return from Part X for each year listed . . . . b 85% of line 2a C Qualifying distributions from Part d Amounts included in line 2c not used directly for active conduct 49420)(3) or 49420)(5) Prior 3 years Tax year ( a) 2010 NOT APPLICABLE (e) Total (b) 2009 (c) 2008 ( d) 2007 , . . . . XII, line 4 for each year fisted of exempt activities . e . . . . Ouahfymg distributions made directly for active conduct of exempt activities Subtract line 2d from line 2c , . , , 3 Complete 3a, b, or c for the alternative test relied upon a 'Assets' alternative test - enter b Value of alt assets . Value of assets qualifying under section 4942(I)(3)(B)(i) . . . -Endowment altemative test(1) (2) enter 213 of minimum invest- ment return shown in Part X. line 6 for each year listed C . . 'Supportalternative test - enter (1) Total support other than gross investment income (interest dividends, rents, payments on securities bans ( section 512(a)(5)), or royalties) (2) from general support public and 5 or more exempt organizations as provided in section 4942 (I)(3)(B)(,u) . . . . . . (3) Largest amount from an port organization of supexempt (4) Gross investment income Supplementary Information (Complete this part only if the foundation had $5,000 at any time during the year - see page 28 of the instructions.) 1 a or more in assets Information Regarding Foundation Managers: List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any tax year (but only if they have contributed more than $5,000) (See section 507(d)(2) ) N/A b List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or other entity) of which the foundation has a 10% or greater interest. N/A Information Regarding Contribution , Grant, Gift, Loan, Scholarship, etc., Programs: 2 Check here ^ ❑ if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds If the foundation makes gifts , grants , etc. (see page 28 of the instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d The name, address, and telephone number of the person to whom applications should be addressed N/A b The form in which applications should be submitted and information and materials they should include a N/A c Any submission deadlines. N/A d Any restrictions factors- or limitations on awards , such as by geographical areas, charitable fields , kinds of institutions, or other N/A ' 17000 OE1490 Form 990-PF (2010) SM7617 1301 V 10-7.2 732532 PAGE 10 Form 9so-PF (201 o) OrmM. Supplementary Information (continued) 3 23-290317 2 Page 11 Grants and Contributions Paid During the Year or Approved for Future Payment Recipient Name and address (home or business) a Paid during the year ATTACHMENT If recipient is an individual , chow any relationship to any foundation manager or substantial contributor Foundation s t at of recipient u Purpose of grant or Contnbubon Am ou nt 7 Total ................................................ ^ 3a b Approved for future payment 53,500. 3b I Total Form 990-PF (2oio) JSA 001491 1 000 SM7617 1301 V 10-7.2 732532 PAGE 11 Form 990-PF (2010) 23-290317 2 Unrela ted business income Enter gross amounts unless otherwise indicated (a) Bvs ne s toes 1 Program service revenue Excluded by section 512 , 513 , or 514 (C) (d ) E.wswn code Amount (b) Amount Page 12 e R e l a t e d of exempt (function income of thse instructions a b c d e f g Fees and contracts from government agencies 2 Membership dues and assessments , , , , 14 3 Interest on savings and temporary cash investments ' 262. 4 Dividends and interest from securities ,•r 5 Net rental income or (loss) from real estate . ' a Debt-financed property . . . . . . . . , b Not debt-financed property , , , , , , , t 6 Net rental income or (loss) from personal property 7 Other investment income 18 8 Gain or (loss) from sales of assets other than inventory 9 Net income or (loss) from special events 219. , , 10 Gross profit or (loss) from sales of inventory 11 Other revenue a b c d e 12 Subtotal Add columns ( b), (d), and ( e) , , , 4 81 . _ 13 Total . Add line 12 , columns (b), (d), and (e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 (See worksheet in line 13 instructions on page 29 to vent' calcula tions ) 481. Relationship of Activities to the Accomplishment of Exempt Purposes Line No. . Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the accomplishment of the foundation 's exempt purposes (other than by providing funds for such purposes ). ( See page 29 of the instructions.) NOT APPLICABLE 1 Form 990-PF (2010) JSA 0E1492 1 000 SM7617 1301 V 10-7.2 732532 PAGE 12 Form 990-PF (2010) 23-2903172 Page 13 Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations Did the organization in section 501(c) directly engage in any of the following or indirectly of the Code (other than section 501(c)(3) organizations) with any other organization or in section 527, relating described Yes No to political organizations? a = Transfers from the reporting foundation to a nonchantable exempt organization of _ (1) Cash ........................................ ................. (2) Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Other transactions (1) Sales of assets to a nonchantable exempt organization . . . . . . .. . . . . . . . . . . . . . . . . . . . . . (2) Purchases of assets from a nonchantable exempt organization (3) Rental of facilities, equipment, or other assets . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . (4) Reimbursement arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (6) Performance of services or membership or fundraising solicitations c answer to value of the Is the 2a any of the goods, foundation other directly above is "Yes," complete assets, or services given or indirectly affiliated the by the with, or X lb ( i ) X 1b ( 2 ) X 1 b ( 3) X 1b (4) X 1b ( S ) . . . . . . . . . . . . . . . . . . . . . . . . . following reporting related to , schedule Column foundation If the one or more (b) should foundation tax-exempt always X X 1c show the received less than X fair market fair market organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 5277 , , , , , , , , , , , , , , , , , , , h X la(2) .. . . . . . . . . . . . . . . . . . . . . . . . . . . 1b 6 Sharing of facilities, equipment, mailing lists, other assets, or paid employees d If the 1a1 ❑ Yes © No If "Yps " rmmnleta tha fnllnwinn srhpriula ( b) Type of organization (a) Name of organ ization Sign (c) Description of relationship Under penalties of pequry , I ded re that I have examined this return , including accompanying schedules and statements , and to the best of my knowledge and rid co I e DedaraUon of preparer ( other than taxpayer or fiduciary is b sed on all information of which preparer has any knowledge belief. Il Here Signature of officer or trustee Preparer 's signal PnntlType preparers name Paid n rPr r Firm's name Use Only L C ^ KPMG LLP Finn's address )o.1601 MARKET STREET PHILADELPHIA, PA JSA 0E1493 1 000 SM7617 1301 V 1 THE NEW MILLENNIUM CHARITABLE FOUNDATION 23-2903172 ATTACHMENT FORM 990PF, PART I - INTEREST ON TEMPORARY CASH INVESTMENTS REVENUE AND EXPENSES PER BOOKS DESCRIPTION 1 GOLDMAN SACHS INTEREST INCOME JP MORGAN INTEREST INCOME TOTAL NET INVESTMENT INCOME 241. 21. 241. 21. 262. 262. ATTACHMENT SM7617 1301 V 10-7.2 732532 PAGE 15 1 THE NEW MILLENNIUM CHARITABLE 23-2903172 FOUNDATION ATTACHMENT 2 FORM 990PF, PART I - DIVIDENDS AND INTEREST FROM SECURITIES REVENUE AND EXPENSES PER BOOKS DESCRIPTION DIVIDEND INCOME - JP MORGAN TOTAL NET INVESTMENT INCOME 6,442. 6,442. 6,442. 6,442. ATTACHMENT 2 SM7617 1301 V 10-7.2 732532 PAGE 16 THE NEW MILLENNIUM CHARITABLE FOUNDATION 23-2903172 ATTACHMENT 3 FORM 990PF, PART I - ACCOUNTING FEES REVENUE AND EXPENSES PER BOOKS DESCRIPTION NET INVESTMENT INCOME ADJUSTED NET INCOME CHARITABLE PURPOSES 8,700. ACCOUNTING FEES TOTALS 8,700. 0. 0 . 0. ATTACHMENT SM7617 1301 V 10-7.2 732532 PAGE 17 3 THE NEW MILLENNIUM CHARITABLE 23-2903172 FOUNDATION ATTACHMENT FORM 990PF, PART I 4 - OTHER EXPENSES REVENUE AND EXPENSES PER BOOKS DESCRIPTION BANKING FEES - TD BANK TOTALS NET INVESTMENT INCOME 10. 10. 10. 10. ATTACHMENT SM7617 1301 V 10-7.2 732532 PAGE 18 4 THE NEW MILLENNIUM CHARITABLE 23-2903172 FOUNDATION ATTACHMENT 5 FORM 990PF , PART II - CORPORATE STOCK ENDING BOOK VALUE DESCRIPTION JP MORGAN EQUITY INVESTMENTS TOTALS ENDING FMV 578,208. 639,684. 578,208. 639,684. ATTACHMENT 5 SM7617 1301 V 10-7.2 732532 PAGE 19 THE NEW MILLENNIUM CHARITABLE FORM 990PF, PART VIII - 23-2903172 FOUNDATION LIST OF OFFICERS, DIRECTORS, AND TRUSTEES ATTACHMENT CONTRIBUTIONS TITLE AND AVERAGE HOURS NAME AND ADDRESS PAUL ROSENBERG 650 NE 5TH AVE BOCA RATON, FL 33432 WEEK DEVOTED TO PRES., PER POSITION TO COMPENSATION SEC GRAND TOTALS EMPLOYEE BENEFIT 6 EXPENSE ACCT AND OTHER PLANS ALLOWANCES 0. 0. 0. 0. 0. 0. ATTACHMENT SM7617 1301 V 10-7.2 732532 PAGE 20 6 23-2903172 THE NEW MILLENNIUM CHARITABLE FOUNDATION ATTAf IMRNT 7 RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR AND VARIETY CLUB 1520 LOCUST STREET, PHILADELPHIA, PA PURPOSE OF GRANT OR CONTRIBUTION FOUNDATION STATUS OF RECIPIENT RECIPIENT NAME AND ADDRESS AMOUNT N/A SERVE DISABLED CHILDREN 33,500. N/A MENTOR & EDUCATE HIGH RISK YOUNG WOMEN 10,000. N/A SUPPORT JEWISH COMMUNITY 2,500. N/A RESEARCH, 2,500. 9TH FLOOR 19102 WOMEN OF TOMORROW 15000 SW 27TH STREET MIRAMAR, FL 33027 JEWISH FEDERATION OF GREATER PHILADELPHIA 2100 ARCH STREET PHILADELPHIA, PA 19103 EAR RESEARCH FOUNDATION 1901 SARASOTA, S AND TREATMENT OF HEARING FL 34239 NATIONAL MUSEUM OF AMERICAN JEWISH 101 EDUCATION, LOSS FLOYD STREET HISTORY 5,000 SUPPORT JEWISH COMMUNITY N/A INDEPENDENCE MALL EAST PHILADELPHIA, PA 19106-2517 TOTAL CONTRIBUTIONS 57,5(10_ PAID ATTACHMENT 7 SM7617 1301 V 10-1.2 732532 PAGE 21 23-2903172 THE NEW MILLENNIUM CHARITABLE FOUNDATION FORM 990-PF PART IV CAPITAL GAINS AND LOSSES FOR TAX ON INVESTMENT INCOME Description Kind of Property Gross sa l e price less ex pe nses of sa l e D epreciation allowed / 3,400. TOTAL GAIN (LOSS) Cost or other FMV as of Adj. basis as of Excess of FMV over ad i ba s i s JPMORGAN ACCESS BALANCED FUND 3,181. Date acquired G ain or ( l o ss) 12/10/2010 219. Date sold 12/13/2010 219. ....... ........................................ .iSA 0E1730 1 000 SM7617 1301 V 10-7.2 732532 PAGE 14 Fonn 8868 (Rev January 2011) Application for Extension of Time To File an Exempt Organization Return Department of the Treasury Internal Revenue Service ^ File a OMB No 1545-1709 fo r eac h retu rn. • 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 Il (on page 2 of this form). Do not complete Part 11 unlesou have already been granted an automatic 3-month extension on a previously filed Form 8868. Electronic filing (e-file) You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation required to file Form 990-T), or an additional ( not automatic ) 3-month extension of time You can electronically file Form 8868 to request an extension of time to file any of the forms listed in Part I or Part 11 with the exception of Form 8870 , Information Return for Transfers Associated With Certain Personal Benefit Contracts , which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form , visit www irs.gov/efile and click on a-file for Chanties & Nonprofits. fURIF Automatic 3-Month Extension of Time . Only submit original ( no copies needed). A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete Part Ionly All other corporations (including 1120-C filers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of time to file income tax returns Type or J Name of exempt organization Employer Identification number THE NEW MILLENNIUM CHARITABLE FOUNDATION print File by the due date for fi ling your return See instructions ❑ Number , street, and room or suite no If a P O box , see instructions 23-2903172 C/O BALLARD SPAHR ANDREWS & INGERSOLL 1735 MARKET STREET City, town or post office , state, and ZIP code For a foreign address , see instructions PHILADELPHIA, PA 19103-7599 Enter the Return code for the return that this application is for (file a separate application for each return) Application Is For Form 990 Form 990-BL Form 990-EZ Form 990-PF Form 990-T sec 401 a or 408 ( a ) trust) Form 990-T trust other than above) • The books are in the care of ^ Return Code 01 02 03 04 05 06 , , , , , , , , , , , Application Is For Form 990-T (co rporation) Form 1041-A Form 4720 Form 5227 Form 6069 Form 8870 01 9 Return Code 07 08 09 10 11 12 PAUL ROSENBERG 215 990-4244 FAX No ^ Telephone No ^ • If the organization does not have an office or place of business in the United States, check this box , , , , , , , , , , , , , , , ^ ❑ . If this is • If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) ^ and attach for the whole group, check this box , , , , , , ^ ❑ . If it is for part of the group, check this box a list with the names and EINs of all members the extension is for I request an automatic 3- month (6 months for a corporation required to file Form 990-T) extension of time 1 until 08 / 15 , 20 11 , to file the exempt organization return for the organization named above The extension is for the organization 's return for or ^ 1771 X calendar year 20 10 , 20 , and ending tax year beginning , 20 ^ 2 If the tax year entered in line 1 is for less than 12 months, check reason❑ Change in accounting period ❑ Initial return ❑ Final return If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any 391. nonrefundable credits. See instructions 3a $ b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and 391. estimated tax payments made Include any prior year overpayment allowed as a credit. 3b $ c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS NONE (Electronic Federal Tax Payment System) See instructions 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. 3a Form 8868 ( Rev. 1-2011) For Paperwork Reduction Act Notice , see Instructions . JSA 0F8054 4 000 V 10-6.1 732532 PAGE 1