Form
8868
Application for Extension of Time To File an
Exempt Organization Return
OMB No. 1545-1709
(Rev January 2011)
Department of the Treasury
Internal Revenue Service
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File a separate application for each return.
FIFZ0501 11/15/10
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If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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If you are filing for an Additional (Not Automatic) 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 8868.
Name of exempt organization
Employer identification number
Number, street, and room or suite number. If a P.O. box, see instructions.
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
Type or
print
File by the
due date for
filing your
return. See
instructions.
1
I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time
until
, 20
, to file the exempt organization return for the organization named above.
The extension is for the organization's return for:
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calendar year 20
or
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tax year beginning
, 20
, and ending
, 20
.
2
If the tax year entered in line 1 is for less than 12 months, check reason:
Initial return
Final return
Change in accounting period
3 a 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
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3 a
$
b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax
payments made. Include any prior year overpayment allowed as a credit
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 b
$
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using
EFTPS (Electronic Federal Tax Payment System). See instructions
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3 c
$
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.
BAA For Paperwork Reduction Act Notice, see Instructions.
Form 8868 (Rev. 1-2011)
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 II 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 e-file for Charities & Nonprofits.
Part I
Automatic 3-Month Extension of Time. Only submit original (no copies needed).
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A corporation 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.
Enter the Return code for the return that this application is for (file a separate application for each return)
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Application
Is For
Return
Code
Application
Is For
Return
Code
Form 990
01
Form 990-T (corporation)
07
Form 990-BL
02
Form 1041-A
08
Form 990-EZ
03
Form 4720
09
Form 990-PF
04
Form 5227
10
Form 990-T (section 401(a) or 408(a) trust)
05
Form 6069
11
Form 990-T (trust other than above)
06
Form 8870
12
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The books are in the care of
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Telephone No.
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FAX No.
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If the organization does not have an office or place of business in the United States, check this box
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If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
. If this is for the whole group,
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check this box
.
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. 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.
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MEDICAL TOURISM ASSOCIATION, INC
26-0753785
10130 NORTHLAKE BOULEVARD, #214-315
WEST PALM BEACH
FL
33412
01
MANAGEMENT
(561) 791-2000
Aug 15
11
X
10
0.
0.
0.