Académique Documents
Professionnel Documents
Culture Documents
G Check all that apply: X Initial return Initial Return of a former public charity Final return
Amended return Address change Name change
A Employer Identification number
1aN/A
b
c
d
e
(e) Gross sales price (f) Depreciation allowed (g) Cost or other basis (h) Gain or (loss)
(or allowable) plus expense of sale (e) plus (f) minus (g)
a
b
C
d
e
Com p lete only for assets showin g g ain in column Ch) and owned by the foundati n on 12/31 /69 (I) Gains (Column (h)
(I) Fair Market Value Q) Adjusted basis (k) E cess of column (i) gain minus column (k), but not less
as of 12/31/69 as of 12/31/69 over olumn 0), if any than -0-) or Losses (from column (h))
a
b
c
d
e
2 Capital gain net income or (net capital loss). If gain, also nter in Part I, line 7
If (loss), er(er -0- in Part I, line 7 } 2
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 the instructions). If (loss), enter -0-
in Part I, line 8 3
PatiV. I 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) N/A
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the /ba period? Yes r] No
If 'Yes,' the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see the instructions before makinb any entries.
(a) (b) (c) (d)
Base period years Adjusted qualifying distributions Net value of Distribution ratio
Calendar year (or tax year noncharitable-use ssets (column (b) divided by column (c))
beginning in)
2009
2008
2007
2006
2005
4 Enter the net value of noncharitable-use assets for 2010 from Part X, line 5 4
8 Enter qualifying distributions from Part XII, line 4 ........ . .. ' . .. ... 8
If line 8 is equal to or greater than line 7, check the box in Part VI, line I b, and complete that part using a I% tax rate. See the
Part VI instructions.
BAA Form 990-PF (2010)
TEEA0303L 07/23/10
Form 990-PF 2010 Heavenl y Father's Foundation 27-6987913 Pa g e 4
J,Pa,rt Vt;',. Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see the instructions
1 a Exempt operating foundations described in section 4940(d)(2), check here..... " and enter 'N/A' on line 1.
Date of ruling or determination letter. (attach copy of letter if necessary - see instr.)
b Domestic foundations that meet the section 4940(e) requirements in Part V, 1 1.
check here. " s and enter I% of Part I, line 27b
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, column (b) ..
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable
foundations only. Others enter -0•) .. . .. 2 0.
3 Add lines 1 and 2 3 1.
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0.
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- 5 1
6 Credits/Payments:
a 2010 estimated tax pmts and 2009 overpayment credited to 2010 . .. 6a
b Exempt foreign organizations - tax withheld at source .. 6b
c Tax paid with application for extension of time to file (Form 8868) 6c
d Backup withholding erroneously withheld . .. 6d 23 . «;
7 Total credits and payments. Add lines 6a through 6d . . 7 23.
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached . . 8
9 Tax due . If the total of lines 5 and 8 is more than line 7, enter amount owed .. . ^ 9 0
10 Overpayment . If line 7 is more than the total of lines 5 and 8, enter the amount overpaid . 10 22
11 Enter the amount of line 10 to be: Credited to 2011 estimated tax 22. j Refunded 11 0.
Par'tV1LA' Statements Reardin Activities
Yes No
1 a D uring th e t ax year, d i d th e f oun datio n a tt emp t t o i nfluence an y national , state , or local le g islation or did it
participate or intervene in any political campaign? la X
b Did it spend more than $100 during the year (either directly or indirectly) for political purposes
(see the instructions for definition). .. 1b X ,
If the answer is 'Yes' to la or 1b, attach a detailed description of the activities and copies of any materials published
or distributed by the foundation in connection with the activities
c Did the foundation file Form 1120 -POL for this year? lc X
d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. . $ 0. (2) On foundation managers... . $ 0.
e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on
foundation managers $ 0.
2 Has the foundation engaged in any activities that have not previously been reported to the IRS? 2 X
If 'Yes,' attach a detailed description of the activities
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 3 X
4a Did the foundation have unrelated business gross income of $1,000 or more during the year? . . 4a X
b If 'Yes,' has it filed a tax return on Form 990 -T for this year? . .. 4b N IA
5 Was there a liquidation , termination , dissolution, or substantial contraction during the year? . . 5 X
If 'Yes, 'attach the statement required by General Instruction T
6 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 conflict
--
with the state law remain in the governing instrument? ... .. 6 X
7 Did the foundation have at least $5,000 in assets at any time during the year? If 'Yes,' complete Part Il, column (c), and Part XV 7 X
8a Enter the states to which the foundation reports or with which it is registered (see the instructions) .
TX
b If the answer is 'Yes' to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General
(or designate) of each state as required by General Instruction G? If 'No,' attach explanation .. 8b X
9 Is the foundation claiming status as a private operating foundation within the meaning of section 49420)(3) or 49420)(5) » "% '$•••>» »••'
for calendar year 2010 or the taxable year beginning in 2010 (see instructions for Part XIV)? If 'Yes,' complete Part XIV. 9 X
10 Did any persons become substantial contributors during the tax year? If 'Yes,' attach a schedule listin g their names
and addresses See Statement 2 10 X
BAA Form 990•PF (2010)
TEEA0304L 02/16/11
Form 990-PF 2010 Heavenl y Father's Foundation 27-6987913 Pag e 5
Fart 1I-A Statements Reaardina Activities (Continued)
11 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 instructions)... . .. 11 X
12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract before
August 17 , 2008? . .. 12 X
13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application ?.. . 13 X
Website address .. P- N/A
-----------------------------------------
14 The books are in care of - Staci_Wilks ____- -- -------------- Telephone no . ^ 254-631-4727
Located at ^ 425C ounty_Road 168 -Cisco_TX_____________- 76437 __o - - - _____
15 Section 4947 (a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here N/A El
and enter the amount of tax-exempt interest received or accrued during the year 15 N/A
Yes No
16 At any time during calendar year 2010, did the foundation have an interest in or a signature or other authority over a
bank , securities , or other financial account in a foreign country? 16 X
See the instructions for exceptions and filing requirements for Form TD F 90.22.1. If 'Yes,' enter the name of the
foreign country ^
Part VU-0 Statements Re g ardin g Activities for Which Form 4720 May Be Re q uired
File Form 4720 if any item is checked in the 'es' column, unless an exception applies. Yes No
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? . I Yes E] No
(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from) a
disqualified person? Yes X No
(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? Yes X flo
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? . . . . Yes X No
(5) Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a dis q ualified p erson)? ... . . . Yes E]flo
(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 period after termination
o f governmen t service, i f t ermina t ing wi th in 90 da ys.) . . . . El Yes XJ No
b If any answer is 'Yes' to la(1)-(6), did any of the acts fail to qualify under the exceptions described in
Regulations section 53.4941 (d)-3 or in a current notice regarding disaster assistance (see the instructions)? lb N A
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 1 a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 20 10? .. .. .. ic
2 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()(5)):
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? . .. . E ]Yes No
If 'Yes,' list the years 01 20 , 20 , 20 , 20
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 'No' and attach statement - see the instructions.) . . . 2b N VA
c If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
r_
20 20 20 20
3a Did the foundation hold more than a 2% direct or indirect interest in any business
e nte rp ris e at a n y t i m e d uri n g th e y ear? . . Yes X7 No •:
b If 'Yes,' did it have excess business holdings in 2010 as a result of (1) any purchase by the foundation
or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
b y th e C ommissioner un d er sec t ion 4943 (c)( 7 )) t o d ispose o f h o ld en s acquire d b y gi ft or b eques t ; or
( 3) th e l apse o f th e 10 -, 15 -, or 20 -year f i r s t p has e h o ld i n g p eriod? ( Use Schedule C, Form 4720, t o
determine if the foundation had excess business holdings in 2010). . 3b N IA
4a Did the foundation invest during the year any amount in a manner that would jeopardize its
charitable purposes? . 4a X
b Did the foundation make any investment in a prior year (but after December 31, 1969) that could
jeopardize its charitable purpose that had not been removed from jeopardy before the first day of
the tax year be g innin g in 2010? 4b X
BAA Form 990-PF (2010)
TEEA0305L 02/16/11
Form 990PF 2010 Heavenl y Father's Foundation 27-6987913 Page 6
rtA P R] Statements Re g ardin g Activities for Which Form 4720 May 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))? . . Yes Q No
(2) Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?.... .. Yes X No
(3) Provide a grant to an individual for travel, study, or other similar purposes? . . Yes X No
(4) Provide a grant to an organization other than a charitable, etc, organization described
in sec t ion 509 (a)( 1 ), (2 ), or ( 3 ), or sec t ion 4940 ( d )( 2 ) ? (see ins t ruc t ions) . • 11 Y es E]N o
(5) Provide for any purpose other than religious, charitable, scientific, literary, or
e d uca t iona l purposes, or f or th e preven t ion o f crue lty t o c h i ld ren or anima l s ? .. 11 Y es XQ po
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 instructions)? 5b N A
Organizations relying on a current notice regarding disaster assistance check here ... .
c 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? . . N/A. J Yes F] No S
If 'Yes, ' attach the statement required by Regulations section 53 4945-5(d)
6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums
on a persona l b ene f it con t ract? . 11 Yes X J No
b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 6b X
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 N !q0
b If es, did the foundation receive any proceeds or have any net income attributable to the transaction? ..N/A 7b
PattV It Information About Officers, Directors, Trustees , Foundation Managers , Highly Paid Employees,
and Contractors
1 List all officers - directors - trustees- foundation managers and their compensation (see instructions)-
(b) Title and average (c) Compensation (d) Contributions to (e) Expense account,
(a) Name and address hours per week (If not paid , enter -0-) employee benefit other allowances
devoted to position plans and deferred
com p ensation
_Dan_H._Wilks----- _ j______ Trustee 0. 0. 0.
425 County Road 168 4.00
Cisco TX 76437
Staci Wi1ks_
_ Trustee. 0. 0. 0.
425 County Road 168 4.00
Cisco TX 76437
------------------------
-------------------------
Z Compensation of five hiahest-Daid emclovees (other than those included on line 1- see instructions). If none- enter 'NONE.'
(a) Name and address of each employee (b) Title and average (c) Compensation (d) Contributions to (e) Expense account,
paid more than $50,000 hours per week employee benefit other allowances
devoted to position plans and deferred
com p ensation
None
------------------------
------------------------
------------------------
------------------------
------------------------
(a) Name and address of each p erson p aid more than $50,000 (b) Typ e of service c Com p ensation
None
---------------------------
------------------------------ -------
------------------------------ -------
----------------------------- --
N 1A
--------------------- - - - L - - - - - - - - - - - - - - - --------------
----------------------- ------------------------------
2 -----------------------
-------------------------
---------------------------- -------------------------
-----
All other program-related investments . See instructions.
3 --------------------------
---------------------------
--------------------------
TEEA0307L 02/16/11
Form 990-PF (2010) Heavenly Father's Foundation 27-6987 913 Page 8
[Eim-rt ]Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
see instructions.)
1 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc, purposes: r }"
a Average monthly fair market value of securities . .. .... 1a
b Average of monthly cash balances 1b 9 , 178.
c Fair market value of all other assets (see instructions ) . .. 1c
dTotal (add lines 1a, b, and c) 1d 9,178. .
e Reduction claimed for blockage or other factors reported on lines la and tc
(attach detailed explanation) 1e 0.
2 Acquisition indebtedness applicable to line 1 assets .... 2 0.
3 Subtract line 2 from line 1d 3 9 , 178.
3 Amounts set aside for specific charitable projects that satisfy the:
a Suitability test (prior IRS approval required) ........ 3a
b Cash distribution test (attach the required schedule ) ..... . . . ...... ..... 3b
4 Qualifying distributions . Add lines 1 a through 3b. Enter here and on Part V, line 8, and Part XII I, line 4 4 0.
5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment income.
Enter 1% of Part I, line 27b (see instructions). 5
6 Adjusted qualifying distributions . Subtract line 5 from line 4 ... 6 0.
Note . The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether t he foundation
qualifies for the section 4940(e) reduction of tax in those years.
BAA Form 990-PF (2010)
TEEA0308L 07/06/09
Form 990-PF (2010) Heavenly Father's Foundation 27-6987913 Page 9
TEEA0309L 07/23/10
Form 990-PF 201o Heavenl y Father's Foundation 27-6987913 10
P tkXJ Private O p eratin g Foundations (see instructions and Part VII-A q uestion 9) /A
1 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 Check box to indicate whether the foundation is a private operating foundation described in section 4942 or 49420) (5)
2a Enter the lesser of the adjusted net Tax year Prior 3 years
income from Part I or the minimum (a) 2010 (b) 2009 (c) 2008 d 2007 (e) Total
investment return from Part X for
each year listed . .
b 85% of line 2a
c Qualifying distributions from Part XII,
line 4 for each year listed .
d Amounts included in line 2c not used directly
for active conduct of exempt activities
e Qualifying distributions made directly
for active conduct of exem p t activities.
Subtract line 2d from line 2c .
3 Complete 3a, b, or c for the
alternative test relied upon:
a 'Assets ' alternative test - enter:
(1) Value of all assets .
(2) Value of assets quali ing under
section 49420)(3)(B)(^
b 'Endowment ' alternative test - enter 2/3 of
minimum investment return shown in Part X,
line 6 for each year listed
c 'Support ' alternative test - enter:
(1) Total support other than gross
investment income (interest,
dividends , rents , payments
on securities loans (section
512(a)(5)), or royalties) .. ......
(2) Support from general public and 5 or
more exempt organizations as provided
in section 4942(I)(3)(B)(nQ.. .......
(3) Largest amount of support from
an exempt organization
(4) Gross investment income
PartXV I Supplementary Information (Complete this part only if the organization had $5 , 000 or more in
assets at any time during the year - see instru ctions.)
1 Information Regarding Foundation Managers:
a 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).)
See Statement 3,
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.
None ,.
iV /A
b The form in which applications should be sublrutted and information and materials they should include:
d Any restrictions or limitations on awards ,,uch as by geographical areas , charitable fields , kinds of institutions, or other factors:
Total 3bl
BAA TEEA0501L 07/23r1o Form 990-PF (2010)
Form990-PF (2010) Heavenly Father's Foundation 27-6987913 Page 12
d If the answer to any of the above is 'Yes,' complete the following schedule . Column (b) should always show the fair market value of
the g oods, other assets , or services given by the re p ortln foundation. If the foundation received less than fair market value in
an y transaction or sharin g arran g ement , show in column eld ) value of th e g oods, other assets, or services received.
(a) Line no. (b) Amount involved (c) Name of noncharitable exem p t organization d Descri p tion of transfers, transactions , and sharin g arran gements
N/A
2a Is the foundation directl y or indirectly affiliated with , or related to , one or more tax - exempt organizations
described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?. .. ... LI Yes No
b If 'Yes,' com p lete the followin g schedule.
(a) Name of organization (b) Type of organization (c) Description of relationship
A
Under penalties of perjury , I declare that I have examined this return, including accom an in schedules and statements and to the best of m knowled a and belief . it is true
correct , an complete Declaration of preparer (other than taxpayer or fiduciary) is b
Sign
Here N/
' Signature of officer or trustee
Pnntrrype preparer' s name Pre arer's signature
BAA
OMB No 1545 0047
Schedule B
(Form 990, 990-EZ, Schedule of Contributors
or 990-PF)
Department of the Treasury Attach to Form 990, 990-EZ, or 990-PF
2010
Internal R eve nu e Se rvi c e
Employer identification number
Name of the organization
General Rule
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one
bontributor. (Complete Parts I and II.)
Special Rules
For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33-1/3% support test of the regulations under sections
509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or
(2) 2% of the amount on (I) Form 990, Part VIII, line lh or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ, that received from any one contributor, during the year,
aggregate contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ, that received from any one contributor, during the year,
contributions for use exclusively for religious, charitable, etc, purposes, but these contributions did not aggregate to more than $1,000.
If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc,
purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively
religious, charitable, etc, contributions of $5,000 or more during the year . . . . .. 0-$
Caution : An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or
990-PF) but it must answer 'No' on Part IV, line 2 of their Form 990, or check the box on line H of Its Form 990-EZ, or on line 2 of its Form
990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990, Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
990EZ, or 990-PF.
TEEA0701L 12/28/10
Schedule B (Form 990, 990-EZ, or 990-PF (2010) Page 1 of 1 of Part I
Name of organization Employer identification number
2 Staci_Wi1ks________________4__---------- Person x
Payroll
425 County Road 168 __________-_____________ $- -- 3L350t000, Noncash
(Complete Part II if there
Ciscol_TX 76437 __________________________ is a noncash contribution.)
Person
----------- ------------------------
Payroll
$ Noncash
(Complete Part II if there
__ is a noncash contribution.)
----------- ------------------------
(a) (b) (c) (d)
Number Name, address, and ZIP + 4 Aggregate Type of contribution
contributions
Person
----------- ------------------------
Payroll
$ Noncash
(Complete Part II if there
is a noncash contribution )
-----------------
(a) (b) (c) (d)
Number Name , address, and ZIP + 4 Aggregate Type of contribution
contributions
Person
----------- --------------------------
Payroll
----------- -------------------------- $- ---------- Noncash
(Complete Part II if there
________ is a noncash contribution.)
----------- ------------------
(a) (b) (c) (d)
Number Name , address, and ZIP + 4 Aggregate Type of contribution
contributions
_ Person
----------- ------------------------
Payroll
$ Noncash
(Complete Part II if there
is a noncash contribution.)
------------ --------------------------
BAA TEEA0702L 10/26/10 Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Schedule B ( Form 990, 990-EZ, or 990-PF ) ( 2010 ) Pa g e 1 of 1 of Part II
Name of organization Employer identification number
N/A
TEEA0703L 10/26/10
Schedule B (Form 990, 990-EZ, or 990 of 1 of Part III
Name of organization Employer identification number
(e)
Transfer of gift
Transferee ' s name, address, and ZIP + 4 Relationship of transferor to transferee
(e)
Transfer of gift
Transferee' s name, address, and ZIP + 4 Relationship of transferor to transferee
(e)
Transfer of gift
Transferee ' s name, address , and ZIP + 4 Relationship of transferor to transferee
(e)
Transfer of gift
Transferee's name , address, and ZIP + 4 Relationship of transferor to transferee
Statement 1
Form 990 -PF, Part I, Line 23
Other Expenses
(a) (b) Net (c) (d)
Expenses Investment Adjusted Charitable
per Books Income Net Income Purposes
Bank service charge $ 10. $ 10. $ 10.
Total 10.
Statement 2
Form 990 -PF, Part VII-A, Line 10
Substantial Contributors During the Tax Year
Statement 3
Form 990-PF, Part XV, Line 1 a
Foundation Managers - 2% or More Contributors
Dan H. Wilks
Staci Wilks
Form 8868 (Rev 1.2011 Pa g e 2
• If you are filing for an Additional (Not Automatic) 3-Month Extension , complete only Part II and check this box . ^ X
Note . Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
• If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).
[^ir Additional (Not Automatic) 3-Month Extension of Time . Only file the original (no copies needed).
I Name of exempt organization I Employer Identification number
Type or
print Heavenly Father's Foundation 27-
I Number , street , and room or suite number If a P 0 box , see instructions
File by the
extended
due date for
Victor K. Munson, CPA
filing the 6060 N. Central Expwy to 560
return. See
instructions. City, town or post office , state , and ZIP code For a foreign address , see instructions
Dallas, TX 75206 ,
Enter the Return code for the return that this application is for (file a separate application for each return) .... ... . . 04 1
Enter the Return code for the return that this application is for (file a separate application for each return) . . . . F-0-F-4
2 If the tax year entered in line 1 is for less than 12 months, check reason: 0 Initial return ❑ Final return
❑ Change In accounting period
If this application is for Form 990-BL, 990-PF, 990-T, 4720, or , enter the tentative tax, less any
nonrefundable credits . See Instructions.
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. 3b $ 0
Balance due. Subtract line 3b from line 3a. Include your payment this form , if required , by using EFTPS
(Electronic Federal Tax Paym ent System). See instructions. I3c1$ 0
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.
For Paperwork Reduction Act Notice , see instructions . Cat. No . 27916D Form 8868 (Rev 1-2011)