OFFICE OF THE NEW HAMPSHIRE ATTORNEY GENERAL 
 CHARITABLE TRUSTS UNIT 
  33 Capitol Street, Concord, NH 03301-6397 
 
                                      NHCT-4 
                                       
 APPLICATION FOR EXTENSION OF TIME TO FILE ANNUAL REPORT WITH 
 CHARITABLE TRUSTS UNIT 
 
This application for extension of time must be received on or before due date of annual filing 
in order to be accepted.  IRS form 8868 is not acceptable for this purpose. 
 
OFFICIAL NAME OF ORGANIZATION:___________________________________________ 
 
CURRENT ADDRESS:______________________________________________________ 
 
Is this a change of address?          YES______NO_______ 
 
 COMPLETE THE FOLLOWING 
 
 I REQUEST AN EXTENSION OF TIME UNTIL:___________________ 
 (only 1 request per report) 
 DATE OF FISCAL YEAR END:__________________________________ 
 REGISTRATION # OF CHARITY:_______________________________ 
 (obtain from mailing label) 
 REASON FOR EXTENSION:____________________________________
 ______________________________________________________________
 
ONLY ONE REQUEST GRANTED PER REPORT.  REQUEST MAXIMUM AMOUNT OF TIME 
REQUIRED, WHICH IS 6 MONTHS FROM DUE DATE.   
$75 ANNUAL FILING FEE MUST ACCOMPANY REQUEST. 
If you do not hear from this Unit WITHIN 21 DAYS you may assume that this request has been 
granted.  YOU WILL HEAR FROM THIS OFFICE ONLY IF THE REQUEST IS DENIED. 
 
Date:_______________________           By:_________________________
                                       Title:_____________________
                                       Phone:______________________
 
FAILURE TO FILE ANNUAL REPORTS WITH THE ATTORNEY GENERAL IN A 
TIMELY MANNER MAY RESULT IN COURT ACTION AND THE IMPOSITION 
OF CIVIL PENALTIES OF UP TO $10,000 PER VIOLATION (RSA 7:28-f II(d)).