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For the period beginning mm/dd/yyyy 2. Check if applicable for NYS G 3. N am e of charitable lead trust 5. Fed* em ployer ID no. E IN - Address change 6. N Y S tate registration no. - - Name change Initial filing Final filing 4. N um ber and street or P. O. box if m ail not delivered to street address R oom /suite 7. T elephone num ber Amended filing C ity or tow n state or country and zip 4 NY registration pending 8. E m ail address Part B - Certification - Signature Required I certify under ...

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