Make A Donation by Mail

NACSSF

PO Box 3923

Cottonwood, AZ 86326

Please include your check, made out to NACSSF, with the form below and mail to NACSSF.

NOTE: To print the form please use the Print button:

You can print this page and fill out by hand, or you can open, fill, download and print it and then mail it to us.

The following information is required by the State of Arizona.  Please print and fill out the form completely.

Full Name________________________________________________________________________

Address__________________________________________________________________________

City______________________________State_________________Zip Code___________________

Phone___________________________________________________________________________

I am donating:

$________to the Original Tax Credit (Up to $1308 for Married Filing Jointly)

$________to the Switcher Tax Credit (Up to $1301 Married Filing Jointly)  (You can donate here only after you have donated $1308 to the Original above.)

$________to the Original Tax Credit (Up to $655 Single/Head of Household)

$________to the Switcher Tax Credit (Up to $652 Single/Head of Household) (You can donate here only after you have donated $655 to the Original credit.)

Recommended School or Student________________________________________________________

Mail this form with your donation & check payable to:  NACSSF, P O Box 3923, Cottonwood, AZ 86326

Check #_______________________________Please no staples or tape.

Visa                    Master Card    ___________________________________________  _____/______

                                                                Card number                                               Expires

Billing Address (if different)_________________________________________________________________________________________

Filing Information

Donation is to be claimed for tax year:   ___2023

Filing status on my income tax return:

___Single, Married Filing Separate, or Head of Household

___ Married Filing Jointly

Have you already donated to another school tuition organization:           ____Yes    ____No     

If yes which STO?__________________________________________________________________________________________________

And how much?____________________________________________________________________________________________________

Thank you for your donation!

NOTE: A SCHOOL TUITION ORGANIZATION CANNOT AWARD, RESTRICT, OR RESERVE SCHOLARSHIPS SOLELY ON THE BASIS OF DONOR RECOMMENDATION. A TAXPAYER MAY NOT CLAIM A TAX CREDIT IF THE TAXPAYER AGREES TO SWAP DONATIONS WITH ANOTHER TAXPAYER TO BENEFIT EITHER TAXPAYER’S OWN DEPENDENT.