| The following information is required by the State of Arizona. Please fill out completely. Thank you. |
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| Full Name |
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| Email Address |
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| Street Address |
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| City |
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State |
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Zip |
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| Phone Number |
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| Filing Status |
Married Filing Jointly
Single, Married Filing Separately, or Head of Household
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| I am Donating: |
| $ |
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To the original tax credit (Up to $555 Single/Head of Household) |
| $ |
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*To the Switcher tax credit (Up to $552 Single/Head of Household) |
| (*You can donate here only after you have donated $555 to the Original Credit) |
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To the original tax credit (Up to $1110 Married Filing Jointly) |
| $ |
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**To the Switcher tax credit (Up to $1103 Married Filing Jointly) |
| (**You can donate here only after you have donated $1110 to the Original Credit) |
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| $ |
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Total Donation Amount (will be totaled automatically) |
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| Recommended School or Student: |
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| Donation Tax Year: |
2018
2019 |
| Have you already donated to another school tuition organization? |
Yes
No |
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| Click Continue – you will then be brought to a new page, then click the Donate button on the new page and you will be able to pay for your donation. Thank you! PLEASE NOTE: If you try to submit more than one time and with different information you may receive an error – please refresh the page if this happens and fill out the form again. |
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