b'NON-BINDING CORPORATE TAX CREDIT FORMMust be completed by the Corporation and emailed to Info@sto4kidz.org for submission to theState of Arizona. NON-BINDING CORPORATE TAXHow to proceed: FORM1) Please determine your business tax liability for the current year.2) Complete and submit your non-binding application to STO4KIDZ.3) STO4KIDZ will submit your applicaon to the Arizona Department of Revenue (ADOR).4) Once your contribuon amount is approved by ADOR, you will have 20 days to fund STO4KIDZ topreserve your tax credit. Todays Date:______/_____/_____ Tax Credit (Check only one)Low Income (A.R.S.43-1183)Disabled/ Displaced (Lexies Law) (A.R.S.43-1184) Corporation Name:___________________________________ Type of Corporation (Check only one)C-CorpS - C o rp Corporation Address: _____________________________________ City : _______________ State: _____ ZIP: ______Phone:_______________________________________Fax:____________________________________________Primary Contact Name : _________________________________________ Primary Contact Title: ________________Primary Contact Email : ____________________________________________________________________________ Corporate EIN: ___________________________________ NAIC Number: ___________________________________ If contributing company is a qualied subchapter S subsidiary, name and EIN of parent S corporation: Accounts Payable Contact (if dierent) _______________________________________________________________ Accounts Payable Address (if dierent) _______________________________________________________________ Contribuon Amount $_____________________________ I would like to contribute to:STO4KIDZ most needed scholarship funds to be used for tuion assistance to qualied applicant students. XRecommended school(s)The Orme SchoolReleaseofInformationPlease indicate if you would permit us to share with our constituents and beneficiaries your contribution information. Yes, you may release information (Corporate name and amount).Yes, you may release information (Corporate name only).No, keep our participation confidential.On behalf of the students your allocated tax credit dollars support, we thank you! NOTE:A school tuition organization cannot award, restrict, or reserve scholarships solely on the basis of a donors recommendation. A taxpayer may not claim a tax credit if the taxpayer agrees to swap donations with another taxpayer to benet either taxpayers own dependent. A.R.S. 43-1603 (C). Any designation of your own dependent as a potential recipient is prohibited. STO4KIDZ is a tax-exempt charitable organization pursuant to federal law, Section 501(C)(3) Federal I.D. Number 82-48864213241 E. Shea Blvd. # 246, Phoenix, AZ 85028'