Arizona State Tax Credit Contribution Form - 2016

Kyrene School District No. 28

2016 Arizona State Tax Credit Contribution Form

Make a tax credit donation to a Kyrene school, you’ll get it back in more ways than one.

Donate up to $400 to a Kyrene school of your choice and deduct that amount from state income taxes through a tax credit

.

*

You can donate in person at the schools or district office, mail this contribution form, or online at:

Yes! My choice is to enhance education!

I am enclosing a

check

money order payable to the Kyrene School of my

choice for $____________ as a contribution to the public school system for extracurricular activity fees.

NOTE: A separate check must be received for each school.

Name ____________________________________________________________ Daytime Phone ______________________________________

Mailing Address _________________________________________ City ________________________ State _____________ Zip Code __________

*Total amount cannot exceed $400 for joint tax return. Individual returns are $200 maximum credit. Corporate and/or business checks are not eligible. ARS 43-1089.01(G)(2)(d)

defines extracurricular activities as school-sponsored activities that supplement the school’s educational program and require enrolled students to pay a fee in order to

participate. Please check with the school if you have questions about specific program eligibility.

Please Note: The above complete information is required in order for this contribution to be used as a TAX CREDIT on your 2016 Arizona State Income report. If the

information is incomplete, your contribution and form will be returned to you. Tax credits must be POSTMARKED by April 15, 2017. Please mail completed form to:

Tax Credits, Kyrene School District No. 28, 8700 South Kyrene Road, Tempe, AZ 85284. This is NOT a receipt. You will be mailed a receipt by the receiving school.

If you have any questions, please call the school directly. Online donation receipts can be obtained from PayPal.

Elementary Schools

Middle Schools

Other Programs

$__________ Kyrene de las Brisas

$__________ Kyrene Akimel A-al

$__________ KASP

(located at Kyrene del Pueblo)

$__________ Kyrene de los Cerritos

$__________ Kyrene Altadeña

$__________ Athletics

(Middle School)*

$__________ Kyrene Aprende

$__________ Kyrene del Cielo

$__________ Kyrene Centennial

$__________ Kyrene de la Colina

$__________ Kyrene Middle School

$__________ Kyrene de la Esperanza

$__________ Kyrene del Pueblo

$__________ Kyrene de la Estrella

$__________ Kyrene de los Lagos

If your donation is listed by the school name only, it will go into the general fund.

$__________ Kyrene de las Lomas

Please specify below if you want tax credit for programs such as community education, character

$__________ Kyrene de las Manitas

education, fine arts and athletics. A separate check must be received for each school or if choosing Athletics.

$__________ Kyrene de la Mariposa

Apply my contribution to the following EXTRACURRICULAR activity at the designated school(s):

$__________ Kyrene del Milenio

________________________________________________________________________

$__________ Kyrene de la Mirada

________________________________________________________________________

$__________ Kyrene Monte Vista

________________________________________________________________________

$__________ Kyrene de los Niños

________________________________________________________________________

$__________ Kyrene del Norte

________________________________________________________________________

$__________ Kyrene de la Paloma

________________________________________________________________________

$__________ Kyrene de la Sierra

________________________________________________________________________

$__________ Kyrene Traditional Academy -

Sureño Campus

$__________ C.I. Waggoner

• 480-541-1000

District Office • 8700 S. Kyrene Road, Tempe, AZ 85284

(NW Corner Kyrene & Warner)

TEMPE • CHANDLER • AHWATUKEE

16-001 (JAN15)