Form I-361 - Exceptional Needs Children Educational Credit
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12.
Maximum educational credit per qualifying student . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
…………………………………………………… . . . . . . . .
1350
STATE OF SOUTH CAROLINA
I-361
DEPARTMENT OF REVENUE
(Rev. 12/21/15)
3692
EXCEPTIONAL NEEDS CHILDREN
EDUCATIONAL CREDIT
20
Name(s) As Shown On Tax Return
SSN or FEIN
Spouse Name (if Co-Contributor)
SSN
Qualifying Student’s Name
Eligible School
PART I.
Questionnaire
Did the qualifying student receive a scholarship from a
No (Complete PART II and PART IV ONLY)
nonprofit scholarship funding organization (SFO)?
Yes (Complete PART III and PART IV ONLY)
PART II.
Contribution as tuition to an eligible school
1.
Total Contribution as Tuition paid to an eligible school from July 1, 2015 to December 31,
2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
$
2.
Maximum educational credit per qualifying student . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
$
10,000.00
3.
Refundable Educational Credit, enter the lesser of Line 1 and Line 2 . . . . . . . . . . . . . . .
3.
$
Enter this credit amount on SC1040, Line 22. Go to Part IV.
PART III.
Contribution as tuition and scholarship from a nonprofit scholarship funding organization
4. Total cost of tuition for the entire 2015-2016 school year . . . . . . . . . . . . . . . . . . . . . . . . . .
$
4.
5. Maximum educational credit per qualifying student . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
$
10,000.00
6. Enter the lesser of line 4 and line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
6.
7. Enter the full scholarship amount that was awarded by the SFO for the 2015-2016 school
year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
7.
8.
Refundable Educational Credit, subtract line 7 from line 6 . . . . . . . . . . . . . . . . . . . . . . .
8.
$
Enter this credit amount on SC1040, Line 22.
IMPORTANT NOTE: The refundable educational credit may not exceed your tentatively approved South Carolina
refundable educational credit.
Name of the Nonprofit Scholarship Funding Organization
PART IV. Signature(s) and Date
I certify that all information on this application, including any attachment is true and correct to the best of my
knowledge.
TAXPAYER SIGNATURE
DATE
SPOUSE'S SIGNATURE
(IF CO-CONTRIBUTOR)
Sign
Here
36921013
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