Form Rev-1123 Ct - Educational Improvement/opportunity Scholarship Tax Credit Election Form Page 2

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REV-1123 CT (02-13)
SECTION II
Complete this section for each shareholder, member or partner receiving a pass-through Educational Improvement or
Opportunity Scholarship Tax Credit. Attach additional schedules if necessary.
Name and address of each owner having an interest in the
Social Security
Percentage of
Total amount of
Taxable year to
entity. Include name, street, city, state, ZIP.
number
distributive
EITC/OSTC credit to
apply the pass-
income to which
pass through to the
through EITC/OSTC
the owner is
owner (pass-through
on behalf of the
entitled
amount x% of
owner (must be
distributive income
the same for all
to which the owner
owners)
is entitled). Also
record on PA
Schedule OC.
YYYY
%
%
%
%
%
%
%
%
%
%
%
%
%
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