Sc Sch.tc-57a - Application For Exceptional Needs Children Scholarship Credit

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STATE OF SOUTH CAROLINA
1350
1350
SC SCH.TC-57A
DEPARTMENT OF REVENUE
(Rev. 11/15/13)
APPLICATION FOR EXCEPTIONAL
3656
NEEDS CHILDREN SCHOLARSHIP CREDIT
20
Attach to your Income Tax Return
Name(s) As Shown On Tax Return
SSN or FEIN
Mailing Address
Contact Person
Street
Contact Person's Title
City
County
State
Zip
Telephone Number
Physical Address
Fax Number
Street
Email
City
County
State
Zip
Date(s) on which the taxpayer made a contribution to a nonprofit Scholarship Funding Organization, amount(s) contributed, and
name(s) of nonprofit Scholarship Funding Organization (Attach seperate sheet if necessary.):
$
Date of contribution
Amount contributed
Name of nonprofit Scholarship Funding Organization
$
Date of contribution
Amount contributed
Name of nonprofit Scholarship Funding Organization
$
Date of contribution
Amount contributed
Name of nonprofit Scholarship Funding Organization
Total qualified contributions(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Date
Signature of Taxpayer
Printed Name of Taxpayer or Officer
Title, If Applicable
NOTE: Total credits for all taxpayers are limited to $8 million. Credits will be approved on a first come, first served basis depending on
when the application was received.
You should use the quickest method available to you.
1) Email a scanned PDF of TC-57A to
SC Department of Revenue
2) Express mail:
300A Outlet Pointe Blvd
Columbia SC 29210
SC Department of Revenue
3) Regular Mail:
Research and Review
Columbia, SC 29214-0019
INSTRUCTIONS
Enter the date of each contribution you made during the tax year and on or before June 30, 2014, to a qualifying nonprofit scholarship
funding organization that provides scholarships to exceptional needs students, the amount of the contribution, and the name of the
qualifying nonprofit scholarship funding organization. Do not include any contribution designated for a specific child or school.
Total credits for all taxpayers are limited to $8 million. Credits will be approved on a first come, first served basis depending on when
the application was received. After you receive approval, include the amount approved on a completed TC-57 Exceptional Needs
Children Scholarship Credit to claim the credit with your income tax return.
36561017

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