Form Sc Sch.tc-57a - Application For Parental Refundable Credit July 1, 2017 - June 30, 2018

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STATE OF SOUTH CAROLINA
1350
DEPARTMENT OF REVENUE
SC SCH.TC-57A
APPLICATION FOR PARENTAL REFUNDABLE CREDIT
(Rev. 6/26/17)
3656
JULY 1, 2017 - JUNE 30, 2018
Your Name
Your Social Security Number
Spouse Name (if filing Federal joint return)
Spouse's Social Security Number
Home address (number and street)
Your phone number
City or town, state, and Zip code
Your email address
Parental Refundable Credit (Tuition Payment(s) to Eligible Schools for Exceptional Needs Children)
Name of qualifying student
Name of eligible school
1. Are you the parent who has custody or care for the qualifying student who is enrolled in an eligible school?
YES
NO
2. Did you pay tuition to an eligible school for your qualifying student?
YES
NO
If you answered “NO” to either question, you do not qualify for the refundable educational credit.
3. What is the full cost of tuition for the 2017-2018 school year?
4. Fill in the table below, listing the eligible tuition payment(s) for the 2017-2018 school year.
Check number or
Date tuition was paid
Tuition payment amount
confirmation number
Tuition paid prior to July 1,
2017 is not eligible for the
2017-2018 parental
refundable credit.
Enter each tuition payment
separately.
Do not submit application
for future tuition payment(s).
Date and Signature(s)
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 APPLICABLE)
DATE
SIGN
HERE
Mail application to: SC Department of Revenue,
Attn: Parental Refundable
Credit, PO Box 125, Columbia, SC 29214
or email a pdf file of this application to taxtech@dor.sc.gov.
36561017

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