Corporate Donor Commitment Form

Corporate Donor Commitment Form
Thank you for your interest in contributing to help fund low-income and disabled
displaced scholarships in the state of Arizona, through the corporate tax credit program.
Please complete and return this commitment form to us. Once we receive this
information, we will fill out the pre-approval form to submit to the Arizona Department
of Revenue (ADOR). Once ADOR approves your contribution amount you will have 10
days to remit payment, or that amount will open back up to other donors and we will
need to resubmit for approval again.
Corporate donations can begin again on July 1st 2015. We will submit your form on
July 1st or on the date you list below. We should hear back from the state within 24
hours of submission of this information.
Corporation Name: ______________________________________
Corporation Address: _____________________________________
City: _________________________ State: ______ Zip: ______________
Corporate FEIN: ______ - ______ - ______
Desired Corporate Donation Amount: $_______________
Primary Contact: _________________________Title: ________________
Phone____________________ Email____________________________
Signature: _________________________________ Dated: __________________
Recommended school(s) (Optional):______________________________________
Date you would like us to submit the pre-approval form, if different that July 1st: ____/ ____ / ____
(You will have 10 days to submit donations once the state approval is received.)