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New Horizon School for the Performing Arts
Arizona Extra Curricular
Tax Credit Contribution Form
I am enclosing a ( __ check or ___ money order) for $___________ as a total contribution
to the public school system for extracurricular activity contributions.
I understand that an amount up to $400.00 qualifies as a direct tax credit on any Arizona State Income Tax return this
calendar year.
An official tax receipt will be mailed to me.
(Joint Returns Max $400/Single Returns Max $200)
CALENDAR YEAR _____________
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Name:
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Address:
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City, State, Zip:
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Social Security Number or Federal Tax ID Number for Businesses (Required)
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Enclosed is my Extra Curricular Tax Credit Donation $:
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Signature:
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Date:
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Print this form and complete the required information. Mail it to:
New Horizon School for the Performing Arts, 446 E Broadway, Mesa, AZ 85204
For any information call New Horizon School for the Performing Arts
Office at 480 655-7444 and ask for Mr. Wyler or send a fax to 480 655-8220.
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