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Educational ImprovementOpportunity Scholarship Tax Credit Election Form REV 1123 FormsPublications 2015

Educational ImprovementOpportunity Scholarship Tax Credit Election Form REV 1123 FormsPublications 2015

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Telephone Number Email Address Identification Number Revenue ID FEIN SSN YYYY 1 Total EITC/OSTC awarded in tax year available for pass through Contribution Date Amount MMDDYYYY TOTAL 2 Amount of EITC/OSTC to be applied to the entity s liability. I the undersigned declare and certify I am a corporate officer general partner or limited liability company member of the abovenamed entity and I have authority to bind the above-named entity to the terms and conditions of this election. Signature of...

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