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Arizona Lutheran Scholarship Organization

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Corporate Donation Form
Corporation Name:
Contact Person:
First Last
Address:
Street Address Address Line 2 City State ZIP Code
Phone
Email
Donation Amount $
Recommended School
Corporate FEIN Number
Name & FEIN Number of Parent S Corp
NAIC Number (if insurance premium tax)

Donor Information
Name
Address
Street Address Address Line 2 City State ZIP Code
Email
Phone
Tax Credit Information
Filing Status
- Married Filing Jointly
- Single Taxpayer
Tax Credit Year
- 2018
- 2019
Have you donated to an STO this year?
- Yes
- No
Total amount of $:
Donation Information
Lutheran School (Optional)
Student Recommendation (Optional)
Amount $
Payment Information
I am paying by
- Check
- Credit Card
make payable to ALSO #:
Name as it appears on card
Card Number
Expiration Date
Security Code/CCV
Signature
Date
MM slash DD slash YYYY
How did you hear about ALSO?
What church do you attend?
Send completed form to

Arizona Lutheran Scholarship Organization
PO Box 13277, Chandler, AZ 85248
NOTICE: A school tuition organization cannot award, restrict, or reserve scholarships only on the basis of a donor’s recommendation. A taxpayer may not claim a tax credit if the taxpayer agrees to swap donations with another taxpayer to benefit either taxpayer’s own dependent. A.R.S. 43-1603 (C). Any designation of your own dependent as a potential recipient is prohibited