EITC Form

Please fill out the form below to apply for the Educational Improvement Tax Credit Program. If you have any questions please contact Director of Leadership Giving Kathy Koller at kkoller@thehill.org.

Required

If an individual or 2 individuals signing jointly fill out the form below. If a business/corporation scroll to that section.

Name

First Name

Last Name

Signature of name above:

Namerequired

First Name

Last Name

Signature of name above:

Date

Must contain a date in M/D/YYYY format

Address 1

City

State

Zip Code

Email Address

Taxpayer ID 1

Taxpayer ID 2

If a Business/Corporation:

Name of Business/Corporation

Your Signature

Name of authorized individual signing for entity

First Name

Last Name

Date

Must contain a date in M/D/YYYY format

Address

City

State

Zip Code

Email Address

Taxpayer ID

Amount of Initial Capital Contribution (due upon acceptance)

Note: Minimum of $3,500 unless Manager determines otherwise.

Amount of second Capital Contribution (due upon acceptance)

Note: Same amount as initial Capital Contribution

By filling out this form I understand that the Manager is to use my Captial Contributions for children attending The Hill School.

EITC Form

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