EITC-OSTC Application:

Application for Educational Improvement Tax Credits (EITC) and Opportunity Scholarship Tax Credits (OSTC) through Community Foundation of Western PA & Eastern OH, to support students enrolled at Beaver County Christian School

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Type of Business Entity:

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Business Name:

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FEIN:

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Street:

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City:

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State:

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Zip:

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PA County:

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Business Description:

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NAICS Code (search for code):

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CEO Name:

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CEO Title:

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Contact Name:

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Contact Title:

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Contact Phone #:

Contact FAX #:

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Contact EMail:

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Business Tax Year End (mm/dd):

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PA Corporate Tax Account ID#:


 

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Choose the tax credit program to which you wish to apply:

(1 required)
Educational Improvement Tax Credit (EITC)   Opportunity Scholarship Tax Credit (OSTC)   Both
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EITC amount to be donated per year to BCCS:

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OSTC amount to be donated per year to BCCS:


 

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Based on the contribution stated above, this application is for the following commitment (SO):

(1 required)
Year 1 of a 1 Year Commitment (75% tax credit)
Year 1 of a 2 Year Commitment (90% tax credit)
Year 2 of a 2 Year Commitment (90% tax credit)
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Calculated amount of tax credits requested per year:

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Please check the taxes to which the business is subject (check all that apply).

(1 required)
Corporate Net Income Tax
Capital Stock Franchise Tax
Bank & Trust Company Shares Tax
Title Insurance Company Shares Tax
Insurance Premiums Tax
Mutual Thrift Institutions Tax
Personal Income Tax of S Corporation Shareholders, or partners in a general or limited partnership.
If the contribution will be personal property or services, please check here and describe below the property or service and appropriate information establishing the value of the contribution.

      Description of above property or services (if checked):


I hereby certify that all information contained herein is true and correct to the best of my knowledge.

I acknowledge that tax credits will be awarded only for approved contributions made to Scholarship Organizations listed by the Department (DCED) at www.newPA.com/EITC . I am aware that contributions must be made within 60 days of the date on the approval letter and receipts must be forwarded to DCED by the business within 90 days of approval. Furthermore, I acknowledge that if I knowingly make false statement to obtain tax credits, I (company, entity, and signer) may be subject to criminal presecution.

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Signature:

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Title:

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Date (mm/dd/yyyy):

By clicking the Submit button I certify that the name above constitutes my official signature for the electronic submission of this application.

* Enter Your Email Address: