2026 Tax Credit Form

Employee Name:*

Email*

example@example.com

I hereby request a payroll deduction for the year 2026 Arizona School Tax Credit.

Please deduct the following dollar amount EVERY PAY PERIOD*

Total 2026 Deduction is not to exceed:*

$200.00 if filing single or$400.00 if filing jointlyOther

I request the donation to be used at:*

Please apply toward:*

General FundOther

Type Signature* Date*

2026 TAX CREDIT