School Tax Credit Verification Form

School Tax Credit Verification Form
Please complete this form to verify eligibility information for a school tax credit claim. All information should be accurate and up to date.
Student or Dependent Full Name
First NameLast Name
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship to Claimant
Name of School Attended
School Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Current Academic Year
Grade Level
Enrollment Status
Claimant's Full Name
First NameLast Name
Claimant's Email Address
example@example.com
Claimant's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty: