Qualified Tuition Program Tax Reporting Form

Qualified Tuition Program Tax Reporting Form
Report qualified tuition program information for tax reporting using the same title throughout the form. Provide the required account, participant, and reporting details below.
Account and Participant Information
Account Holder/Legal Owner Full Name
First NameMiddle NameLast Name
Participant/Beneficiary Full Name
First NameMiddle NameLast Name
Relationship to Participant/Beneficiary
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Email
example@example.com
Tax Reporting Details
Tax year
Filing type
Reported amount (USD)
Certification and Submission
Certification Acknowledgement
Submitter Signature
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