2023 Illinois Invest in Kids Tax Credit Scholarship Program Donor Restriction Form

2023 Illinois Invest in Kids Tax Credit Scholarship Program Donor Restriction Form

Thank you for your generous support of the Illinois Tax Credit Scholarship program, made possible by the Illinois Invest in Kids Act.

Please use this form to provide more information about restrictions related to the use of your gift and the release of your information to benefiting schools.

Please complete separate submissions for each Contribution Authorization Certificate (CAC).

We will honor all donor restrictions for the Illinois Tax Credit Scholarship Program provided we have enough qualifying applicants and/or appropriate information from the school(s). If not, for the 2023 calendar year, Big Shoulders Fund will utilize the funding for the next deserving applicant to meet the state’s guidelines for the program.

For questions related to this form or the Tax Credit Program, contact info@bigshouldersfund.org or the Big Shoulders Fund main office: 312.751.8337.

Donor Last Name*

Please enter the last name of the individual reserving the credit as it appears on the Contribution Authorization Certificate (CAC).

Donor First Name*

Please enter the first name of the individual reserving the credit as it appears on the Contribution Authorization Certificate (CAC).

Donor Email*

Contribution Authorization Certificate (CAC) Number*

Please enter the ten digit (xxx-xxxx-xxx) number found on page 2 of your CAC.

Have you already sent a copy of your CAC to Big Shoulders Fund? If no, please upload a copy of your CAC(s) below.*

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Contribution Authorization Certificate

Please upload a copy of your Contribution Authorization Certificate.

Drag and drop files here or

Region*

Indicate the Region in which you have made your Tax Credit Reservation(s).

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Credit Reservation Amount*

Enter the total amount of the credit reservation on the Contribution Authorization Certificate.

I plan to remit my payment by:

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Is your donation restricted for specific school(s) or a group of schools?

If yes, please list each school and the amount of the contribution you would like to designate for each. For school groups, please indicate your selection from the following: Big Shoulders Fund Region 1, Archdiocese Region 1, Agudath Israel Schools, Other. If Other, please provide more detail below.

If your donation is restricted for a specific school(s), may we share your information with the school(s)?

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Anonymous

Would you like your donation to be recognized as 'Anonymous' in Big Shoulders Fund publications and annual report?

Would you like to receive the Big Shoulders Fund newsletter?

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Comments

Please use this field to provide any further information related to your donation.

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