User Account Manager by L2SAdmin | Oct 11, 2020 Contribution Form 2022 Please select the tax year for which you will be donating: * Tax Year 2022 Select Tax Filing Status * Individual Filer Married Filing Jointly Married Filing Separately C Corporation or Trust Entity-level Filer Owner of Pass-Through Entity Filing an Individual Return Owner of Pass-Through Entity Filing a Married Joint Return Owner of Pass-Through Entity Filing a Married Separate Return Note: The Tax Credit Limit for Individual Filers is $1,000 Note: The Tax Credit Limit for Married Filing Jointly tax filers is $2,500 Note: The Tax Credit Limit for Married Filing Separately tax filers is $1,250 Note: The Tax Credit Limit for C Corporations or Trusts is up to 75% of GA Tax Liability Note: The Tax Credit Limit for Entity-level tax filers is up to 75% of GA Tax Liability Note: The Tax Credit Limit for Owners of Pass-Through Entities Filing an Individual, Married Jointly, or Married Separate Return is $10,000 Donor Information Taxpayer's First Name * First Middle Initial Middle Initial Last Name * Last Suffix Suffix Taxpayer's SS# * Spouse's First Name (if married filing jointly) First Middle Initial Middle Initial Last Name Last Suffix Suffix Spouse's SS# For Entities Name of Entity EIN (for entities) Contact Person & Title (for entities) Email * Phone * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Tax Year End of Contributor Contribution Amount in USD * $ Enter amount of contribution 75% of est. GA income tax liability: (for C-Corps and Trusts only) $ 6% of estimated GA income from pass through entity or entities: (for S Corps, LLCs & Partnerships only) $ Designated School (type GENERAL if you don't wish to designate a particular school) Signature Clear reCAPTCHA If you are human, leave this field blank. Submit
