• REVENUE DIVISION

    Tax Credits/Special Refunds

    1816 W 7th St., Room 2370

    Post Office Box 8054

    Little Rock, Arkansas 72203-8054

    Phone: (501) 682-7106

    Fax: (501)682-4896

    www.dfa.arkansas.gov

     

  • Philanthropic Investment in Arkansas Kids Program

    Tax Credit Application and Receipt of Eligible Contribution

  • 1. Scholarship Granting Organization

  • Name of Organization: ACE Scholarships SGO Arkansas, LLC     

    FEIN: 87-4130018

    Address: 5251 DTC Pkwy, Ste 300, Greenwood Village, CO 80111

    Telephone: (303) 407-0611

    Name and Title of SGO Official Completing Form: Tina Burke, Director of Development Operations

  • 2. Donor

  • * If entity is Partnership or LLC, please provide a separate attachment that includes name of members, SSN/FEIN, and ownership percentage.

  • 3. Eligible Contribution Information

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  • Consent to Release Tax Credit Information to SGO - Donor authorizes the Department of Finance and Administration (DFA) to notify the Scholarship Granting Organization (SGO) of the amount of tax credit that is certified and granted to Donor (Donor's initial required in appropriate box below)

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  • 4. Signatures of SGO Official and Donor

  • The persons signing below affirm that the information contained within this application is true and accurate and the eligible contribution above was made by the Donor and actually received by the SGO. In order for this application to be considered for a tax credit, the SGO must provide a copy of this completed and signed application to the Tax Credits/Special Refunds Section of the Department of Finance and Administration electronically at the following e-mail address: PIAKP.TaxCredit@dfa.arkansas.gov.

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