Individual Owner of S-Corp, Member of a LLC, or Partner in a Partnership Donor TMH Tax Credit Application

"*" indicates required fields

Thank you so much for supporting The Methodist Home (TMH). With your participation, we will change lives for young people aging out of Georgia’s foster care system. Please complete the form below and TMH will apply for the tax credit on your behalf.

If TMH previously applied for the credit on your behalf or you selected the incorrect tax filing status, please go back and select the appropriate application form. Click Here!

I am filing my taxes this year as:*

Application limit is up to $5,000 through June 30th, then unlimited if credit fund has not reached $20 million cap

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

Tax Payer's Name*

First Name Middle Initial Last Name

Social Security Number*

Enter number only; no spaces or dashes, please.

Spouse Name (if applicable)

First Name Middle Initial Last Name

Spouse's Social Security Number

Enter number only; no spaces or dashes, please.

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Name(s) of Pass-Through Entity(ies)*

Contribution Amount*

For Tax Year*

Current tax year end date*

Authorization*

I authorize The Methodist Home to submit this application to the Georgia Department of Revenue (DOR) for pre-approval. Once DOR approval is received, I commit to fund my full approved contribution amount to The Methodist Home within 60 days of the approval or by 12/31 of the same tax year, whichever comes first.

Phone

This field is for validation purposes and should be left unchanged.