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               Arizona Form  
                                                   Credit for Contributions Made or  
                  322                                  Fees Paid to Public Schools                                                                                     2022
Include with your return.
                  • Do not use this form for contributions to private school tuition organizations.
                  • Use Form 323 for contributions to private school tuition organizations.

      For the calendar year 2022 or fiscal year beginning     M M D D            2 0 2 2  and ending      M M D D Y Y Y Y .
Your Name as shown on Form 140, 140NR, 140PY or 140X                                                 Your Social Security Number

Spouse’s Name as shown on Form 140, 140NR, 140PY or 140X (if joint return)                           Spouse’s Social Security Number

Part 1 Current Year’s Credit
A. Cash contributions made or fees paid January 1, 2022 through December 31, 2022.
 • If you are married and filing separate returns, be sure to include all cash contributions or fees paid by you and your spouse.
 • Do not include those cash contributions or fees paid for which you or your spouse claimed a credit on the 2021 tax return.
 • If you made cash contributions or paid fees to more than three public schools, complete the Continuation Sheet on page 3 and 
     include it with the credit form.  If you made more than ten (10) contributions or paid fees to the same public school, see  
    instructions.
       (a)                   (b)                              (c)                                    (d)                                                               (e)
      Date of           Public School                      Name of Public School              School District Name or                                                  Cash 
     Contribution         CTDS Code              to which you made contributions or paid fees Charter Holder Name                                                      Contribution Made
     MM/DD/2022                                                                                                                                                        or Fees Paid

1         2 0 2 2                                                                                                                                                                       00
          2 0 2 2
2                                                                                                                                                                                       00
          2 0 2 2
3                                                                                                                                                                                       00
4  If you made contributions or paid fees to more than three public schools, enter the amount from line 4h 
   of the Continuation Sheet, otherwise enter “0” ........................................................................................................          4                   00
5  Total contributions made or fees paid to public schools during 2022: Add lines 1 through 4, column (e) .........                                                 5                   00
B. Cash contributions made or fees paid January 1, 2023 through April 18, 2023 for which you or your spouse are claiming a 
 credit on the 2022 tax return.
 • If you are married and filing separate returns, be sure to include all cash contributions or fees paid by you and your spouse.
 • If you made cash contributions or paid fees to more than three public schools, complete the Continuation Sheet on page 3 and 
     include it with the credit form.  If you made more than ten (10) contributions or paid fees to the same public school, see  
    instructions.
       (a)                   (b)                              (c)                                    (d)                                                               (e)
      Date of           Public School                      Name of Public School              School District Name or                                                  Cash 
     Contribution         CTDS Code              to which you made contributions or paid fees Charter Holder Name                                                      Contribution Made
     MM/DD/2023                                                                                                                                                        or Fees Paid

6         2 0 2 3                                                                                                                                                                       00
          2 0 2 3
7                                                                                                                                                                                       00

8         2 0 2 3                                                                                                                                                                       00
9  If you made contributions or paid fees to more than three public schools, enter the amount from line 9h 
   of the Continuation Sheet, otherwise enter “0” ........................................................................................................          9                   00
10 Total contributions made or fees paid January 1, 2023 through April 18, 2023 for which you are claiming 
   a credit on the 2022 tax return.  Add lines 6 through 9, column (e) .....................................................................                        10                  00
11 Add lines 5 and 10.  Enter the total ........................................................................................................................... 11                  00
12 Single taxpayers or heads of household, enter $200.  Married taxpayers, enter $400 ...................................                                           12                  00
13 Total current year’s credit:  Enter the smaller of line 11 or 12.  In most cases, if you are married filing a 
   separate return, enter one-half of the smaller of line 11 or 12.  See instructions. ............................................                                 13                  00

ADOR 10941 (22)



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 Your Name (as shown on page 1)                                                                     Your Social Security Number

 Part 2 Available Credit Carryover
                (a)                (b)                        (c)                                   (d)
            Taxable Year        Original Credit    Amount Previously                                Available Carryover:
        from which you are         Amount                Used                                       Subtract column (c) 
        carrying the credit                                                                         from column (b).

 14             2017                            00                                               00                 00

 15             2018                            00                                               00                 00

 16             2019                            00                                               00                 00

 17             2020                            00                                               00                 00

 18             2021                            00                                               00                 00
 19     Total Available Carryover:  Add lines 14 through 18,  
        column (d).............................................................................. 19                 00

 Part 3 Total Available Credit
 20     Current year’s credit:  Enter the amount from Part 1, line 13.
        Also, enter this amount on Arizona Form 301, Part 1, line 8, column (a) .............................................   20        00
 21     Available credit carryover from Part 2, line 19, column (d).
        Also, enter this amount on Arizona Form 301, Part 1, line 8, column (b) .............................................   21        00
 22     Total Available Credit:  Add line 20 and line 21.
        Also, enter this amount on Arizona Form 301, Part 1, line 8, column (c) .............................................   22        00

                                                         Print Form
 ADOR 10941 (22)                                         AZ Form 322 (2022)                                                        Page 2 of 3



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 Your Name (as shown on page 1)                               Your Social Security Number

                                    AZ Form 322 - Credit for Contributions
                                    Made or Fees Paid to Public Schools
                                        Continuation Sheet

Part 1 - Continued Current Year’s Credit
If you need more space to list all public schools, complete additional sheets and enter those totals on the appropriate line(s) 
on page 1.

A. Cash contributions made or fees paid January 1, 2022 through December 31, 2022.
      (a)                       (b)        (c)                                                   (d)                       (e)
      Date of      Public School        Name of Public School                    School District Name or                   Cash 
      Contribution CTDS Code        to which you made contributions or paid fees  Charter Holder Name                      Contribution Made
    MM/DD/2022                                                                                                             or Fees Paid

 4a       2 0 2 2                                                                                                                           00

 4b       2 0 2 2                                                                                                                           00

 4c       2 0 2 2                                                                                                                           00

 4d       2 0 2 2                                                                                                                           00

 4e       2 0 2 2                                                                                                                           00

 4f       2 0 2 2                                                                                                                           00

 4g       2 0 2 2                                                                                                                           00

 4h Add all amounts in column (e) and enter the total.  Also, enter this amount on page 1, line 4 ..................... 4h                  00

B. Cash contributions made or fees paid January 1, 2023 through April 18, 2023.
      (a)                       (b)        (c)                                                   (d)                       (e)
      Date of      Public School        Name of Public School                    School District Name or                   Cash 
      Contribution CTDS Code        to which you made contributions or paid fees  Charter Holder Name                      Contribution Made
    MM/DD/2023                                                                                                             or Fees Paid

 9a       2 0 2 3                                                                                                                           00

 9b       2 0 2 3                                                                                                                           00

 9c       2 0 2 3                                                                                                                           00

 9d       2 0 2 3                                                                                                                           00

 9e       2 0 2 3                                                                                                                           00

 9f       2 0 2 3                                                                                                                           00

 9g       2 0 2 3                                                                                                                           00

 9h Add all amounts in column (e) and enter the total.  Also, enter this amount on page 1, line 9 ..................... 9h                  00

                                        Print Form
 ADOR 10941 (22)                        AZ Form 322 (2022)                                                                 Page 3 of 3






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