Arizona Form      Credit for Corporate Contributions to School Tuition Organizations 
                                       for Displaced Students or Students with Disabilities –                                       2021
               341-S                  Distribution to Individual Shareholders of an S Corporation

   For the calendar year 2021 or fiscal year beginning    M M D D 2 0 2 1  and ending    M M D D Y Y Y Y  .

S Corporation Name                                                                                                               Employer Identification Number

S Corporations:
• Complete Form 341-S for each individual shareholder in the S Corporation.
• Include a copy of this form with your return.
• Provide a copy of this form to each individual shareholder.
• Keep one copy for your records.

Individual Shareholders:
• Use this form to complete your Form 341-I.
• If you file your tax return on a calendar year basis but the corporation files a return for a fiscal year, claim this credit on 
 your tax return for the year in which the corporation’s fiscal year ends. For example, if the corporation’s tax year ends in 
 February 2021, claim this credit on your 2021 tax return.

Individual Shareholder’s Name                                Social Security Number                                              Ownership Percentage
                                                                                                                                                               %

                                 (a)                                       (b)
                   School Tuition Organization Name               Credit Approval Number

 1

 2

 3

 4

 5

 6

 7

 8

 9

10

11 Total contributions to school tuition organizations from Form 341, Part 1, line 13 ..............                             11                  00

12 Individual shareholder’s ownership percentage ..................................................................              12                  %
13 Individual shareholder’s portion of credit:  Multiply line 11 by line 12. Enter the result here 
   and on Form 341‑I, Part 1, line 11. This is the amount of credit available to the 
   individual shareholder ...................................................................................................... 13                  00

 NOTE:  If you claim the credit and itemize deductions on federal Schedule A, add back the lesser of the amount on line 13 or 
 the amount that was deducted on Arizona Schedule A.  See instructions for more details. 
ADOR 11244 (21)
                                                                                                                                    Print