Arizona Form                              Credit for Contributions 
                 352                    to Qualifying Foster Care Charitable Organizations                                                                                             2022
Include with your return.
     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 January 1, 2022 through December 31, 2022.
  • The                                                                          for 2022 to claim the contributions listed in Part A.                                                                                                                                                                                    foster care charitable organization must be certified by the department 
   For more information, see page 1 of the instructions.
  • If                                                   all cashyou arecontributionsmarriedmadeand filingby you andseparateyour spouse.                                                                                                      returns, be sure to include 
  • Do not include those cash contributions for which you or your spouse claimed a credit on the 2021 tax return.
  • If                                                                                                                                                                                               you made cash contributions to more than three qualifying foster care charitable organizations (QFCO), complete the 
     Continuation Sheet on page 3 and include it with the credit form.  If you made more than ten (10) contributions to the same 
     QFCO, see instructions. 
       (a)        (b)                                                      (c)                                                                                                         (d)
    Contribution Qualifying Foster                      Name of Qualifying Foster Care Charity                                                                                         Cash 
       Date       Care Charity     (Contributions to qualifying non-foster care charitable organizations are claimed on AZ Form 321)                                                   Contribution
    MM/DD/2022    Code

       2 0 2 2
1                                                                                                                                                                                                  00
       2 0 2 2
2                                                                                                                                                                                                  00
       2 0 2 2
3                                                                                                                                                                                                  00
4   If you made contributions to more than three qualifying foster care charitable organizations, enter the 
    amount from line 4h of the Continuation Sheet, otherwise enter “0” .................................................................                                            4              00
5   Total contributions made to qualifying foster care charitable organizations during 2022:  Add lines 1 
    through 4, column (d) .................................................................................................................................................         5              00

B. Cash contributions made January 1, 2023 through April 18, 2023 for which you or your spouse are claiming a credit on the  
  2022 tax return.
  •  The foster care charitable organization must be certified by the department for 2023 to claim the contributions listed in Part B. 
   For more information, see page 1 of the instructions.
  • If                                                   all cashyou arecontributionsmarriedmadeand filingby you andseparateyour spouse.                                                                                                      returns, be sure to include 
  • If                                                                                                                                                                                               you made cash contributions to more than three qualifying foster care charitable organizations (QFCO), complete the  
    Continuation Sheet on page 3 and include it with the credit form.  If you made more than ten (10) contributions to the same 
     QFCO, see instructions. 
       (a)        (b)                                                      (c)                                                                                                         (d)
    Contribution Qualifying Foster                      Name of Qualifying Foster Care Charity                                                                                         Cash 
       Date       Care Charity     (Contributions to qualifying non-foster care charitable organizations are claimed on AZ Form 321)                                                   Contribution
    MM/DD/2023    Code

       2 0 2 3
6                                                                                                                                                                                                  00
       2 0 2 3
7                                                                                                                                                                                                  00
8      2 0 2 3                                                                                                                                                                                     00
9   If you made contributions to more than three qualifying foster care charitable organizations, enter the 
    amount from line 9h of the Continuation Sheet, otherwise enter “0” .................................................................                                            9              00
10  Total contributions made to the qualifying foster care charitable organizations January 1, 2023  
    through April 18, 2023 for which you are claiming a credit on your 2022 return:  Add lines 6 through 9, 
    column (d) .................................................................................................................................................................... 10             00
11  Add lines 5 and 10.  Enter the total..........................................................................................................................                  11             00
12  Single taxpayers or heads of household, enter $500.  Married taxpayers, enter $1,000. .............................                                                             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 line 12.  See instructions.....................................                                                    13             00

ADOR 11294 (22)                                                                                                                                                                        Page 1 of 3

 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   Amount Previously Used        Available Carryover:
        from which you are 
        carrying the credit                                                            Subtract column (c) 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 22, 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 22, 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 22, column (c) ................................................. 22      00

                                                         Print Form
 ADOR 11294 (22)                                         AZ Form 352 (2022)                                                           Page 2 of 3

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

                                     AZ Form 352- Credit for Contributions to 
                                Qualifying Foster Care Charitable Organizations 
                                            Continuation Sheet 

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

 A. Cash contributions made January 1, 2022 through December 31, 2022.
      (a)           (b)                                  (c)                                                                           (d)
      Contribution Qualifying Foster         Name of Qualifying Foster Care Charity                                                    Cash 
      Date         Care Charity      (Contributions to qualifying non-foster care charitable organizations are claimed on AZ Form 321) Contribution
    MM/DD/2022      Code

 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 (d) and enter the total.  Also, enter this amount on page 1, line 4 .................... 4h                          00

B. Cash contributions made January 1, 2023 through April 18, 2023.
      (a)           (b)                                  (c)                                                                           (d)
      Contribution Qualifying Foster         Name of Qualifying Foster Care Charity                                                    Cash 
      Date         Care Charity      (Contributions to qualifying non-foster care charitable organizations are claimed on AZ Form 321) Contribution
    MM/DD/2023      Code

 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 (d) and enter the total.  Also, enter this amount on page 1, line 9 .................... 9h                          00

                                             Print Form
 ADOR 11294 (22)                             AZ Form 352 (2022)                                                                        Page 3 of 3