Tax Credit Justification for PO#__________________
At this time we do not have enough information to justify the request as tax credit
expenditure. If you feel that the expense is truly eligible for tax credit in support of an
Extra Curricular Activity or Character Education (A.R.S. 43-1089.01), please fill out this
form for your own records and send a copy for our files. By submitting this form, the
campus assumes responsibility for justifying this expenditure to auditors, legislators and
taxpayers. This form should be saved as an aid for you to maintain records of justification.
Upon a finding of noncompliance in a state audit, it may be necessary to reduce your
campus funds by this expenditure.
Principal’s signature
School Name
Date
Character Education (Program 169, Function 1609 or Project 01609):
The Message or Pre-Approved Provider
____________________________________________________________________________________________
(Please list the Pre-Approved Provider or describe the specific message that promotes Character Education on the line
above. Students are either making something that has these words or using something that has these words.)
The Traits
Which character traits are applied or reinforced through this message? (Check All that Apply)
__Truthfulness
__Responsibility
__Compassion
__Diligence
__Sincerity
__Trustworthiness
__Respect
__Attentiveness
__Obedience
__Orderliness
__Forgiveness
__Virtue
__Fairness
__Caring
__Citizenship
__Integrity
The Activity
How will students receive this specific message through use of this item?
Pre-Approved Providers
The requestor may also list one of the
pre-approved provider programs that is
being implemented at the school.
http://www.azed.gov/charactereducation/cemgproviders/
Achieve It 360
Character Counts
Character First
Character Matters
Character Plus
I Care
Ignite Consulting
KC’s Martial Arts
KOI Education
Life Solutions of Phoenix
Playworks
Release the Fear
Six Seconds
The Be Kind People Project The Flippen Group
Tomorrow’s Leaders
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Bucketfillers for Life Casa Center for Positive Social Change
UPI Education
The Leader in Me
Creative Spirit
Tax Credit Justification for PO#__________________
Extra Curricular Activity:
_______________________________________________________________________________________________________
(Please describe the activity in the line above.)
Principal’s signature
School Name
Date
An activity is the action that describes an event of student participation that has a clear start date/time and an end
date/time and that is not exclusively for recreational or entertainment value. Activities may be considered extracurricular
if they occur either OFF school property or OUTSIDE normal instructional hours (A.R.S.15-901 (A)(1)(b)(i)). Non-graded
educational activities during instructional time may also be considered extra-curricular. (A.R.S. 43-1089.01).
_____ Food (Object 6609) and Supplies (Object 6610):
Allowed as part of an award banquet or travel expenses (including mileage reimbursement) occurring during a field trip.
Per governing board policy (DKC-R) the cost must be limited to $12.50 per meal per participant. These expenditures are
for student and adult participants, who are providing a required service in support of the activity (which may include
teachers, coaches and the required minimum chaperones). Items will need to be broken out by food and supplies.



Cost of all supplies ___________ and food __________
Number of participants _________
Total cost per participant _________
____ Awards / Incentives ______________________________________________________________________
(Please describe the student accomplishment that will be recognized)
An award banquet is an event that may include meals that recognizes that past accomplishments of participating students.
Per governing board policy the cost of an individual award may not exceed $25.00.



Cost of awards _________
Number of students receiving awards ________
Cost of awards per student __________
_____ Purchased Services
Does the person who will be providing a service in support of this activity work for the district? _________
If so please submit a PAW for the work and we will close the purchase order.
_____Equipment & Capital
If the answer to any of the questions in the section below is “NO” then the item will be disallowed.
1. Is this item something that the district would not have purchased as part of the normal operation and
maintenance or curriculum? _________
2. Is it reasonable to conclude that the capital item will be for the exclusive use of that activity or the exclusive use in
support of the health and safety needs of that activity? _________
3. Is the use of the item by someone considered participation in or support of the activity? _________
______Land Improvements (Function 4xxx is not allowed)
Items that are directly or indirectly attached to the ground beyond the length of the activity are considered land
improvements and will be disallowed as tax credit purchases. Is this item a land improvement?__________
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Tax Credit Justification for PO#__________________
Extra- Curricular Activity
Determination Chart
A.R.S. §43-1089.01 defines when the tax credit can be
claimed for an extracurricular activity.
YES
NO
YES
NO
Is the activity school-sponsored? (No separate
liability insurance is necessary)
1. Sponsorship implies liability of the school which would
require school personnel chaperone.
Travel would also need board approval
2. Is the school charging a fee? (Note 1)
3. Is the activity for enrolled students?
4. Is the activity educational?
A.R.S. §15-342 (24) defines an extracurricular activity
5.
Is the activity optional? (Does it affect grade if not
participate?)
6. Is the activity noncredit?
·If the answers are yes to the above six questions, then extracurricular
activities fees tax credit monies may be used to support the activity.
· If the answer is no to any of the questions, then the tax credit monies may
not be used to support the activity.
Note 1 – To cover this requirement, a school may publish a nominal
participation fee of $1 on their schedule of fees to cover all other extracurricular
activities a student may wish to participate in.
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Tax Credit Justification for PO#__________________
Other Unallowable Tax Credit Expenditures
Advanced Placement Testing
Playground equipment
Classroom SMART boards (Wickenburg 2010)
Short Term Capital
Additional Course Fee ($160)
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Tax Credit Justification for PO#__________________
Allowable extra curricular activities
Advanced placement test / AP Testing / SAT
Character Education
Field Trips (non credit)
Athletics
Sports
Fine Arts
Music
Band
Orchestra
Choir
Performing Arts / Drama
Academic Competitions
Clubs
After school enrichment (VIK)
Tutoring (South Valley Junior High)
Extended Kindergarten (FDK Fees?)
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Tax Credit Justification for PO#__________________
Elementary
All field trip monies will be deposited at the appropriate grade level.
All other programs will go into the general fund.
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