Form G2-Lp - Withholding On Sales Or Assignment Of Lottery Payments - 2014
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Form G2-LP
(12/14)
Withholding on Sales or Assignment of Lottery Payments
Check here if the purchase is an installment sale
Amended Return
1. Seller's/Assignor's Name
2. Seller's/Assignor's Social Security or FEI Number
9. Date of purchase or
________________
installment payment date
3. Seller's/Assignor's Address
10. Winning amount
________________
City
State
ZIP Code
11. Purchase price or
________________
installment payment amount
4. Buyer's/Assignee's Name
5. Buyer's/Assignee's Social Security or FEI Number
12. Amount withheld
________________
6. Buyer's/Assignee's Address
Remit to:
Georgia Department of Revenue
Processing Center
City
State
ZIP Code
PO Box 105678
Atlanta, GA 30348-5678
7. Contact person
8. Telephone Number
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Instructions
Line 1
If more than one seller/assignor, submit a separate form for each.
Line 2
Social Security Number if an individual; FEI number if a corporation or other organization.
Line 3
If mailing address is a Post Office Box, also list street address.
Line 4
If more than one buyer/assignee, submit a separate form for each.
Line 5
Social Security Number if an individual; FEI number if a corporation or other organization.
Line 6
If mailing address is a Post Office Box, also list street address.
Line 7
Contact name for buyer/assignee.
Line 8
Telephone number for contact person.
Line 9
Date the purchase/closing took place. If the purchase is made on an installment basis, enter the date
of the installment payment.
Line 10
Original amount the assignor won.
Line 11
Purchase price of the lottery winnings. If the purchase is made on an installment basis, enter the
amount of the installment payment.
Line 12
Amount withheld - 6% of the total purchase price. If the purchase is made on an installment basis, enter
6% of the installment payment amount.
Remit tax by mailing this form with payment for the amount on Line 12 within 10 days of the purchase
date or installment payment date. Both buyer/assignee and seller/assignor should retain copy of the form.
Seller/assignor must attach a copy of this form to their Georgia individual income tax return.
NOTE: See Policy Statement IT-2010-1-27 at for more information or contact the
Withholding Review Unit at 1-877-423-6711.
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