Fillable Form G-1003 - Income Statement Return (Page 2 of 2) in pdf

Instructions for Preparing the G-1003

If you file and pay electronically or are filing Form G2-FL, you must file the G-1003 and related state-

ments electronically. Also employers who are federally required to file income statements electronically

must file them electronically for Georgia purposes. Reg. 560-7-8-.33. Even if the employer is not required

to file electronically, they may choose to do so. To obtain a copy of our specifications, visit our website

_________________

or call 1-877-GADOR11 (1-877-423-6711).

Income statements are due on or before February 28th of the following calendar year. If this date is a

weekend or holiday, the due date is the next business day. If a business closes during the taxable year,

income statements are due within 30 days after payment of final wages. Please note for a flow-through

entity, the G-1003 and the related G2-As for nonresident members are due by the earlier of the date

such entity’s income tax return is filed or the due date for filing such entity’s income tax return (without

extension).

Submit non-wage statements (1099s ) only if Georgia tax is withheld. Statements that do not indicate

Georgia tax withheld may be filed under the Combined Federal/State Filing Program.

Submission requirements: The G2-As should be filed with a separate G-1003 that is being filed to report

withholdings on nonresident members share of taxable income sourced to Georgia. Submit one Form G-1003

for W2s, 1099s and W2-Cs.

The “Number of Forms,” “Form Type” “Georgia Taxable Wages” and “Georgia Tax Withheld” blocks must

be completed where applicable .

Copies of the corrected W2s/1099s/G2-As must accompany all amended returns.

Submit Form G-1003 and paper copies of income statements to:

Processing Center

Ge o r gi a De p a rt m e nt o f R e ve n u e

PO Box 105685

Atlanta, GA 30348-5685

PLEASE DO NOT mail this entire page. Please cut along dotted line and mail coupon only.

PLEASE DO NOT STAPLE OR PAPER CLIP.

Cut on dotted line

G-1003

EMPLOYER NAME AND ADDRESS

(Rev. 12/14)

Income Statement Return

Amended Return

Domestic employer

with no GA Tax Withheld

DO NOT SUBMIT PAYMENT WITH THIS FORM

GA Withholding ID

FEI Number

Number of Forms

Vendor Code

Tax Year

040

Form Type

Check here if correction to

Social Security Numbers only.

W-2

G2-A

1099

W2-C

Georgia Taxable Wages

Georgia Tax Withheld

Under penalty of perjury, I declare that this return has been examined by me and to the best of my knowledge and belief it is true,

correct and complete.

PROCESSING CENTER

Signature

Title

GEORGIA DEPARTMENT OF REVENUE

PO BOX 105685

Telephone

Date

ATLANTA GA 30348-5685

10300000000000000000004000000000000

Form G-1003 - Income Statement Return Page 2

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