Ga-V - Withholding Tax Payment Voucher

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MAIL TO:
*GA-V
(Rev. 3/00)
Georgia Department of Revenue
P.O. Box 740387
Georgia Department of Revenue
Department
Atlanta, Georgia 30374-0387
WITHHOLDING TAX PAYMENT VOUCHER
Use Only
Telephone No. (404) 656-4181
Misc.
USE ONLY FOR YEAR INDICATED
GA Withholding Number
FEI Number
Tax Period
Due Date
Enter Payment Amount
$
Name and Address
Signature
Title
Telephone
Date
Department Use Only

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