Form G-2-A - Withholding On Distributions To Non-Resident Members/shareholders F
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1Form G-2-A
WITHHOLDING ON DISTRIBUTIONS TO NON-RESIDENT MEMBERS/SHAREHOLDERS
TAX YEAR
1. PAYOR’S STATE ID NUMBER
2. PAYOR’S FEDERAL ID NUMBER
3. BUSINESS ENTITY NAME AND ADDRESS
4. RECIPIENT’S ID NUMBER
5. RECIPIENT’S NAME AND ADDRESS
6. AMOUNT OF DISTRIBUTION
7. GEORGIA TAX WITHHELD
8.
GEORGIA DEPARTMENT OF REVENUE
P.O. BOX 740387
ATLANTA, GA 30374-0387
COPY 1- STATE COPY
Form G-2-A
WITHHOLDING ON DISTRIBUTIONS TO NON-RESIDENT MEMBERS/SHAREHOLDERS
TAX YEAR
1. PAYOR’S STATE ID NUMBER
2. PAYOR’S FEDERAL ID NUMBER
3. BUSINESS ENTITY NAME AND ADDRESS
4. RECIPIENT’S ID NUMBER
5. RECIPIENT’S NAME AND ADDRESS
6. AMOUNT OF DISTRIBUTION
7. GEORGIA TAX WITHHELD
8.
GEORGIA DEPARTMENT OF REVENUE
P.O. BOX 740387
ATLANTA, GA 30374-0387
COPY 2- TO BE ATTACHED TO GEORGIA RETURN
Form G-2-A
WITHHOLDING ON DISTRIBUTIONS TO NON-RESIDENT MEMBERS/SHAREHOLDERS
TAX YEAR
1. PAYOR’S STATE ID NUMBER
2. PAYOR’S FEDERAL ID NUMBER
3. BUSINESS ENTITY NAME AND ADDRESS
4. RECIPIENT’S ID NUMBER
5. RECIPIENT’S NAME AND ADDRESS
6. AMOUNT OF DISTRIBUTION
7. GEORGIA TAX WITHHELD
8.
GEORGIA DEPARTMENT OF REVENUE
P.O. BOX 740387
ATLANTA, GA 30374-0387
COPY 3- RECIPIENT’S RECORDS
Form G-2-A
WITHHOLDING ON DISTRIBUTIONS TO NON-RESIDENT MEMBERS/SHAREHOLDERS
TAX YEAR
1. PAYOR’S STATE ID NUMBER
2. PAYOR’S FEDERAL ID NUMBER
3. BUSINESS ENTITY NAME AND ADDRESS
4. RECIPIENT’S ID NUMBER
5. RECIPIENT’S NAME AND ADDRESS
6. AMOUNT OF DISTRIBUTION
7. GEORGIA TAX WITHHELD
8.
GEORGIA DEPARTMENT OF REVENUE
P.O. BOX 740387
ATLANTA, GA 30374-0387
COPY 4- PAYOR’S COPY
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