Form 500 Es - 500-Es Worksheet/individual Estimated Tax
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1
2State of Georgia
Department of Revenue
Instructions
1. Download (free) the latest version of Adobe Reader (7.0).
2. Complete the worksheet below to automatically create your payment voucher.
3. Click the “Print” button to print a completed 500 ES payment voucher.
4. Cut the payment voucher along the dotted line and mail the voucher and your payment only to
the address on the voucher
DO NOT fold, staple or paper clip items being mailed.
DO NOT mail in the worksheet, keep this for your records
500-ES Worksheet
1. Taxpayer’s SSN :
2. Spouse’s SSN :
3. Name : .............................
4. Street Address Line 1 :
5. Street Address Line 2 :
6. City :
7. State:
8. Zip:
-
0000
9. Check Type Of Return : ..........................................
Individual :
Fiduciary:
10. Check If Address Change : ........................................................................................................
11. Calendar Year or Fiscal Year Ending :
Select
12. Due Date : .................................................................
Select
13. Amount Paid : ..........................................................
Print
Clear
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Parent category: Financial