Form 501 - Fiduciary Income Tax Return - 2011
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Georgia Department of Revenue
501
Processing Center
Georgia Form
(
R
e
. v
5/11)
P.O. Box 740316
Fiduciary Income Tax Return
Atlanta, Georgia 30374-0316
____/____/____
____/____/____
2010 OR OTHER TAX YEAR BEGINNING
ENDING
500 UET Exception Attached
A. Federal Employer Id. No.
Name of Estate or Trust
B. Date of Creation of Trust or
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elephone No.
Decedent’s Death
Address of Fiduciary (Number and Street)
City, State, and Zip Code
C. Name and address on last year’s return if different from above. If no return was filed last year, state reason.
D. Indicate latest taxable year (within last 5 years) adjusted by INTERNAL REVENUE SERVICE ___________________________________________
If Internal Revenue Service adjusted net income within last 5 years, a detailed statement of such adjustment must be submitted under separate cover to:
Georgia Department of Revenue, Processing Center, P.O. Box 740316 , Atlanta, Georgia 30374-0316.
1. Income of fiduciary (Adjusted total income from attached Form 1041) .....................
1.
2. Adjustments: (List of all items in Schedule 3, Page 2) ...............................................
2.
3. Total (Line 1 plus or minus Line 2) .............................................................................
3.
4. Beneficiaries’ share of income (Total of Schedule 2) .................................................
4.
5. Balance (Line 3 less Line 4) .......................................................................................
5.
6. Exemptions: (Trusts $1,350 / Estates $2,700) ............................................................
6.
7. Net taxable income of fiduciary (Line 5 less Line 6) .....................................................
7.
8. Total tax ......................................................................................................................
8.
9. Less Credits (See instructions) ...................................................................................
9.
10. Balance ...................................................................................................................... 10.
11. Less payments on Georgia estimated income tax or Georgia tax withheld .................. 11.
12. Balance of tax due ..................................................................................................... 12.
13. Interest ....................................................................................................................... 13.
14.
_______
__________
__________ . 14.
Penalties-Late Payment
Late Filing
Underpayment Estimated
15. Total amount due (Pay this amount in full to Georgia Department of Revenue) ............ 15.
16. Overpayment (Line 10 less Line 11) ............................................................................ 16.
17. Amount to be refunded .............................................................................................. 17.
18. Amount of Line 16 to be credited to 2011 estimated tax ............................................. 18.
1.
2.
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3.
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4
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2.
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TOTAL (Enter also on Line 4, Schedule 1)
DECLARATION: I/we declare under the penalties of perjury that I/we have examined this return (including accompanying schedules and statements) and to the best of our knowledge and
belief it is true, correct, and complete. If prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge.
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Department Use Only
THE FIDUCIARY MUST ATTACH TO THIS RETURN A COPY OF
ITS FEDERAL RETURN AND SUPPORTING SCHEDULES
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