500 ES
500 ES
(Rev. 3/00)
MAIL TO:
GEORGIA INDIVIDUAL
GEORGIA DEPT. OF REVENUE
ESTIMATED TAX
P.O. BOX 740319
ATLANTA, GA 30374-0319
Type of Return:
(404) 656-4674
Individual
Fiduciary
For Calendar Year Ending ______________ or Fiscal Year Ending ________________________ 20____
Insert Name and Address in Box Below
Department Use
Change of Address
Only Misc.
Quarter
Due Date
Taxpayers Social Security Number
Amount Due
Spouses Social Security Number
$
SCHEDULE FOR ESTIMATING GEORGIA INCOME TAXES
1.
$________________
1.
Adjusted gross income expected during the current year
2.
$________________
2.
Less: Deductions
3.
$________________
3.
Balance (Line 1 less Line 2)
4.
$________________
4.
Less: Personal exemption and exemption for dependents
5.
$________________
5.
Balance (Line 3 less Line 4)
6.
$________________
6.
Applicable Retirement Exclusion, see worksheet
7.
$________________
7.
Taxable income (Line 5 less Line 6)
8.
$________________
8.
Tax on amount on Line 7 (See tax rate schedule)
9.
$________________
9.
Less: Withholding tax and other credits
10. $________________
10.
Your estimated tax (line 8 less Line 9)
11. $________________
11.
Credit from prior years return to be credited to this estimate
12. $________________
12.
Estimated tax due this year (Line 10 less Line 11)
(Figures may be rounded off.)
Do Not Cut This Page
Please send in entire sheet.