Georgia Form 500 Draft - Individual Income Tax Return (Page 3 of 7) in pdf

500

Georgia Form

YOUR SOCIAL SECURITY NUMBER

Individual Income Tax Return

Georgia Department of Revenue

2007

21.

Low Income Credit

21a.

21b.

21c.

(See Tax Booklet on Pg. 11)

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4

22.

Department Use Only

DO NOT WRITE IN THIS BOX

22.

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4

23.

Total prepayment credits (Add Lines 19, 20 and 21c).......................

23.

24.

If Line 18 exceeds Line 23 enter BALANCE DUE STATE...................

24.

25.

If Line 23 exceeds Line 18 enter OVERPAYMENT amount.................

25.

26.

Amount to be credited to 2007 ESTIMATED TAX ........................

26.

27.

Georgia Wildlife Conservation Fund (No gift of less than $1.00)

27.

28.

Georgia Children and Elderly Fund (No gift of less than $1.00)..... .

28.

29.

Georgia Cancer Research Fund (No gift of less than $1.00) ........

29.

30.

Georgia Greenspace Trust Fund (No gift of less than $1.00) .......

30.

31.

Georgia National Guard Foundation (No gift of less than $1.00)

31.

32.

Dog & Cat Sterilization Fund (No gift of less than $1.00) ..................

32.

33.

Save the Cure Fund (No gift of less than $1.00)................................

34.

Form 500 UET (Estimated tax penalty)................................................

34.

(If you owe) Add Lines 24, 27 thru 34

35.

THIS IS THE AMOUNT YOU OWE

.......................................................

35.

Sign below and mail 525-TV with return and payment to: Georgia Department of Revenue, Processing Center, PO Box 740399,

Atlanta, Georgia, 30374-0399. (GREEN STRIPE ENVELOPE)

Include your GA Form 500, Sch. 1

DO NOT STAPLE YOUR CHECK, W-2’S OR TAX RETURN. ENCLOSE ALL ITEMS IN THE RETURN ENVELOPE.

36.

(If you are due a refund) Subtract the sum of Lines 26 thru 34 from Line 25

............................................................

THIS IS YOUR REFUND

36.

, Atlanta, Georgia, 30374-

Sign below and mail return to: Georgia Department of Revenue, Processing Center, PO Box 740380

0380.

(BLUE STRIPE ENVELOPE)

DO NOT STAPLE YOUR W-2’S NOR TAX RETURN. ENCLOSE ALL ITEMS IN THE RETURN ENVELOPE.

Georgia Public Revenue Code Section 48-2-31 stipulates that taxes shall be paid in lawful money of the United States, free of any expense to the State

of Georgia. Under penalty of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my

knowledge and belief it is true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which the preparer has

knowledge.

PHONE

NUMBER

Check the box

Taxpayer’s Signature

(Check box if deceased)

DATE

to authorize the

Georgia

Department of

Revenue to

discuss the