Georgia Form 500 Draft - Individual Income Tax Return (Page 4 of 7) in pdf

Georgia Form 500 Draft - Individual Income Tax Return Page 4

500

Georgia Form

Individual Income Tax Return

Georgia Department of Revenue

2007

YOUR SOCIAL SECURITY NUMBER

SCHEDULE 1 ADJUSTMENTS to INCOME BASED on GEORGIA LAW

(see Tax Booklet on Pages7 and 8)

ADDITIONS to INCOME

1. Interest on Non-Georgia Municipal and State Bonds......................................

2. Lump Sum Distribution....................................................................................

3. Federal deduction for income attributable to domestic production activities.......

(IRC Section 199)

4. Other (specify)

5. Total Additions (enter sum of Lines 1-4 here)

SUBTRACTION from INCOME

6. Retirement Income Exclusion (see Tax Booklet on Page 12)

a. Self: Date of Birth

Date of Disability:

Type of Disability:

6a.

Type of Disability:

Date of Disability:

b. Spouse: Date of Birth

6b.

7. Social Security Benefits (Taxable portion from Federal return).......................7.

8. Georgia Higher Education Savings Plan.........................................................8.

9. Interest on United States Obligations (See Tax Booklet on Page 7) ...............9.

10. Other Adjustments (specify)

Adjustment

Amount

Adjustment

Amount

Adjustment

Amount

Adjustment

Amount

Total...................................10.

11. Total Subtractions (enter sum of Lines 6-10 here)........................................11.

12. Net Adjustments (Line 5 less Line 11.

Enter Net Total here and on Line 9 of Page 1)(+ or -)..................................12.

Page 4

Georgia Form 500 Draft - Individual Income Tax Return Page 4