Form It-Hc - Certification Of Georgia Housing Tax Credit Page 3
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CLEAR
IT-HC (Rev. 12/13)
Name of Taxpayer ________________________________________
FEI / SS# / NAIC # of Taxpayer /Shareholder____________________
Tax Year
FYE
FYE
FYE
FYE
FYE
FYE
FYE
FYE
FYE
FYE
FYE
20__
20__
20__
20__
20__
20__
20__
20__
20__
20__
20__
Credit Amount
Unused
Carryforward
Total Available
Credit
Georgia Tax
Liability
Current Year
Credit Allowed
Unused
Georgia
Housing Credit
Recaptured
Credit
Check if Transfer has occurred (this does not apply to insurance companies).
For Insurance Companies Only:
“I give (my) permission to the Office of the Insurance and Safety Fire Commissioner to share the
information contained herein with the Georgia Department of Revenue, Department of Community Affairs,
or other government agencies as necessary to verify and process the requested tax credit.”
Signature
Print Name
Date
Attach the following documentation when filing the Georgia State Income Tax Return or
Insurance Premium Tax Return where the credit is claimed:
•
A properly executed Form IT-HC, Page 3, reflecting the total amount of credit
claimed;
•
A Georgia K-1 equivalent indicating the amount of State credit allocated; and
A schedule that includes each property for which a credit is claimed with a
•
building-by-building allocation.
***Failure to attach these documents will result in disallowance of the credit.***
NOTE: Do NOT submit a claim for credit for any property for which a Federal Form 8609
has not been issued. Estimates will not be accepted.
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