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CLEAR
IT-FC 2016 (03/14/16)
STATE OF GEORGIA
Department of Revenue
Film Tax Credit
(This form is to be used for Tax Years beginning on or after January 1, 2016.)
Tax Year Beginning _______________________
FEI Number ____________________________
Tax Year End _______________________
Georgia Withholding Tax Account Number
A. Business Information
______________________________________
Name and address of Taxpayer (Legal Name)
______________________________________
Film Withholding ID
______________________________________
______________________________________
Georgia Sales Tax Registration Number
______________________________________
______________________________________
______________________________________
Date company began doing business in
Contact Person, Title
Georgia
______________________________________
______________________________________
______________________________________
If Corporation, please provide state of
Telephone Number/E-mail Address of Contact
incorporation
Person
______________________________________
______________________________________
Is this Production Company a Qualified Interactive Entertainment Production Company*?
Yes or
No
A Qualified Interactive Entertainment Production Company must use credit code 133 when claiming the film tax credit on its income tax return.
Has tax been withheld on loan-out companies and paid to the Department?
Yes or
No
B. Project Information
1. Name of Project (if multiple projects, please attach a list for each individual project)
___________________________________________________________________________________
2. Attach a copy of the Certifications(s) from the Georgia Department of Economic Development.
3. Attach a spreadsheet breakdown of the base investment in Georgia (breakdown may be by expense
category).
4. Attach an employee listing for employees whose wages are included in the base investment. List must
include name, social security number and Georgia wages.
A Qualified Interactive Entertainment Production Company is a company that maintains a business location physically located in Georgia; in the
calendar year directly preceding the start of the taxable year of the qualified interactive entertainment production company, had a total aggregate
payroll of $500,000 or more for employees working within Georgia; has gross income less than $100 million for the taxable year; and is primarily
engaged in qualified production activities related to interactive entertainment which have been approved by the Department of Economic Development.
Any company that has gross income less than $100 million for the taxable year and is primarily engaged in qualified production activities related to
interactive entertainment must maintain a business location physically located in Georgia and in the calendar year directly preceding the start of
the taxable year of the qualified interactive entertainment production company they must have had a total aggregate payroll of $500,000 or more for
employees working within Georgia in order to qualify for the film tax credit. The qualified interactive entertainment production company must have
received an approved Form IT-QIEPC.
Total aggregate payroll means the total sum expended by a production company or qualified interactive entertainment production company on
salaries paid to employees working within this state in a state certified production or productions. For purposes of this paragraph:
(a) With respect to a single employee, the portion of any salary which exceeds $500,000.00 for a single production shall not be included when
calculating total aggregate payroll; and
(b) All payments to a single employee and any legal entity in which the employee has any direct or indirect ownership interest shall be considered as
having been paid to the employee and shall be aggregrated regardless of the means of payment or distribution.
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