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Georgia Form IT-QEE-SSO1
(Last Rev. 12/11)
Please print your numbers like this in black or blue ink:
Please print your numbers like this in black or blue ink:
Qualified Education Expense Credit Letter of Confirmation
Georgia Department of Revenue
Version 1
This form is the second step in the process of applying for the qualified education expense credit. It should be
completed by the student scholarship organization and provided to the taxpayer. This form is used to confirm
that the taxpayer made the contribution to the student scholarship organization.
Enter for Student Scholarship Organization:
TAXPAYER IDENTIFICATION NUMBER
FISCAL YEAR ENDING
NAME OF STUDENT SCHOLARSHIP ORGANIZATION
DEPARTMENT USE ONLY
STREET ADDRESS
CITY
STATE
ZIP CODE
CONTACT PERSON
TELEPHONE NUMBER
The Official Code of Georgia Annotated Section 48-7-29.16 establishes an income tax credit for qualified education expenses.
A credit is allowed for the expenditure of funds by the taxpayer to a student scholarship organization, operating pursuant to
Chapter 2A of Title 20, which uses the contribution for tuition and fees for a qualified school or program.
In order to claim this tax credit, this letter of confirmation of donation should be attached to the taxpayer’s return when it is filed.
Enter for Contributing Taxpayer
FIRST NAME OR NAME OF ENTITY
MI
TAXPAYER IDENTIFICATION NUMBER
LAST NAME IF INDIVIDUAL
SUFFIX
ADDRESS (NUMBER AND STREET or P.O. BOX)
CITY
STATE
ZIP CODE
AMOUNT OF CONTRIBUTION
DATE OF CONTRIBUTION
,
.
,
00
PREAPPROVED AMOUNT OF CREDIT
.
,
,
00