Form Ga-V - Withholding Payment Voucher - 2016 Page 2

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Instructions for Completing the GA-V
Taxes are withheld when wages are paid, not when the payroll period ends.
Form GA-V must be used to submit monthly payments on or before the 15th of the following month. ANY payment
received after the 15th of the following month will be subject to late charges. Do not send penalty or interest with a
payment. If the 15th is a weekend or holiday, the due date is the next business day.
Taxpayers who withhold $500 or more on any one return (quarterly total) must submit payments by Electronic Funds
Transfer (EFT).
Form GA-V is NOT required if no tax is withheld for a particular month or if payment was made via EFT.
Mail this completed form with your payment to:
Processing Center
Georgia Department of Revenue
PO Box 740387
Atlanta, Georgia 30374-0387
Contact the Withholding Tax Unit at 1-877-GADOR11 (1-877-423-6711) if you need additional information or assistance.
PLEASE DO NOT mail this entire page. Please cut along dotted line and mail only voucher and payment.
PLEASE DO NOT STAPLE OR PAPER CLIP. PLEASE REMOVE ALL CHECK STUBS.
Cut on dotted line
Name and Address:
GA-V
(Rev. 03/23/16)
Withholding Payment Voucher
GA Withholding ID
FEI Number
Tax Period
Due Date
Vendor Code
040
Under penalty of perjury, I declare that this voucher has been examined by
PLEASE DO NOT STAPLE OR PAPER CLIP. REMOVE ALL CHECK STUBS.
me and to the best of my knowledge and belief it is true, correct and
complete.
Signature
Title
Telephone
Date
PROCESSING CENTER
GEORGIA DEPARTMENT OF REVENUE
PO BOX 740387
$
Amount Paid
ATLANTA GA 30374-0387
0010000000000000004000000000003

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