Form It 552 - Corporation Application For Tentative Carry-Back Adjustment Under Section 48-7-21 Of The Georgia Public Revenue Code - 2017
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IT 552 ( Rev. 03/03/17)
ATTACH THIS FORM TO FACE OF
LOSS YEAR RETURN, WHEN PRACTICABLE
CORPORATION APPLICATION FOR TENTATIVE CARRY-BACK ADJUSTMENT
UNDER SECTION 48-7-21 OF THE GEORGIA PUBLIC REVENUE CODE
MAIL TO: GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
PO BOX 740397
ATLANTA, GEORGIA 30374-0397
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DATE RECEIVED
A. Enter the taxable year of Net Operating Loss and/or Net Capital Loss,
Net Operating Loss $
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B. Was a GA consolidated return filed for the year specified in item A? [
]Yes [
]No
(attach Schedule D)
C. Explain all changes of corporate title, if any, made during the three years immediately preceding loss year.
D. UNPAID TAXES: Show amounts unpaid, including taxes, and additional tax due because of notice from this department, for all taxable years.
TAXABLE YEAR
AMOUNT ASSESSED
AMOUNT PAID
UNPAID TAX
UNPAID INTEREST
E. If there has been a change in your accounting period, give the date permission to change was given
F. If this is an application of a dissolved corporation, give date of dissolution
G. If you have filed an amended return or had an audit please attach a copy.
H. Are you a financial institution required to file Form 900 with Georgia?
THIRD PRECEDING TAXABLE
SECOND PRECEDING TAXABLE
FIRST PRECEDING TAXABLE
YEAR ENDED
YEAR ENDED
COMPUTATION OF
YEAR ENDED
(b) Liability after
(c) Return as filed, or
(d) Liability after
(e) Return as filed, or
(f) Liability after
DECREASE IN TAX
(a) Return as filed or
application of carry-back
liability as last determined
application of carry-back
liability as last determined
application of carry-back
liability as last determined
1. Taxable income before deducting line 2
2. (a) NOL Deduction and/or (b) Net Cap.
Loss Deduction resulting from carry-back
3. Line 1 less line 2
4. Tax on line 3
5. Less Georgia Credits
6. Balance (line 5 from line 4)
7. Less line 6 (b) (d) (f)
8. Decrease in tax (line 7 from line 6)
-ATTACH THIS FORM TO FACE OF LOSS YEAR RETURN, WHEN PRACTICABLE-
I, the undersigned, president or other principal officer of the corporation for which this application is made declare under the penalties of perjury that this application (including any accompanying schedules
and statements) has been examined by me and is, to the best of my knowledge and belief, a true, correct, and complete application, made in good faith, pursuant to the Georgia Public Revenue Code and
the regulations issued thereunder. It is understood that this is a tentative carry-back adjustment subject to later detailed audit and does not constitute a claim for credit or refund.
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FOR DEPARTMENT USE ONLY
APPROVED BY_____________________________________________ DATE PAID ___________________________________
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