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Georgia Form
(
Rev. 11/11)
Georgia Department of Revenue
Amended Fiduciary Income Tax Return
Processing Center
P.O. Box 740316
Atlanta, Georgia 30374-0316
Page 1
2011
FOR FILING YEAR
Change in Trust or Estate Name
Federal Amended Return Filed
____/____/
____/____/
Change in Fiduciary
BEGINNING
ENDING
(please attach copy)
500 UET
Exception Attached
Amended due to IRS changes
Change of Address
A. Federal Employer Id. No.
Name of Estate or Trust
Date of Creation of Trust
N
a
m
e of Fiduciary
Title of Fiduciary
T
elephone No.
B.
Date of Decendent’s Death
( Apt., Suite or Building Number)
C.
Address of Fiduciary (Number and Street)
City
State
Zip Code
Country
D.
If no return was filed last year, state reason
Schedule 1 - Computation of Tax
1.
1. Income of fiduciary (Adjusted total income from attached Form 1041)..............................
2.
2. Adjustments: (List of all items in Schedule 3, Page 3).......................................................
3.
3. Total (Net total of Line 1 and 2)....................................................................................
4.
4. Beneficiaries’ Share of Income (Total of Schedule 2)........................................................
5.
5. Balance (Line 3 less Line 4) .......................................................................... ....................
6.
6. Exemptions:
6a. Trust $1350
6b. Estate $2700 ................................................
7.
7. Net taxable income of fiduciary (Line 5 less Line 6)..........................................................
8.
8. Total tax.................................................................................................................. . ..........
9a.
9. Less Credits:
9a. Other State Credit..........................................................................
9b.
9b. Pass Through and Business Credits...........................................
9c.
9c. Total............................................................................................
10.
10. Tax less credit (Net total of Line 8 less Line 9, if 0 or less, enter 0)..........................
11a.
11. Less payments: 11a. Georgia Estimated Tax Paid..........................................................
11b. Georgia Tax Withheld.................................................................
11b.
11c. Amount paid with original return, plus any additional payments
11c.
made after it was filed.................................................................
11d. Total ............................................................................................
11d.