Form It-Aff2 - Affidavit Of Seller'S Gain
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1IT-AFF2 (Rev. 12/11)
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AFFIDAVIT OF SELLER'S GAIN
Seller’s Name
Seller’s Identification Number (SSN or FEI)
Street Address
Spouse’s Identification Number (if jointly owned)
City
State
ZIP Code
* If the seller is a disregarded single member limited liability company (SMLLC), both the SMLLC and its owner should
be listed as the seller.
INSTRUCTIONS
The seller is required to execute this form or a similar document and present it to the buyer when the seller wishes to
establish the gain to be recognized from a sale of real property, against which gain the withholding imposed by O.C.G.A.
Section 48-7-128 is to be applied. In order to be subject to withholding only upon the gain recognized, the seller must
submit this affidavit to the buyer. If a payment is due, the buyer must submit this form along with the withholding return to
the Department of Revenue. A copy is not required to be submitted to the Department when no withholding tax is due,
unless specifically requested by the Department.
The seller is to complete this document by calculating the gain below. The seller should retain the documentation of the cost
basis, depreciation, and selling expenses claimed. This documentation should only be provided to the Department when
requested.
1. SALES PRICE
$
2. COST BASIS INCLUDING IMPROVEMENTS $
3. DEPRECIA
I T
O
N
$
4. ADJUSTED COST BASIS (line 2 minus line
) 3
$
5. SELLING EXPENSES
$
6. NET TAXABLE GAIN (LOSS) (line 1 minus lines 4 and 5)
$
Under penalties of perjury, I swear that the above information is to the best of my knowledge and belief, true, correct, and
complete.
______________________________________________
_______________________________________________
Seller’s Signature (and Title, if applicable)
Date
Sworn to and subscribed before me this
______day of _______________________, ______
_____________________________Notary public
My commission expires____________________
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