Georgia Form 501 - Fiduciary Income Tax Return - 2015 Page 6

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Instructions for the Individual/Fiduciary (525-TV) Payment Voucher
For faster and more accurate posting to your account, use a payment voucher with a valid scanline
______________________________________
from Georgia Department of Revenue’s website or one produced by an
________________________________________________
approved software company listed at /approved-software-vendors.
Only complete this voucher if you owe taxes.
Complete the name and address field located on the upper right side of the voucher.
Please write your SSN or FEIN on your check or money order.
Remove your check stub to keep with your records.
If you are filing electronically, mail only your voucher and payment to:
Processing Center
Georgia Department of Revenue
P O Box 740323
Atlanta, Georgia 30374-0323
If you are filing a paper return; mail your return, 525 TV payment voucher and your payment to the address
that appears on the return.
Georgia Public Revenue Code Section 48-2-31 stipulates that taxes shall be paid in lawful money of the United
States, free of any expense to the State of Georgia.
Print
Clear
PLEASE
DO NOT mail this entire page. Please cut along dotted line and mail only your voucher and payment.
PLEASE DO NOT STAPLE. PLEASE REMOVE ALL ATTACHED CHECK STUBS.
Cut along dotted line
Individual or Fiduciary Name and Address:
525 TV
(Rev. 06/22/15)
Individual and Fiduciary Payment Voucher
Amended Return
Paper Return
Electronically Filed
Type of Return:
[X]FIDUCIARY
Tax Year
Taxpayer’s SSN or Fiduciary FEIN
Spouse’s SSN
(if joint or combined return)
Daytime Telephone Number
Vendor Code
040
PLEASE DO NOT STAPLE. REMOVE ALL CHECK STUBS.
PROCESSING CENTER
GEORGIA DEPARTMENT OF REVENUE
$
Amount Paid
PO BOX 740323
ATLANTA GA 30374-0323
52500000102220000000000000004000000000007

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