Georgia Form 500 - Indvidual Income Tax Return/georgia Form Ind-Cr - State Of Georgia Individual Credit Form - 2015

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500

Page

Georgia Form

(Rev. 09/02/15)

Individual Income Tax Return

Georgia Department of Revenue

2015

(Approved web version)

Fiscal Year

Beginning

Please print your numbers like this in black or blue ink:

Fiscal Year

version)

Ending

YOUR FIRST NAME

YOUR SOCIAL SECURITY NUMBER

LAST NAME

SUFFIX

Special Program Code

See IT-511 Tax Booklet

SPOUSE’S SOCIAL SECURITY NUMBER

SPOUSE’S FIRST NAME

DEPARTMENT USE ONLY

LAST NAME

SUFFIX

CHECK IF ADDRESS HAS CHANGED

ADDRESS (NUMBER AND STREET or P.O. BOX)

(Use 2nd address line for Apt, Suite or Building Number)

500 UET Exception

Attached

CITY (Please insert a space if the city has multiple names)

STATE

ZIP CODE

(COUNTRY IF FOREIGN)

Residency Status

4. Enter your Residency Status with the appropriate number.................................................................................................................

1. FULL- YEAR RESIDENT

2. PART- YEAR RESIDENT

3. NONRESIDENT

Part-Year Residents and Nonresidents must omit Lines 9 thru 14 and use Schedule 3 of Form 500, page 8.

Filing Status

5. Enter Filing Status with appropriate letter (See I T - 5 1 1 Tax Booklet)...................................................................................

....

A. Single

B.Married filing joint

C.Married filing separate(Spouse’s social security number must be entered above)

D. Head of Household or Qualifying Widow(er)

6. Number of exemptions (Check appropriate box(es) and enter total in 6c.)

6a. Yourself

6b. Spouse

6c.