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Form 525-Tv - Individual And Fiduciary Payment Voucher - Georgia Department Of Revenue

State of Georgia Department of Revenue

KEEP THESE INSTRUCTIONS AND WORKSHEET WITH YOUR RECORDS

Instructions

1. Download (free) the latest version of Adobe Reader.

2. Complete the worksheet below to automatically create your payment voucher.

3. Click the “Print” button to print a completed 525 TV Individual/Fiduciary payment voucher.

4. Cut the payment voucher along the dotted line and mail the voucher and your payment only to

the address on the voucher.

DO NOT fold, staple or paper clip items being mailed.

DO NOT mail in the worksheet, keep this for your records.

525TV Individual/Fiduciary Worksheet

2. Spouse’s SSN :

Taxpayer's SSN:

3. Tax Year : .................................

4. Daytime Phone Number :

Select

5. Individual or Fiduciary Name:

6. Street Address Line 1 :

7. Street Address Line 2 :

8. City :

9. State:

10. Zip:

11. Check Type of Return : Amended Return:

Paper :

Electronically Filed :

12. Please Select Tax Type of Return : ......................................................

Select

13. Amount Paid : ........................................................................................

Clear

Form 525-Tv - Individual And Fiduciary Payment Voucher - Georgia Department Of Revenue