Form It-303 - Application For Extension Of Time For Filing State Income Tax Returns Page 2
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MAIL TO:
IT-303
(Rev. 12/2012)
Form
Georgia Department of Revenue
Processing Center
PO Box 740320
Atlanta, GA 30374-0320
Georgia Department of Revenue
APPLICATION FOR EXTENSION OF TIME
FOR FILING STATE INCOME TAX RETURNS
IMPORTANT! ACCEPTANCE OF FEDERAL EXTENSIONS
A FEDERAL EXTENSION WILL BE ACCEPTED AS A GEORGIA EXTENSION IF: (1) THE RETURN IS RECEIVED WITHIN THE TIME AS EXTENDED BY
THE INTERNAL REVENUE SERVICE, AND (2) A COPY OF THE FEDERAL EXTENSION(S) IS ATTACHED TO THE RETURN WHEN FILED. NOTE:
THERE IS NO EXTENSION FOR PAYMENT OF TAX. INCOME TAX OR CORPORATE NET WORTH TAX MUST BE PAID BY THE PRESCRIBED DUE
DATE TO AVOID THE ASSESSMENT OF LATE PAYMENT PENALTIES AND INTEREST.
THIS IS NOT A PAYMENT FORM! REMIT PAYMENT ON FORM IT-560 OR IT-560C.
COMPLETE THIS FORM IN TRIPLICATE. MAIL THE ORIGINAL PRIOR TO THE RETURN DUE DATE AND KEEP 2 COPIES. ATTACH ONE COPY TO
RETURN WHEN FILED AND RETAIN ONE COPY FOR YOUR RECORDS. WE WILL NOTIFY YOU ONLY IF YOUR EXTENSION REQUEST IS DENIED.
SECTION 1
NAME
SOCIAL SECURITY NUMBER OR FEIN
ADDRESS
CITY
STATE
ZIP CODE
NAME OF TAXPAYER FOR WHOM EXTENSION IS FILED, IF DIFFERENT FROM ABOVE
ADDRESS
CITY
STATE
ZIP CODE
SECTION 2
APPLICATION IS HEREBY MADE FOR AN EXTENSION OF TIME FOR THE FOLLOWING STATE TAX RETURN:
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Individual--Form 500
Partnership--Form 700 (5 months only)
Fiduciary--Form 501 (5 months only)
Corporate Income Tax
Net Worth Tax (For Period Beginning)
Other
NOTE: Except as noted above, extensions are limited by law to six (6) months, please see line 6 of instructions.
SECTION 3
REASON FOR EXTENSION:
I AFFIRM THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE AND ACCURATE. THIS AFFIRMATION
IS MADE UNDER THE PENALTIES PRESCRIBED BY LAW.
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IF SIGNED BY AGENT, AGENT’S FIRM OR TRADE NAME
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