Form It-Consv - Conservation Tax Credit -
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STATE OF GEORGIA
Department of Revenue
Conservation Tax Credit
( This form is to be used by a taxpayer who donated property
for conservation purposes in a taxable year beginning on or after January 1, 2008)
IT-CONSV 2008 (10/11)
Tax Year End _____________________
A. Business Information of Taxpayer Donating Property
Name
Federal Employer Identification Number/Social Security Number
Street Address
Type of Business:
Partnership/LLC
Sole Proprietor
S Corporation
C Corporation
Individual
Other(Specify)_________________________________
City
State
ZIP Code
Tax Year End
Contact Person
Telephone Number
E-mail Address
If Corporation please provide the state of incorporation
Date of Contribution
B. Recipient of Donated Property
Name of Governmental Entity or Organization ________________________________________________
Street Address _______________________________________ _________________________________
P. O. Box
City __________________________ State ____ ZIP Code _____________
Phone Number(s) ____________________
Fax Number ________________________
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Parent category: Financial