Form It-Consv - Conservation Tax Credit - Page 3
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3IT-CONSV 2008 (10/11)
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Part IV Application of Credit and Carry Forward
1)
Amount of credit (from Line 2(d), Part II or Line 2(d), Part III) *
$ _____________________
2)
Credit Carried Forward from Prior Years **
$ _____________________
3)
Total Credit Available in the Current Year
$ _____________________
(Add Line 1 plus Line 2)
4)
Georgia Income Tax Liability for Current Year
$ _____________________
5)
Remaining Tax Credit
$ _____________________
(Line 3 less Line 4 – Not less than zero)
* The credit amount allowed for a taxable year shall not exceed $250,000 for an individual,
married couple filing a joint return, trust, or estate as determined under O.C.G.A. § 48-7-20 and
shall not exceed $500,000 for an entity as determined under O.C.G.A. § 48-7-21.
** The credit carry forward shall not exceed ten years (O.C.G.A. § 48-7-29.12(d)) and must be
reduced by any credit that is sold.
An Approved and Completed Certification Form from the Department of Natural Resources must be
attached to this Form.
The Department will accept an appraisal that meets the Internal Revenue Service requirements.
To be signed by Applicant
I endorse the accuracy of the information provided in this application. I affirm that the donated property is
not dedicated under local government regulation or ordinance, or dedicated to increase building density
levels under such regulations or ordinances.
I agree to provide any additional documentation requested by the Georgia Department of Revenue for
approval of this credit.
____________________________________________
_______________________________
Signature of Owner/Corporate Officer/or Individual
Date
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