Form Cr-Aff - Affidavit By Nonresident
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CR-AFF (7/14)
AFFIDAVIT BY NONRESIDENT
This form is to be completed by a nonresident member included in a composite
return filing whose tax is computed under Options 1 or 2 of Regulation 560-7-8-.34.
This form is to be completed by each nonresident member and returned to the
entity.
The completed form should be retained by the entity and made available if requested
by the Department.
Name
Taxpayer’s Federal Identification Number
Street Address
Tax Year Ending
City, State and Zip Code
Telephone Number
Georgia Filing Status (e.g. Single, Married Filing Jointly, Married
Filing Separately, Head of Household)
Flow-through Entity’s Name
Entity’s Federal Identification Number
Under penalty of perjury, I swear that the above information is to the best of my
knowledge and belief, true, correct and complete; AND that for the above stated tax
period, I do not have any income from any sources within the state of Georgia other than
from the flow-through entity listed above.
__________________________________
___________________________
Taxpayer’s Signature
Date
1
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