Georgia Form 500 (Rev. 06/22/22) Individual Income Tax Return Georgia Department of Revenue (Approved web version)

2022 Page 1

2. PART- YEAR RESIDENT TO 3. NONRESIDENT CITY (Please insert a space if the city has multiple names)

STATE ZIP CODE SPOUSE’S FIRST NAME MI 6a. Yourself 6b. Spouse 6c. 5. Enter Filing Status with appropriate letter (See IT-511 Tax Booklet)................................................................................... .... .... 5. rsion) Fiscal Year Ending 6. Number of exemptions (Check appropriate box(es) and enter total in 6c.) Filing Status Omit Lines 9 thru 14 and use Form 500 Schedule 3 if you are a part-year or nonresident filer. (Use 2nd address line for Apt, Suite or Building Number) LAST NAME

SUFFIX LAST NAME

SUFFIX ADDRESS (NUMBER AND STREET or P.O. BOX) CHECK IF ADDRESS HAS CHANGED

SPOUSE’S SOCIAL SECURITY NUMBER (COUNTRY IF FOREIGN) DEPARTMENT USE ONLY YOUR SOCIAL SECURITY NUMBER 1. 2. 3. 1. FULL- YEAR RESIDENT 4. Enter your Residency Status with the appropriate number .... ...................................................................................................... Residency Status 4. Fiscal Year Beginning YOUR FIRST NAME

MI 7a. 7a. Number of Dependents (Enter details on Line 7b., and DO NOT include yourself or your spouse)...................................... (For Name Change See IT-511 Tax Booklet) STATE ISSUED YOUR DRIVER’S LICENSE/STATE ID

This Page (1) is required for processing D. Head of Household or Qualifying Surviving Spouse A. Single B. Married filing joint C. Married filing separate (Spouse’s social security number must be entered above) PRINT COMPLETED FORM RESET Select

Pag e 2 Georgia Form500 Individual Income Tax Return Georgia Department of Revenue 2022

YOUR SOCIAL SECURITY NUMBER

7b. Dependents (If you have more than 4 dependents, attach a list of additional dependents) First Name, MI. Last Name Social Security Number Relationship to You 9. Adjustments from Form 500 Schedule 1 (See IT-511 Tax Booklet) ....................... 10. Georgia adjusted gross income (Net total of Line 8 and Line 9)............................. 8. Federal adjusted gross income (From Federal Form 1040)..................................... If amount on line 8, 9, 10, 13 or 15 is negative, use the minus sign (-). Example -3456.

8. (Do not use FEDERAL TAXABLE INCOME) If the amount on Line 8 is $40,000 or more, or your gross income is less than your W-2s you must include a copy of your Federal Form 1040 Pages 1, 2, and Schedule 1. 10. 9. INCOME COMPUTATIONS First Name, MI. Last Name Social Security Number Relationship to You First Name, MI. Last Name Social Security Number Relationship to You Social Security Number Relationship to You 11. Standard Deduction (Do not use FEDERAL STANDARD DEDUCTION).............. (See IT-511 Tax Booklet) c. Total Standard Deduction (Line 11a + Line 11b)................................................... b. Self: 65 or over? Blind? Spouse: 65 or over? Blind? Total x 1,300=......................... Use EITHER Line 11c OR Line 12c (Do not write on both lines) 11c. 11b. 11a. 12. Total Itemized Deductions used in computing Federal Taxable Income. If you use itemized deductions, you must include Federal Schedule A. a. Federal Itemized Deductions (Schedule A- Form 1040)............................... b. Less adjustments: (See IT-511 Tax Booklet) ................................................ 12a. 12c. 12b. c. Georgia Total Itemized Deductions..................................................................

13. Subtract either Line 11c or Line 12c from Line 10; enter balance.......................... 13.

First Name, MI. Last Name This Page (2) is required for processing RESET PAGE 2 PREVIOUS PAGE SELECT SELECT SELECT SELECT

Georgia Form500 Individual Income Tax Return Georgia Department of Revenue 2022 YOUR SOCIAL SECURITY NUMBER Pag e 3 INCOME STATEMENT DETAILS Only enter income on which Georgia tax was withheld. Enter income from W-2s, 1099s, and G2-As on Line 4 GA Wages/Income. For other income statements complete Line 4 using the income reported from Form G2-RP Line 12 or 13; Form G2-LP Line

11, or for Form G2-FL enter zero. 14a. Enter the number from Line 6c.

Multiply by $2,700 for filing status A or D 14a. 14b.

Enter the number from Line 7a. or multiply by $3,700 for filing status B or C Multiply by $3,000.......................................... 14b. 14c. 14c. Add Lines 14a. and 14b. Enter total ......................................................

16. 16. 17a. 17b. 17.

Low Income Credit 17c. ........................ 18. 19.

Other State(s) Tax Credit (Include a copy of the other state(s) return) ....... 18. C redits used from IND-CR Summary Worksheet ........................................ 19. 20. Total Credits Used from Schedule 2 Georgia Tax Credits (must be filed electronically) 20. 21. 21. 22. 22. Balance (Line 16 less Line 21) if zero or less than zero, enter

zero .......... Total Credits Used (sum of Lines 17-20) cannot ex ceed Line 16

........................

..... 15a. 15a. Income before GA NOL (Line 13 less Line 14c or Schedule 3, Line 14)..... 15b. 15b. Georgia NOL utilized (Cannot exceed Line 15a or the amount after applying the 80% limitation, see IT-511 Tax Booklet for more information).... 15c. 15c. Georgia Taxable Income (Line 15a less Line 15b)..................................... Tax (Use Tax Rate Schedule in the IT-511 Tax Booklet) ..........................

(INCOME STATEMENT A)

(INCOME STATEMENT B)

(INCOME STATEMENT C)

.

PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 4.

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1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE:

W -2 G2-A G2-LP G2-A W -2 G2-LP G2-A W -2 G2-LP 1099 G2-FL G2-RP 1099 G2-FL G2-RP 1099 G2-FL G2-RP 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. GA WAGES / INCOME 5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. GA TAX WITHHELD

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Georgia Form500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER 2022

Page 4 Estimated Tax paid for 2022 and Form IT-560 ......................................... 25. 23. 24. Other Georgia Income Tax Withheld

........................................................ 24. (Enter Tax Withheld Only and include W-2s and/or 1099s) 23. (Must include G2-A, G2-FL, G2-LP and/or G2-RP) Georgia Income Tax Withheld on Wages and 1099s ............................. 28. If Line 22 exceeds Line 27, subtract Line 27 from Line 22 and enter

balance due............................................................................................... 28. 26. overpayment .............................................................................................. 27. 29. If Line 27 exceeds Line 22, subtract Line 22 from Line 27 and enter 29. 30. Amount to be credited to 2023 ESTIMATED TAX ................................. 31. 32. Georgia Wildlife Conservation Fund (No gift of less than $1.00)............. Georgia Fund for Children and Elderly (No gift of less than $1.00)........ 33. Georgia Cancer Research Fund (No gift of less than $1.00) ................. 34. Georgia Land Conservation Program (No gift of less than $1.00)........... 35. 36 . Georgia National Guard Foundation (No gift of less than $1.00) ............. Dog & Cat Sterilization Fund (No gift of less than $1.00)....................... Saving the Cure Fund (No gift of less than $1.00)................................. (No gift of less than $1.00) Realizing Educational Achievement Can Happen (REACH) Program ............. 38. 37. 37. 31. 30. 32. 33. 34. 35. 36. 38. 25. 26. Schedule 2B Refundable Tax Credits.......................................................... (Cannot be claimed unless filed electronically) 27. Total prepayment credits (Add Lines 23, 24, 25 and 26)...........................

2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID (INCOME STATEMENT E)

2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 1. WITHHOLDING TYPE: 3. EMPLOYER/PAYER STATE WITHHOLDING ID 4. GA WAGES / INCOME 1. WITHHOLDING TYPE: 5. GA TAX WITHHELD 5. GA TAX WITHHELD 4. GA WAGES / INCOME 1. WITHHOLDING TYPE: 5. GA TAX WITHHELD 4. GA WAGES / INCOME

(INCOME STATEMENT F)

(INCOME STATEMENT D) W- 2 1099 G2-A G2-FL G2-LP G2-RP W- 2 1099 G2-A G2-FL G2-LP G2-RP W- 2 1099 G2-A G2-FL G2-LP G2-RP

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Georgia Form500 Individual Income Tax Return Georgia Department of Revenue 2022

YOUR SOCIAL SECURITY NUMBER Pag e 5 40.

Form 500 UET (Estimated tax penalty) 500 UET exception attached 40. 39. Public Safety Memorial Grant (No gift of less than $1.00)....................... 39.

Taxpayer’s Signature Spouse’s Signature (Check box if deceased) (Check box if deceased) By providing my e-mail address I am authorizing the Georgia Department of Revenue to electronically notify me at the below e-ma il address regarding any updates to my account(s). Taxpayer’s E-mail Address Preparer’s Firm Name Signature of Preparer Name of Preparer Other Than Taxpayer

I authorize DOR to discuss this return with the named preparer. Taxpayer’s Phone Number Spouse’s Signature Date Preparer’s Phone Number Preparer’s FEIN Preparer’s SSN/PTIN/SIDN Spouse’s Date of Death Taxpayer’s Date of Death Taxpayer’s Signature Date 44. Routing 43. (If you owe) Add Lines 28, 31 thru 42 .................................................... THIS IS YOUR REFUND......................................................................... Number Account

Type: Checking

Savings Number MAKE CHECK PAYABLE TO GEORGIA DEPARTMENT OF REVENUE, Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740399 ATLANTA, GA 30374-0399

43. 44. (If you are due a refund) Subtract the sum of Lines 30 thru 42 from Line 29 If you do not enter Direct Deposit information or if you are a first time filer you will be issued a paper check. 44a. Direct Deposit (U.S. Accounts Only)

I/We declare under the penalties of perjury that I/we have examined this return (including accompanying schedules and statements) and to the best of my/our knowledge and belief, it is true, correct, and complete. If prepared by a person other than the taxpayer(s), this declaration is based on all information of which the preparer has knowledge.

41. Penalty: Late Payment and/or Late Filing.................................................... 41. 42. Interest ........................................................................................................ 42. Refund Due Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740380 ATLANTA, GA 30374-0380 Mail pages 1-5 and any applicable schedules, forms, and documentation. DO NOT staple pages. This Page (5) is required for processing PRINT COMPLETED FORM RESET PAGE 5 PREVIOUS PAGE

Do: Use a payment voucher with a valid scanline. Only complete this voucher if you owe taxes. Complete the voucher in its entirety. Write your SSN or FEIN on your check or money order. Make check or money order payable to: Georgia Department of Revenue Remember if the due date falls on a weekend or holiday, the tax shall be due on the next day that is not a weekend or holiday. Mail your voucher and payment to the address listed below if your return was filed electronically. Processing Center Georgia Department of Revenue P O Box 740323 Atlanta, Georgia 30374-0323 Mail your return, payment voucher and payment to the address that appears on the return if filing a paper return. Do not: Georgi a Public Revenue Code Section 48-2-31 stipulates that taxes shall be paid in lawful money of the United States, free of any expense to the State of Georgia. 525-TV (Rev. 06/21/22) Individual and Fiduciary Payment Voucher Cut along dotted line Individual or Fiduciary Name and Address: Amended Return Paper Return Electronically Filed Type of Return: Taxpayer’s SSN or Fiduciary FEIN Spouse’s SSN (if joint or combined return) Tax Year Daytime Telephone Number Vendor Code 040 PLEASE DO NOT STAPLE. REMOVE ALL CHECK STUBS. PROCESSING CENTER GEORGIA DEPARTMENT OF REVENUE PO BOX 740323 ATLANTA GA30374-0323 Amount Paid $

Dos and Don’ts Checklist for the Individual/F iduciary (525-TV) Payment Voucher Payments can be made electronically on the Georgia Tax Center (GTC) gtc.dor.ga.gov/ . Mail this entire page. Staple your payment and voucher together. Print on both sides of the paper. Handwrite any information. [X] 09-INDIVIDUAL PREVIOUS PAGE

SCHEDULE 1 ADJUSTMENTS to INCOME BASED on GEORGIA LAW

YOUR SOCIAL SECURITY NUMBER Schedule 1 Page 1 Georgia Form500 (Rev. 06/22/22) Schedule 1 Adjustments to Income 2022 See IT-511 Tax Booklet

10.

2. 3. 1. 5. 4. 6. 14.

11. 9. 8. 13. ADDITIONS to INCOME 1. Interest on Non-Georgia Municipal and State Bonds ................................... 2. Lump Sum Distributions .........................................................................................

3. Reserved......................................................................................................................

6. Total Additions (Enter sum of Lines 1-5 here)..............................................

Other (Specify) 4. Net operating loss carryover deducted on Federal return....................................... 5. SUBTRACTION from INCOME (See IT-511 Tax Booklet) 7. Retirement Income Exclusion 8. Social Security Benefits (Taxable portion from Federal return).................... 9. Path2College 529 Plan ..............................................................................

10. Interest on United States Obligations (See IT-511 Tax Booklet )

11. Reserved ..................................................................................................

12. Other Adjustments (Specify) 13. Total Subtractions (Enter sum of Lines 7-12 here) ....................................... 14. Net Adjustments (Line 6 less Line 13). Enter Net Total here and on

Line 9 of Page 2 (+ or -) of Form 500 or 500 X ..........................................

Taxpayer Date of Birth: 7a. a. Retirement Income Exclusion - Complete Schedule 1, page 2. b. Military Retirement Income Exclusion (Must be under 62 years of age) - Complete Schedule 1, page 3. . 7b. 7c. Type of Disability:

c. Date of Disability:

12. Spouse Date of Birth: 7d. d. Retirement Income Exclusion - Complete Schedule 1, page 2. e. Military Retirement Income Exclusion (Must be under 62 years of age) - Complete Schedule 1, page 3. . 7e. 7f.

Type of Disability:

f. Date of Disability:

Required for Retirement Income Exclusion and Military Retirement Income Exclusion Required for Retirement Income Exclusion and Military Retirement Income Exclusion (Approved web version) RESET SCH 1 PG 1 RETURN TO PAGE 2

Schedule 1 Page 2 Georgia Form500 (Rev. 06/22/22) Schedule 1 Adjustments to Income 2022 YOUR SOCIAL SECURITY NUMBER *If age 62-64 or less than age 62 and permanently disabled enter $35,000, or if age 65 or older enter $65,000. (TAXPAYER) (SPOUSE) SCHEDULE 1 RETIREMENT INCOME EXCLUSION See IT-511 Tax Booklet 1. 2. Salary and wages...................................... 3. 4.

Other Earned Income (Losses)..................... Total Earned Income.................................... zero .......................................................... 6. Interest Income......................................... Maximum Earned Income........................... 7. Dividend Income ....................................... 9. 8. Alimony...................................................... 10. 5. Smaller of Line 3 or 4; if zero or less, enter

Capital Gains (Losses)............................... 11. Taxable IRA Distributions......................... 12. Other Income (Losses).............................. (See IT-511 Tax Booklet) Taxable Pensions ..................................... Income (Losses).....(See IT-511 Tax Booklet) 13. Rental, Royalty, Partnership, S Corp, etc. enter zero ................................................ 15. 14. Total of Lines 6 through 13; if zero or less, Add Lines 5 and 14 .................................... 16. Maximum Allowable Exclusion* .................. (Approved web version) 17. Smaller of Lines 15 and 16; enter here and on Form 500, Schedule 1, Lines 7a & d for Retire- ment Exclusion or Lines 7c & f for Retirement Exclusion for Disability............................ RESET SCH 1 PG 2 PREVIOUS PAGE 4000 4000

Schedule 1 Page 3 Georgia Form500 (Rev. 06/22/22) Schedule 1 Adjustments to Income 2022 YOUR SOCIAL SECURITY NUMBER SCHEDULE 1 MILITARY RETIREMENT INCOME EXCLUSION

See IT-511 Tax Booklet (Approved web version) (TAXPAYER) (SPOUSE)

See IT-511 Tax Booklet 1. Taxable Military Retirement from 1099-R 2. Base Military Exclusion............................. 3. Enter the smaller of Line 1 or Line 2 .........

If your taxable military retirement is less than 17,501 STOP HERE and enter line 3 on Schedule 1, Line 7b and 7e. 4. Taxable Georgia Salary and Wages...............

5. Other Earned Georgia Income.......................

6. Total Georgia Earned Income.........................

7. Total additional Military Exclusion allowed.......

8. Enter the smaller of Line 1 or Line 7. Enter this amount on Schedule 1, Lines 7b and e....... 1. Do you have any military retirement income? Do I Qualify for Military Retirement Exclusion? No. You do not qualify. Do not complete this page. Yes. You may qualify if you meet the age requirements. 2. Are you under the age of 62? No. You do not qualify. Do not complete this page. Yes. You qualify for Military Retirement Income Exclusion. Complete this page. If your Georgia earned income is less than 17,501 STOP HERE and enter line 3 on Schedule 1, Line 7b and 7e. 3. Include this page with your Form 500/500X, if applicable. RESET SCH 1 PG 3 PREVIOUS PAGE 17500 17500 35000 35000

Credit remaining from previous years (If from a business, do not include amounts elected to be applied to withholding)................................... 2.

1.

2. Credit Code ............................................................................................... 1.

3. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 4. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 5. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 6. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 7. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 8. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR

9. Total available credit for this tax year (sum of Lines 2 through 8).........................

10. Enter the amount of the credit sold (only certain credits can be sold, see IT-511 Tax Booklet)........................................................................................ 12.

Potential carryover to next tax year (Line 9 less Lines 10 and 11).......................... 12. 9. 10. 11. 11. Credit used for this tax year....................................................................................

YOUR SOCIAL SECURITY NUMBER Georgia Form500 (Rev. 06/22/22) Schedule 2 Georgia Tax Credits 2022 SCHEDULE 2 GEORGIA TAX CREDIT USAGE AND CARRYOVER See IT-511 Tax Booklet Schedule 2 Page 1 (Approved software version) CREDITS MUST BE FILED ELECTRONICALLY CREDITS MUST BE FILED ELECTRONICALLY RESET SCH 2 PREVIOUS PAGE SEL

Credit remaining from previous years (If from a business, do not include amounts elected to be applied to withholding)................................... 2.

1.

2. Credit Code ............................................................................................... 1.

3. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 4. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 5. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 6. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 7. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR 8. COMPANY/INDIVIDUAL NAME

CREDIT CERTIFICATE # FEIN/SSN CREDIT GENERATED THIS TAX YEAR

YOUR SOCIAL SECURITY NUMBER Georgia Form500 (Rev. 06/22/22) Schedule 2B Georgia Tax Credits 2022 SCHEDULE 2B REFUNDABLE TAX CREDITS See IT-511 Tax Booklet Schedule 2B Page 1 Note: A purchased Timber Tax Credit is not a refundable tax credit. Use Schedule 2 if the Timber Tax Credit was purchased.

9. Total available credit for this tax year (sum of Lines 2 through 8).........................

10. Enter the amount of the credit sold (only certain credits can be sold, see IT-511 Tax Booklet)........................................................................................

12.

Potential carryover to next tax year (Line 9 less Lines 10 and 11).......................... 12. 9. 10. 11. 11. Credit used for this tax year.................................................................................... (Approved software version) CREDITS MUST BE FILED ELECTRONICALLY CREDITS MUST BE FILED ELECTRONICALLY RESET SCH 2 PG2 PREVIOUS PAGE SE

YOUR SOCIAL SECURITY NUMBER Schedule 3 Page 1 Georgia Form500 (Rev. 06/22/22) Schedule 3 Part-Year Nonresident 2022 (Approved web version) DO NOT USE LINES 9 THRU 14 OF PAGES 2 AND 3 FORM 500 or 500X Income earned in another state as a Georgia resident is taxable but other state(s) 3. BUSINESS INCOME OR (LOSS) 3. BUSINESS INCOME OR (LOSS) 2. INTEREST AND DIVIDENDS 7. TOTAL ADJUSTMENTS FROM FORM 500, 2. INTEREST AND DIVIDENDS

(COLUMN B) 3. BUSINESS INCOME OR (LOSS) 1. WAGES, SALARIES, TIPS, etc 7. TOTAL ADJUSTMENTS FROM FORM 500, 6. TOTAL ADJUSTMENTS FROM FORM 1040 2. INTEREST AND DIVIDENDS 7. TOTAL ADJUSTMENTS FROM FORM 500, 6. TOTAL ADJUSTMENTS FROM FORM 1040 6. TOTAL ADJUSTMENTS FROM FORM 1040 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 1. WAGES, SALARIES, TIPS, etc SCHEDULE 1 4. OTHER INCOME OR (LOSS) SCHEDULE 1 4. OTHER INCOME OR (LOSS) 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 1. WAGES, SALARIES, TIPS, etc 4. OTHER INCOME OR (LOSS) FEDERAL INCOME AFTER GEORGIA ADJUSTMENT 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 SCHEDULE 1 RESIDENTS AND NONRESIDENTS. SCHEDULE 3 COMPUTATION OF GEORGIA TAXABLE INCOME FOR ONLY PART-YEAR INCOME NOT TAXABLE TO GEORGIA GEORGIA INCOME

(COLUMN C) tax credit may apply. See IT-511 Tax Booklet. (COLUMN A) 8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 8. ADJUSTED GROSS INCOME: 8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 LINE 5 PLUS OR MINUS LINES 6 AND 7

14. Income before GA NOL: Subtract Line 13 from Line 8, Column C Enter here and on Line 15a, Page 3 of Form 500 or Form 500X........................ 14.

13. Multiply Line 12 by Ratio on Line 9 and enter result............................................ 13. 11a. Enter the number on Line 6c from Form 500 or Form 500X multiply by $2,700 for filing status A or D or multiply by $3,700 for filing status B or C..................................... 11a. 11b. Enter the number on Line 7a from Form 500 or Form 500X multiply by $3,000 .. 11b. 12. Total Deductions and Exemptions: Add Lines 10a, 10b, 11a, and 11b ............ 12. 10b. Additional Standard Deduction Self: 65 or over? Blind? Spouse: 65 or over? Blind? Total X 1,300= 10b. 11. Personal Exemptions from Form 500 or Form 500X (See IT-511 Tax Booklet)

10a. Itemized or Standard Deduction (See IT-511 Tax Booklet)........................................................ 10a. 9. RATIO: Divide Line 8, Column C by Line 8, Column A enter percentage ....... 9. % Not to exceed 100% RESET SCH 3 RETURN TO PAGE 3

YOUR SOCIAL SECURITY NUMBER Form IND-CR 201 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 1 Page (Rev. 06/22/22) (Approved web version) Disabled Person Home Purchase or Retrofit Credit - Tax Credit 201 O.C.G.A.§ 48-7-29.1 provides a disabled person credit equal to the lesser of $500 per residence or the taxpayer’s income tax

liability for the purchase of a new single-family home that contains all of the accessibility features listed below. It also provides a credit equal to the lesser of the cost or $125 to retrofit an existing single-family home with one or more of these features. The disabled person must be the taxpayer or the taxpayer’s spouse if a joint return is filed. Qualified features are: One no-step entrance allowing access into the residence. Interior passage doors providing at least a 32-inch-wide opening. Reinforcements in bathroom walls allowing installation of grab bars around the toilet, tub, and shower, where such facilities are provided. Light switches and outlets placed in accessible locations. To qualify for this credit, the disabled person must be permanently disabled and have been issued a permanent parking permit by the Department of Revenue or have been issued a special permanent parking permit by the Department of Revenue. This credit can be carried forward 3 years. For more information, see Regulation 560-7-8-.44. 1. Credit remaining from previous years............................................................................. 1. – Include with Form 500 or 500X, if this schedule is applicable.– 2. 2. 3. 4. Potential carryover to next tax year (Line 1 plus Line 2 less Line 3) .............................. 4. Purchase of a home that contains all four accessibility features OR total of accessibility features added to retrofit a home (up to $125 per feature) cannot exceed $500 per residence................................................................................................................... 3.

Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 1)..........................................................................................................

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YOUR SOCIAL SECURITY NUMBER Form IND-CR 202 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version) 30%

Child and Dependent Care Expense Credit - Tax Credit 202

O.C.G.A. § 48-7-29.10 provides taxpayers with a credit for qualified child & dependent care expenses. The credit is a percentage of the credit claimed and allowed under Internal Revenue Code § 21 and claimed by the taxpayer on the taxpayer’s Federal income tax return. This credit cannot be carried forward. The credit is computed as follows: 1. Amount of child & dependent care expense credit claimed on Federal Form 1040. 2. Georgia allowable rate ...................................................................................... 3. Allowable Child & Dependent Care Expense Credit (Line 1 x .30)............................ 4.Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 2)..................................................................................................................... 1. 2. 4. 3. – Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR02 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 203 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version) Georgia National Guard/Air National Guard Credit - Tax Credit 203

O.C.G.A. § 48-7-29.9 provides a tax credit for Georgia residents who are members of the National Guard or Air National Guard and are on active duty full time in the United States Armed Forces, or active duty training in the United States Armed Forces for a period of more than 90 consecutive days. The credit shall be claimed and allowed in the year in which the majority of such days are served. In the event an equal number of consecutive days are served in two calendar years, then the exclusion shall be claimed and allowed in the year in which the ninetieth day occurs. The credit shall apply with respect to each taxable year in which such member serves for such qualifying period of time. The credit cannot exceed the amount expended for qualified life insurance premiums nor the taxpayer’s income tax liability. Qualified life insurance premiums are the premiums paid for insurance coverage through the service member’s Group Life Insurance Program administered by the United States Department of Veterans Affairs. Any unused tax credit is allowed to be carried forward to the taxpayer’s succeeding year’s tax liability. 1. Credit remaining from previous years....................................................... 1. 2. Enter amount of qualified life insurance premiums ............................................ 2. 3.Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 3)...................................................................................... 3. 4. Carryover to next tax year (Line 1 plus Line 2 less Line 3)......................... 4.

– Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR03 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 204 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version) 10% 150 Qualified Caregiving Expense Credit - Tax Credit 204

O.C.G.A. § 48-7-29.2 provides a qualified caregiving expense credit equal to 10 percent of the cost of qualified caregiving expenses for a qualifying family member. The credit cannot exceed $150. Qualified services include Home health agency services, personal care services, personal care attendant services, homemaker services, adult day care, respite care, or health care equipment and other supplies which have been determined by a physician to be medically necessary. Services must be obtained from an organization or individual not related to the taxpayer or the qualifying family member. The qualifying family member must be at least age 62 or been determined disabled by the Social Security Administration. A qualifying family member includes the taxpayer or an individual who is related to the taxpayer by blood, marriage or adoption. Qualified caregiving expenses do not include expenses that were subtracted to arrive at Georgia net taxable income or for which amounts were excluded from Georgia net taxable income. There is no carryover or carry-back available. The credit cannot exceed the taxpayer’s income tax liability. For more information, see Regulation 560-7-8-.43. Additional Qualifying Family Member Name, if applicable: Qualifying Family Member Name: Age, if 62 or over If disabled, date of disability Name: SS# Relationship Age, if 62 or over If disabled, date of disability Name: SS# Relationship 3. 1. Qualified caregiving expenses........................................................................... 2. Percentage limitation....................................................................................... 3. Line 1 multiplied by Line 2................................................................................ 4. Maximum credit............................................................................................... 5. Enter the lesser of Line 3 or Line 4 ...................................................................... 2. 1. 4. 5. 6. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 4)....................................................................................................................

6. – Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR04 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 206 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 1 Page (Rev. 06/22/22) (Approved web version) 500 3. Amount of the disaster assistance received................................................. 4. Maximum credit........................................................................................ 5. Enter the lesser of Line 3 or Line 4................................................................. Disaster Assistance Credit - Tax Credit 206 O.C.G.A. § 48-7-29.4 provides for a credit for a taxpayer who receives disaster assistance during a taxable year from the Georgia Emergency Management and Homeland Security Agency or the Federal Emergency Management Agency. The amount of the credit is equal to $500 or the actual amount of the disaster assistance, whichever is less. The credit cannot exceed the taxpayer’s income tax liability. Any unused tax credit can be carried forward to the succeeding years’ tax liability but cannot be carried back to the prior years’ tax liability. The approval letter from the disaster assistance agency must be enclosed with the return.

The following types of assistance qualify: Grants from the Department of Human Services’ Individual and Family Grant Program. Grants from GEMA/HS and/or FEMA. Loans from the Small Business Administration that are due to disasters declared by the President or Governor. Disaster assistance agency 2. Date assistance was received.................................................................... 2. 3. 4. 5. 6. Credit used this tax year (enter here and include in IND-CR Summary Worksheet Line 6).......................................................................................... 6. 7. Carryover to next tax year (Line 1 plus Line 5 less Line 6) ............................ 7. 1. Credit remaining from previous years............................................................ 1. , , , – Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR06 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 207 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version) Rural Physicians Credit - Tax Credit 207

2. The physician must practice and reside in a rural county. For taxable years beginning on or after January 1, 2003, a physician qualifies for the credit if they practice in a rural county and reside in a county contiguous to a rural county. A rural county is defined as one with 65 or fewer persons per square mile according to the United States Decennial Census of 1990 or any future such census. For taxable years beginning on or after January 1, 2012, the United States Decennial Census of 2010 is used. For taxable years beginning on or after January 1, 2022, the United States Decennial Census of 2020 is used (see regulation 560-7-8-.20 for transition rules). A listing of rural counties for purposes of the rural physicians credit may be obtained at the following web page: dor.georgia.gov

3. The physician must be licensed to practice medicine in Georgia, primarily admit patients to a rural hospital, and practice in the fields of family practice, obstetrics and gynecology, pediatrics, internal medicine, or general surgery. A rural hospital is defined as an acute-care hospital located in a rural county that contains 80 or fewer beds. For taxable years beginning on or after January 1, 2003, a rural hospital is defined as an acute-care hospital located in a rural county that contains 100 or fewer beds. For more information, see Regulation 560-7-8-.20.

1. County of residence 2. County of practice 3. Type of practice 4. Date started working as a rural physician 5. Number of hospital beds in the rural hospital 1. County of residence 2. County of practice 3. Type of practice 4. Date started working as a rural physician 5. Number of hospital beds in the rural hospital O.C.G.A. § 48-7-29 provides for a $5,000 tax credit for rural physicians. The tax credit may be claimed for not more than five years. There is no carryover or carry-back available. The credit cannot exceed the taxpayer’s income tax liability. In order to qualify, the physician must meet the following conditions: Taxpayer Spouse Only enter the information for the taxpayer and/or the spouse if they are a rural physician.

6. Rural physicians credit, enter $5,000 per rural physician......... 6. 7. 7. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 7)..................................................... – Include with Form 500 or 500X, if this schedule is applicable.

– 1. The physician must have started working in a rural county after July 1, 1995. If the physician worked in a rural county prior to that date, a period of at least three years must have elapsed before the physician returns to work in a rural county. RESET INDCR07 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 208 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version)

Georgia Code Section 48-7-29.15 provides an income tax credit for the adoption of a qualified foster child. The amount of the credit is $2,000 per qualified foster child per taxable year, commencing with the year in which the adoption becomes final, and ending in the year in which the adopted child attains the age of 18. This credit applies to adoptions occurring in the taxable years beginning on or after January 1, 2008 and before January 1, 2021. Any unused credit can be carried forward until used. Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2008 and before January 1, 2021

1. Credit remaining from previous years.................................................. 1. 2. Enter $2,000 per qualified foster child.................................................. 2. 3. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 8)................................................................................. 3. 4. Carryover to next year (Line 1 plus Line 2 less Line 3)........................ 4. – Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR08 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 209 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version) 33.33% A taxpayer is allowed the tax credit for a purchase of one eligible single-family residence made between June 1, 2009 and November 30, 2009. The credit amount is the lesser of 1.2 percent of the purchase price of the eligible single-family residence or $1,800.00. The amount of the tax credit that may be claimed and allowed in a single tax year cannot exceed the lesser of 1/3 of the credit or the taxpayer’s income tax liability. Any unused tax credit can be carried forward but cannot be carried back. Eligible Single-Family Residence Tax Credit - Tax Credit 209 O.C.G.A. § 48-7-29.17 provides taxpayers a credit for the purchase of an eligible single-family residence located in Georgia. An eligible single-family residence is a single-family structure (including a condominium unit as defined in O.C.G.A.§ 44-3-71) that is occupied for residential purposes by a single family, that is: a) Any residence (including a new residence, one occupied at the time of sale, or a previously occupied residence) that was for sale prior to May 11, 2009 and that remained for sale after May 11, 2009; or b) A residence with respect to which a foreclosure event has taken place and which is owned by the mortgagor or the mortgagor’s agent; or c) An owner-occupied residence with respect to which the owner’s acquisition indebtedness was in default on or before March 1, 2009. Acquisition indebtedness is debt incurred in acquiring, constructing, or substantially improving a qualified residence and which is secured by such residence. Refinanced debt is acquisition debt if at least a portion of such debt refinances the principal amount of existing acquisition indebtedness. The taxpayer must have claimed the credit in 2009 in order to claim the unused credit below. 1. 1. Total credit. (Enter amount from 2009 IND-CR, Part 9, Line 5.)............................... 2. Maximum allowed per year................................................................................... 3. Maximum credit allowed, (multiply Line 1 by Line 2)................................................ 3. 2. 4. Enter unused credit (Total credit less amounts used in previous years).................. 5. Credit allowed, lesser of Line 3 or Line 4.................................................................. 4. 5. 6. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 9)........................................................................................................................ 6. 7. Carryover to next tax year (Line 4 less Line 6)............................................................. 7. – Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR09 PREVIOUS PAGE

Form IND-CR 212 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 1 Page (Rev. 06/22/22) (Approved web version) YOUR SOCIAL SECURITY NUMBER 1000

500

375

750

Community Based Faculty Preceptor Tax Credit - Tax Credit 212 O.C.G.A. § 48-7-29.22 provides an income tax credit for a community based faculty preceptor that conducts a preceptorship rotation(s). This tax credit is applicable for taxable years beginning on or after January 1, 2019 and ending on or before December 31, 2023. For a community based faculty preceptor who is a physician as defined in O.C.G.A. § 43-34-21, the credit shall accrue on a per preceptorship rotation basis in the amount of $500 for the first, second, or third preceptorship rotation and $1,000 for the fourth, fifth, sixth, seventh, eighth, ninth, or tenth preceptorship rotation completed in one calendar year. For a community based faculty preceptor who is an advanced practice registered nurse as defined in O.C.G.A. § 43-26-3 or a physician assistant as defined in O.C.G.A. § 43-34-102, the credit shall accrue on a per preceptorship rotation basis in the amount of $375 for the first, second, or third preceptorship rotation and $750 for the fourth, fifth, sixth, seventh, eighth, ninth, or tenth preceptorship rotation completed in one calendar year. An individual shall not accrue credit for more than ten preceptorship rotations in one calendar year. The credit cannot be carried forward and cannot be carried back. Certification from the Area Health Education Centers Program Office at Augusta University must be enclosed with the return. By filing this form I certify that I did not receive payment during such tax year from any source for the training of a medical student, advanced practice registered nurse student, or physician assistant student.

A. Community Based Faculty Preceptor Tax Credit for a physician 1. Number of Rotations (enter no more than 3) X (not to exceed $1,500)................................................... Fourth through Tenth Rotation First through Third Rotation 2. Number of Rotations (enter no more than 7) X (not to exceed $7,000) ............................................................ 3. Add Line 1 and Line 2, Current Year Credit Amount (cannot exceed $8,500)............. 1. 2. 3. B. Community Based Faculty Preceptor Tax Credit for an advanced practice registered nurse or physician assistant. 1. Number of Rotations (enter no more than 3) X (not to exceed $1,125)................................................... First through Third Rotation 1. Fourth through Tenth Rotation 2. Number of Rotations (enter no more than 7) X (not to exceed $5,250)................................................... 2. 3. Add Line 1 and Line 2, Current Year Credit Amount (cannot exceed $6,375)............. 3. C. Community Based Faculty Preceptor Tax Credit Total 1.Credit used this year (enter no more than the total of Line A3 and Line B3)(enter here and include on IND-CR Summary Worksheet Line 10)................................................ 1. – Include with Form 500 or 500X, if this schedule is applicable. – RESET INDCR12 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 213 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version)

– Include with Form 500 or 500X, if this schedule is applicable. – O.C.G.A. § 48-7-29.15 provides an income tax credit for the adoption of a qualified foster child. This credit applies to adoptions occurring in taxable years beginning on or after January 1, 2021. The amount of the credit is $6,000 per qualified foster child per taxable year, commencing with the year in which the adoption becomes final, for five taxable years and $2,000 per qualified foster child per taxable year thereafter, and ending in the year in which the adopted child attains the age of 18. This credit cannot be carried forward.

Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2021- Tax Credit 213

1. Enter $6,000 per qualified foster child (if in first five taxable years of the adoption)...................................................................................... 1. 2. Enter $2,000 per qualified foster child (for years after first five taxable years of adoption)....................................................................... 2. 3. Add Line 1 and Line 2, Current Year Credit Amount ............................. 3.

4. Credit used this year (enter no more than the amount on line 3)(enter here and include on IND-CR Summary Worksheet Line 11).................. 4. RESET INDCR13 PREVIOUS PAGE

YOUR SOCIAL SECURITY NUMBER Form IND-CR 214 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved web version) Teacher Recruitment and Retention Credit – Tax Credit 214

A taxpayer who is designated by the Department of Education as a participating teacher in the teacher recruitment and retention program provided for in Code Section 20-2-251 shall be allowed a credit against the tax imposed by Code Section 48-7-20 in an amount equal to $3,000.00 per school year for up to five school years, which must be consecutive. Only teachers who have been designated as qualifying by the Department of Education should complete this form. For more information about the designation: https://www.gadoe.org Please note:

Each designated teacher may claim a credit amount of $3,000.00 per qualifying school year for no more than five school years, which must be consecutive, subject to conditions set forth in Code Section 20-2-251.

The credit taken on any year tax return cannot exceed your tax liability for the year. Any unused amounts of the credit can be carried forward for three years.

For more information, see Georgia Code Sections 20-2-251 and 48-7-29.23. 1. Credit remaining from previous year ................................................................................

1. – Include with Form 500 or 500X, if this schedule is applicable.– 2. 4. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 12) .............................................................................................................................. 2. 4. 5. Potential carryover to next tax year (Line 3 less Line 4)......................................................

5.

Credit generated this tax year .......................................................................................... .

3. 3.

Total credit available (Line 1 + Line 2).............................................................................. . RESET INDCR14 PREVIOUS PAGE

Georgia FormIND-CR Summary Worksheet (Rev. 06/22/22) State of Georgia Individual Credit Form Georgia Department of Revenue 2022 YOUR SOCIAL SECURITY NUMBER

1 Page (Approved web version) IND-CR SUMMARY SCHEDULE WORKSHEET All applicable IND-CR Schedules (201, etc.) must be attached to Form 500 or Form 500X. Keep IND-CR Summary Worksheet for your records.

1. Only Georgia Individual Tax Credits (series 200) are claimed on Form IND-CR supporting schedules (IND-CR 201 through 214). 2. Enter the amount of credit used for the current tax year from each applicable IND-CR schedules on Lines 1-12. 3. If there is a credit remaining from previous years eligible for carryover for this tax year, the supporting IND-CR schedule must be completed even if the credit is not used for this tax year. 4. The total of Line 13 should be entered on Form 500 or Form 500X, Page 3, Line 19. 5. All applicable IND-CR schedules must be attached to Form 500 or Form 500X for the credit(s) to be allowed on the return. Note: The other state(s) tax credit and low income credit are claimed directly on Form 500. Series 100 Georgia tax credits (except Schedule 2B refundable tax credits) are claimed on Form 500 Schedule 2 and returns that include the series 100 credits must be filed electronically. The total credit amount used from the low income credit, the other state(s) tax credit, all IND-CR schedules, and all Schedule 2s cannot exceed the tax liability listed on Line 16 of Form 500 or 500X.

7. Rural Physicians Credit (IND-CR 207, Line 7) ...................................................... 8. Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2008 and Before January 1, 2021 (IND-CR 208, Line 3)...............................................................................................

9. Eligible Single-Family Residence Credit (IND-CR 209, Line 6) ............................. 7. 8. 12. Teacher Recruitment and Retention Credit (IND-CR 214, Line 4)......................... 12. 9. 3. Georgia National Guard /Air National Guard Credit (IND-CR 203, Line 3) ............ 4. Qualified Caregiving Expense Credit (IND-CR 204, Line 6) .................................. 5. Reserved ............................................................................................................... 6. Disaster Assistance Credit (IND-CR 206, Line 6) .................................................. 3. 4. 6. 5. 1. Disabled Person Home Purchase or Retrofit Credit (IND-CR 201, Line 3) ............ 2. Child and Dependent Care Expense Credit (IND-CR 202, Line 4) ........................ 2. 1.

10. Community Based Faculty Preceptor Credit (IND-CR 212, Line C1) .................. 10. 11. Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2021 (IND-CR 213, Line 4)................................

11.

13. Total of Lines 1 through 12 (Enter here and on Form 500/500X, Page 3 Line 19) 13.

RESET SUMMARY RETURN TO PAGE 3

IT 511 Rev. 02.15.23 Frank M. O'Connell Revenue Commissioner Brian P. Kemp Governor Georgia Department of Revenue 2022 Individual Income Tax 500 and 500EZ Forms and General Instructions WHAT'S INSIDE? ELECTRONIC FILING Charitable Contributions/Donations....................................25 Filing Requirements..............................................................9 Form 500 Instructions.....................................................11-13 Free Electronic Filing ...........................................................4 General Information...........................................................7-8  Georgia Tax Center...............................................................2 free! Georgia Tax Rate Schedule................................................55 Low Income Tax Credit Worksheet.....................................21 Mailing Addresses................................................................5 Message from Commissioner O'Connell.........................1 Other State's Tax Credit Worksheet.................................. 20 ON-LINE PAYMENTS Part-year Resident and Nonresident Instructions.........18-19 Payment Options.................................................................4 The Georgia Department of Revenue accepts Visa, American Express, MasterCard, and Discover credit cards for payment of: Penalty and Interest..........................................................7-8 Requesting an Extension to File..........................................7 Retirement Income Exclusion ...........................................17 Return Filing Tips.................................................................6 Schedule For Estimating Georgia Income Taxes...............21 Tax Credits....................................................................22-24 Taxpayer's Assistance..........................................................3 What's New..........................................................................7 Check My Refund Status.................................................... 4 Follow us on Facebook and Twitter Forms in tax booklet: Form 500, Form 500EZ, and Form IND-CR Visit dor.georgia.gov for more information about these and other topics of interest.  Receive your refund by direct deposit!  File fast and securely from your home PC! √Current-year and prior-year individual tax payments √Liabilities on Department of Revenue-issued assessment notices √Individual estimated tax payments √Note: a convenience fee will be charged by the provider  Check refund status  Make payments  See page 2 for more information on GTC Tax returns pril 18, 2 due A 023

Page 1 FROM THE COMMISSIONER Did you know that by registering an account with the Department of Revenue’s Georgia Tax Center (GTC), you can sign up to receive notifications when any activity takes place on your account? These notifications help you closely monitor your tax status and help combat fraudulent activity. Visit gtc.dor.ga.gov to register. For assistance, you may visit our self-service instructional videos at http://dor.georgia.gov/georgia-tax-center-help/how-videos. Did you also know that taxpayers who file their returns electronically and have their refunds directly deposited into their bank accounts receive their refunds much more quickly than those who filed a paper return? If you have been considering electronic filing, some of the benefits include: □ Faster and more accurate processing □ Receiving your refund by mail or direct deposit □ The ability to file from your home PC or have your taxes prepared by a professional electronic return originator □ Elimination of mailing paper returns The Department of Revenue encourages taxpayers to take time to review and adjust their Georgia income tax withholding if they received a substantial refund last year. By reducing withholding amounts, taxpayers have immediate use of their earnings, and won’t have to wait until the following year to get their money. Please use the Form G-4 (or G-4P if you are receiving a pension) to determine your withholding allowances. These forms can be found on the Department’s website at dor.georgia.gov. If you file electronically and need to make a payment, you may pay by electronic check using the Georgia Tax Center. Visit gtc.dor.ga.gov or visit our self-service instructional videos at http://dor.georgia.gov/georgia-tax-center-help/how-videos. For additional information contact the Taxpayer Services Call Center at 1-877-423-6711. The Department of Revenue, as outlined in the Taxpayer Bill of Rights, will provide “fair, courteous and timely service” to the taxpayers of Georgia. We have implemented several initiatives to ensure we uphold that standard. Our mission is to administer the tax laws of the state of Georgia fairly and efficiently in order to promote public confidence and compliance while providing excellent customer service. Visit https://dor.georgia.gov/taxpayer-bill-rights to view a copy of the Taxpayer's Bill of Rights. Frank M. O'Connell Revenue Commissioner

Page 2 Individual Income Tax Online Services What is the Georgia Tax Center? The Georgia Tax Center (GTC) is the Department of Revenue’s secure self-service customer facing portal for making online Individual or Business Tax payments and for corresponding with the Department of Revenue. Who Can Sign Up for GTC? Any individual that has filed an Individual Income Tax Return or would like to submit a Georgia esti- mated tax payment is eligible to use GTC. GTC Features You will be able to do the following without a GTC login: • Check refund status • Make quick payments (estimated tax payments or assessment payments) • Protest proposed assessments • Request penalty waivers • Submit additional documentation A login is required to do the following: • Receive notification when a return is filed with your SSN or a refund has been issued • Request an Installment Plan Agreement (IPA) • Request an Offer in Compromise (OIC) • Submit a Power of Attorney (POA) • Request to view your 1099-G electronically in GTC • View account balance • Make payments • Perform general account maintenance - address change, preapproval of credits, view credits, etc. How Do I Sign Up? To use GTC, visit our website at https://gtc.dor.ga.gov. First time users must register before accessing tax accounts. To register, you will need: • Social Security Number (SSN) • Federal Adjusted Gross Income (Federal AGI) from the most recent return filed in the State of Georgia • A valid e-mail address Note: Third party filers can sign up for GTC to access their clients information with the proper doc- umentation and authorization. For more information see https://dor.georgia.gov/taxes/informa- tion-tax-professionals/third-party-filers-0 Please visit our website to sign up for access to GTC, find helpful links, instructions, and how to videos: dor.georgia.gov/georgia-tax-center-help

Page 3 Taxpayer's Assistance and Resources Find us on the web by going to dor.georgia.gov • Download Tax Forms • Find Answers to Frequently Asked Questions • Access Check My Refund Status • View the Taxpayer's Bill of Rights • Find Georgia Regulations Customer Contact Center: 1-877-423-6711 dor.georgia.gov/individual-taxes Get help with: • Refunds • Billing • Web Access Helpful Resources and Services • Volunteer Income Tax Assistance (VITA) - dor.georgia.gov/need-help-your-taxes or call 1-800-906-9887 • Free File Alliance visit dor.georgia.gov/free-file-alliance • AARP - Senior citizens 1-888-AARPNOW (1-888-227-7669) from February 1 to April 15 • Georgia Relay - Deaf and hard of hearing taxpayers (TDD) visit georgiarelay.org Federal Tax Changes/Conformity, Legislation, and other Policy Information Visit dor.georgia.gov/rules-policies/income-tax for more information on: • Federal Tax Changes/Conformity with Federal Changes • New Legislation • Regulations • Rules and Policies Georgia did not adopt the revised net operating loss provisions in the 2020 CARES Act and the modification to the Code Section 461(l) limitation in the 2020 CARES Act and the American Res- cue Plan Act of 2021. • For losses incurred in taxable years beginning on or after January 1, 2018, there is an 80% limitation on the usage of net operating losses (the 80% limitation is based on Georgia taxable net income). • The I.R.C. Section 461(l) adjustment (limitation on losses for noncorporate taxpayers) is required in the same manner as was required before the CARES Act. • For more information on Georgia's treatment of the Cares Act, see https://dor.georgia.gov/rules-pol- icies/income-tax/income-tax-federal-tax-changes

Page 4 The Department of Revenue has partnered with certain software companies to offer free and/or low cost online filing services to Georgia taxpayers under the Free File Alliance Program. Under this agreement, qualified taxpayers can prepare and file their Georgia individual income tax returns for free or a low cost using approved software. Each software company has income limitations and other restrictions for their free services. Please review each company’s offer before selecting a product. For more information, visit our website at dor.georgia.gov/free-file-alliance. If you do not qualify for free electronic services, you may file electronically using software produced by an approved vendor listed on our website dor.georgia.gov/approved-software-vendors. Volunteer Income Tax Assistance (VITA) The VITA program was established by the IRS to assist qualified individuals with free electronic tax preparation services. Assistance is geared towards individuals with low to moderate income (less than $55,000 per year). The preparers are IRS-certified and can prepare basic income tax returns. There are several VITA locations in the metro area and throughout Georgia. For more information visit our website at dor.georgia.gov/need-help-your-taxes. 2-D Barcode The two-dimensional (2D) barcode that appears on your return is the encoded information you entered on your return. This barcode reduces errors and saves time in processing the return. The 2D barcode is only visible after your return has been printed. FREE ELECTRONIC FILING Check My Refund Status Check the status of your refund online at gtc.dor.ga.gov. You may also check the sta- tus of your refund by calling (1-877-423-6711). Please allow 12 weeks to receive refunds. The Depart- ment is taking additional fraud prevention measures to ensure tax refunds are issued to the correct individuals. You will receive your refund via paper check if you are a first time Georgia filer or if you have not filed your taxes in five or more years. This applies for both electronic and paper return filers. Note: A claim for refund must be made within three (3) years from the later of the date the tax was paid or the due date of the return, including extensions. Payment Options GTC accepts individual income and estimated tax pay- ments. For information about GTC, visit our website at gtc.dor.ga.gov or visit our self-service instructional videos at dor.georgia.gov/georgia-tax-center-help. The Georgia Department of Revenue accepts Visa, American Express, MasterCard, and Discover credit cards as payment for current year individual income tax due on original Forms 500, 500EZ, and 500ES, as well as for liabilities presented to taxpayers via Georgia Department of Revenue assessment notices. To make a payment, use ACI Payments, Inc.'s secure website at acipayonline.com. There is a convenience fee for this service. This fee is paid directly to the company. For more information on payments, visit our website at dor. georgia.gov/credit-card-payments or contact the Taxpay- er Services Customer Contact Center at 1-877-423-6711. Installment Payment Agreement. You must meet the following criteria for an installment payment agreement:  Returns for all years must be filed  Agreements are up to 60 months  Payments should be made through automatic debit from your bank account Note: There is a set up cost associated with initiating an Installment Payment Agreement. Installment payment requests may be submitted online via the Georgia Tax Center (GTC) at gtc.dor.ga.gov. Please contact the Installment Payment Agreement Section at 404-417-2122 or via e-mail to installment.payment@ dor.ga.gov to determine eligibility. For more information on Installment Payment Agreements, visit our website at https://dor.georgia.gov/installment-agreements-faq.

Page 5 Mailing Address Tax Returns Form 500 without payment: Form 500 with payment: PROCESSING CENTER PROCESSING CENTER GEORGIA DEPARTMENT OF REVENUE GEORGIA DEPARTMENT OF REVENUE PO BOX 740380 PO BOX 740399 ATLANTA GA 30374-0380 ATLANTA GA 30374-0399 Form 500X Amended: PROCESSING CENTER GEORGIA DEPARTMENT OF REVENUE PO BOX 740318 ATLANTA GA 30374-0318 _______________________________________________________________________________________ Payments without Return Form 500-ES Individual Estimate Tax Voucher PROCESSING CENTER GEORGIA DEPARTMENT OF REVENUE PO BOX 740319 ATLANTA GA 30374-0319 Form 525-TV Payment Voucher Note: If you filed electronically and making a payment by check PROCESSING CENTER GEORGIA DEPARTMENT OF REVENUE PO BOX 740323 ATLANTA GA 30374-0323 Form IT-560 Extension Payment Voucher PROCESSING CENTER GEORGIA DEPARTMENT OF REVENUE PO BOX 105198 ATLANTA GA 30348-5198 Note: Sending your return by certified mail delays the processing of your return and your refund.

Page 6  -  Mailed my return to the correct address Are Social security number(s) on the return accurate and complete? Added all the dependents' information, if applicable Checked math and calculations  Rounded to the nearest dollar Correctly calculated the tax amount using the Tax Rate Schedule in the IT-511 Tax Booklet.  Completed the Income Statement Detail section where Georgia income tax was withheld on Forms W-2s, 1099s, G2-RPs, G2-LPs, G2-As, and/or G2-FLs. Attached/included the forms with my return. Signed and dated my return Both spouses signed the joint return, even if there was only one income Note: Anyone paid to prepare the return must also sign it Completed and included all schedules and IND-CRs that are applicable Filing Checklist Dos and Don'ts For Filing Paper Returns Do Do include your W-2(s), 1099(s), GR-2P(s) and other supporting income statements Do complete the Income Statement Details section for Georgia tax withheld Paper Filing: Do send your return, check/money order, and 525-TV voucher to the address on the return  Do use GTC or the Form IT-560 to make an extension payment  Do make your check or money order payable to the Georgia Department of Revenue Don't  Do not include cents on your return  Do not staple your W-2(s), 1099(s) and other forms to your return  Do not use the Form 500 to correct a previously filed return - Use Form 500X Note: Sending your return by certified mail delays the processing of your return and your refund.

Page 7 When to File. Calendar year taxpayers are required to file on or before April 18, 2023. Fiscal year taxpayers must file on or before the 15th day of the fourth month after the close of their taxable year. Extension to File. The Georgia return must be filed along with a copy of Federal Form 4868 or the IRS confirmation letter on or before the extended Federal due date. If you do not need a Federal extension, you may use Georgia Form IT- 303 to request an extension to file your Georgia return. An extension to file does not extend the date for paying the tax. Taxes must be paid electronically via GTC or with Form IT-560 by the statutory due date to avoid late payment penalty and interest. The amount paid should be entered on Form 500, Line 25. Amended Returns. File Form 500X to correct information reported on Form 500. Do not use Form 500 to correct a previously filed return or use Form 500X as an original return. When Electronic Filing is Required. Taxpayers that remit payments by electronic funds transfer, whether on a mandatory or voluntary basis, must file all associated returns electronically. A return preparer who prepares an income tax return, must electronically file the return, when the federal counterpart of such return is required to be filed electronically pursuant to the Internal Revenue Code of 1986 or Internal Revenue Service regulations. Also, a return is required to be electronically filed if the return generates, allocates, claims, utilizes, or includes in any manner a series 100 tax credit. (see page 21) Penalty and Interest. New lines have been added to the Form 500 to allow amounts for late payment and/ or filing penalties and for interest. Tax not paid by the statutory due date of the return is subject to interest and ½ of 1 percent late payment penalty per month, or fraction thereof. Also, a monthly late filing penalty is imposed at a rate of 5 percent of the tax not paid by the original due date. Interest accrues until the tax due has been paid in full. The combined total of late filing and late payment penalty cannot exceed 25 percent of the tax not paid by the original due date. An extension of time for filing the return does not What's New Teacher Recruitment and Retention Credit (IND- CR 214) For taxable years beginning on or after January 1, 2022, this credit is available to teachers selected by the Department of Education to participate in the teacher recruitment and retention program. For more information, see IND-CR 214 for more details. Military Retirement Exclusion: For taxable years beginning on or after January 1, 2022,a taxpayer under the age of 62 can exclude up to $17,500 of military retirement income or up to $35,000 if such taxpayer has more than $17,500 of earned income. See page 15 for detailed information.  Dependent Personal Exemption for Unborn Children with Detectable Human Heartbeat: If at any time on or after July 20, 2022, and through December 31, 2022, a taxpayer has an unborn child (or children) with a detectable human heartbeat, the taxpayer may claim a dependent personal exemption in the amount of $3,000 for each unborn child. Use description UNBORNDEP. Please see instructions on page 11 for more information. Schedule 1: The Line 12 on Form 500 has been reduced to a single line on Schedule 1 for this and future tax years. Therefore, taxpayers with multiple subtractions on Schedule 1, Line 12 should either file electronically to add additional lines or attach a schedule to the paper return. House Bill 149 Addition: For owners of a pass- through entity or entities that have elected to pay tax at the entity level, enter your allocable share of loss that was apportioned and allocated at the entity level on Schedule 1, Line 5. Use description PTEADD. See 560-7-3-.03(9)(a). GENERAL INFORMATION  House Bill 149 Deduction: For owners of a pass- through entity or entities that have elected to pay tax at the entity level, enter your allocable share of income that was taxed at the entity level on Schedule 1, Line 12. Use description PTEDED. See 560-7-3-.03(9)(a).  Standard Deductions: The standard deductions have increased for tax year 2022. For more information, see the 2022 Form 500-ES instructions.  Historic Rehabilitation Tax Credits: These credits have been revised, for more information, see https://dor.georgia.gov/tax-credit-summaries.

Page 8 Frivolous Return Penalty - $1,000. (A frivolous return is one that contains incorrect or insufficient information necessary to accurately compute the appropriate tax liability with the intent to delay or impede Georgia tax law or is based on a frivolous position.)  Negligent Underpayment Penalty - 5 percent of the underpaid amount.  Fraudulent Underpayment Penalty - 50 percent of the underpaid amount.  Failure to File Estimated Tax Penalty - 9 percent per year for the period of underpayment. Use Form 500 UET to calculate the penalty.  Interest accruing for months beginning before July 1, 2016 accrues at the rate of 12 percent annually. Interest that accrues for months beginning on or after July 1, 2016 accrues as provided by Georgia Code Section 48-7-81. Assessments. If your return is reviewed and it is deter- mined that you owe additional taxes, generally, you will be issued a Proposed Assessment. Once a Proposed Assessment is issued, you have 30 days to complete a protest on the Georgia Tax Center (GTC) website. After 30 days, the Department will issue an Official Assess- ment and Demand for Payment. You have 30 days to file an appeal with either the Georgia Tax Tribunal or in the appropriate Superior Court. For more informa- tion and rights as a taxpayer, see the Taxpayer Bill of Rights on the Department’s website at dor.georgia.gov. Supporting Documents. We will request information to support the amounts listed on your Georgia income tax return and related schedules when necessary. How- ever, in addition to withholding statements (W-2s,1099s, G2-RPs, etc.) where taxes were withheld you must include the following documentation with your Geor- gia return when it is filed for the following situations:  The amount on Form 500, Line 8 is $40,000 or more, or less than the total income on your W-2(s) - submit a copy of Pages 1, 2, and Schedule 1 of your Federal return (the Federal Schedule 1 must be includ- ed if a copy was submitted with your federal return).  You itemize deductions - submit a copy of Federal Form 1040 Schedule A. GENERAL INFORMATION extend the date for making the payment. Additional penalties may apply as follows: You claim the Georgia child and dependent care expense credit - submit the appropriate Federal child care credit schedule.  You claim a credit for taxes paid to another state(s)- submit a copy of your return filed with the other state(s).  These documents should be submitted with your tax return. Innocent Spouse Relief. Individuals who were granted innocent spouse relief by the Internal Revenue Service may be eligible for relief from liability for Georgia tax, interest and penalty. I n d i v i d u a l R e t i r e m e n t A c c o u n t s . T h e provisions concerning taxability and conversion from a traditional IRA to a Roth IRA are the same for Georgia and the Internal Revenue Service. Withholding on Lump-sum Distributions. The payee of any non-periodic payment may elect to have withholding made on the non-periodic distributions from a pension, annuity, or similar fund. The election shall remain in effect until revoked by the payee. See Form G-4P for more information. Income from Partnerships and S Corporations. Nonresident partners must pay Georgia income tax on their portion of the partnership’s Georgia income. Nonresident shareholders must pay Georgia income tax on their portion of the S Corporation's Georgia income; resident shareholders and partners must report their total S Corporation or partnership income (but may be eligible for the credit for taxes paid to other states or a subtraction when the income is taxed at the entity level in Georgia or another state). Federal Audit. Whenever a Federal audit or other Address Changes. You must notify the Department of your address change. Notification of an address change can be made through GTC inside a logon, by calling 1-877-423-6711 or writing the new address on your tax return and checking the address change box. Name Change. The Department currently re- quires a copy of one of the following four doc- uments in order to change a person’s name: • Social Security Card • Driver’s License • Name change decree from Superior Court • Marriage Certificate

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 You are required to file a Federal income tax return;  You have income subject to Georgia income tax that is not subject to Federal income tax;  Your income exceeds the standard deduction and personal exemptions as indicated below: A. Single, Head of Household or Qualifying Surviving Spouse 1. Under 65, not blind.................................$ 8,100 2. Under 65, and blind................................$ 9,400 3. 65 or over, not blind................................$ 9,400 4. 65 or over, and blind.............................$ 10,700 B. Married filing Joint 1. Both under 65, not blind........................$ 14,500 2. One 65 or over, not blind.......................$15,800 3. Both under 65, both blind......................$ 17,100 Both under 65, one blind.......................$ 15,800 FILING REQUIREMENTS Both 65 or over, not blind......................$ 17,100 6. One 65 or over, and blind......................$17,100 7. One 65 or over, and both blind..............$18,400 8. Both 65 or over, and blind.....................$ 19,700 C. Married filing Separate 1. Under 65, not blind................................$ 7,250 2. Under 65, and blind...............................$ 8,550 3. 65 or over, not blind...............................$ 8,550 4. 65 or over, and blind..............................$9,850 These requirements apply as long as your le- gal residence is Georgia, even if you are absent from or live outside the State temporarily. A cred- it for taxes paid to another state is allowed. See the worksheet on page 20 for more information. Part-year and Nonresidents 1. Part-year residents and nonresidents who work in Georgia or receive income from Georgia sources are required to file Georgia Form 500 and complete Form 500 Schedule 3 to calculate Georgia taxable income. Note: Form 500 Schedule 3 should only be attached if it is applicable. 2. A married part-year resident or nonresident with income earned in Georgia whose spouse is a nonresident with no Georgia source income may file either a separate return claiming only their own personal exemption and dependent exemptions and deductions or a joint return claiming total allowable deductions. 3. If one spouse is a resident and one is a part- year resident or nonresident, enter 3 in the residency status box and complete Form 500, Schedule 3 to calculate Georgia taxable income. Part-year Residents 1. If you are a legal resident of Georgia for only a portion of the tax year and are required to file a Federal income tax return, you are required to file a Georgia income tax return. 2. Part-year residents who claim a credit for taxes paid to another state for income earned while a resident must include a copy of the individual income tax return filed with that state(s) with their Georgia return. Otherwise the credit will not be allowed. Nonresidents 1. Nonresidents who work in Georgia or receive income from Georgia sources and are required to file a Federal return are required to file a Georgia income tax return. 2. Legal residents of other states are not required to file a Georgia tax return if their only activity for 5. 4. Federal adjustment results in a change in net income for any year, you are required to furnish under separate cover, within 180 days, a schedule reflecting all changes. Please include the schedule when you file form 500X. Additionally, if the changes result in a refund, the refund must be claimed within one year of the date the changes are submitted. If you do not submit a return reflecting all changes and the Commissioner receives this information in a report from the United States Government, the Commissioner will issue an assessment for tax due within five years from the date the report is received from the United States Government. A taxpayer who fails to notify the Commissioner within 180 days forfeits any Georgia refund as a result of an IRS audit if the normal statute of limitations has expired. However, 90 percent of any overpayment can be applied to a balance due for another year that is a result of the same IRS audit. Withholding on Nonresidents. Withholding is required on the members' share of the taxable income sourced to this state, whether distributed or not, from Partnerships, Limited Liability Companies and S Corporations. Withholding should be reported on Form G2-A and entered on Form 500, Line 24. Include a copy of Form G2-A with your return. Withholding is also required on the sale or transfer of real property and associated tangible personal property by nonresidents of Georgia. Tax withheld is reported on Form G2-RP and should be entered on Form 500, Line 24. Include a copy of Form G2-RP with your return. Full-year Residents Full-year residents are taxed on all income, except tax exempt income, regardless of the source or where de derived. You are required to file a Georgia income tax return if:

financial gain or profit in Georgia consists of performing services for an employer as an employee where the wages for such services does not exceed the lesser of five percent of the income received from performing services in all places during the taxable year or $5,000. 3. A nonresident, who receives deferred compensation or income from the exercise of stock options that were earned in Georgia in a prior year is required to pay tax on the income, but only if the prior year’s income exceeds the lesser of: 1) 5 percent of the income received by the person in all places during the current taxable year; or 2)$5,000. However, the income is not taxed if federal law prohibits the state from taxing it. Federal law prohibits state taxation of some types of retirement income including pensions as well as income received from nonqualified deferred compensation plans if the income is paid out over the life expectancy of the person or at least 10 years. See Regulation 560-7-4-.05 for more information. Taxpayers Required to File Form 1040NR Individuals who are required to file Federal Form 1040NR must file Georgia Form 500. Similar to Federal income tax rules, most of these Georgia taxpayers are only allowed to deduct the applicable Georgia personal exemption and expenses reflected on Form 1040NR. Most taxpayers are not allowed to take the standard deduction and are allowed only limited itemized deductions as shown on Form 1040NR, Schedule A. Military Personnel Residents. Military personnel who are legal residents of Georgia are subject to Georgia income tax on all income regardless of the source or where earned, unless specifically exempt by Georgia law. Military personnel who serve outside of the continental U.S. may file their Georgia income tax return within six months after they come back to the continental U.S. No penalties or interest will accrue during this period. Members of the National Guard or Air National Guard who are on active duty for a period of more than 90 consecutive days are allowed a tax credit against their individual income tax. The credit cannot exceed the amount expended for qualified life insurance premiums or the taxpayer’s income tax liability and should be claimed on Form IND-CR. Nonresidents. Military personnel who are not legal residents of Georgia are only required to file a Georgia income tax return if the person earns income during their off duty hours from sources in Georgia or if the person has income from property located in Georgia or the person receives business income from Georgia sources. If required, nonresident military personnel should file Georgia Form 500 and use Schedule 3 to calculate Georgia taxable income. (See pages 18 - 19 for instructions on completing Schedule 3.) Spouses of Military Personnel. A spouse of a military person shall neither lose or acquire their legal residence solely to be with the military person serving in compliance with military orders but this provision only applies if the legal residence FILING REQUIREMENTS of the spouse is the same as the military person or the spouse of a military person has elected to use the same residence for purposes of taxation as the military person. Income for services performed by the spouse of a military person shall not be considered Georgia income if the military person is not a legal resident of Georgia but this only applies if the spouse is in Georgia solely to be with the military person serving in compliance with military orders and the legal residence of the spouse is the same as the military person or the spouse of a military person has elected to use the same residence for purposes of taxation as the military person. The affected taxpayer should exclude the income on Schedule 3, Column C, Line 7 of the Form 500. No amounts should be entered on Schedule 3, Column A, Line 7 of Georgia Form 500. Combat Zone Pay Military income earned by a member of the National Guard or any reserve component of the armed services while stationed in a combat zone or stationed in defense of the borders of the United States pursuant to military orders is not subject to Georgia income tax. The exclusion from income is only with respect to military income earned during the period covered by such military orders. A copy of the Federal return must be enclosed with the Georgia return to claim this exclusion. The exclusion is limited to the amount included in Federal Adjusted Gross Income. Estimated Tax Estimated tax is required for each individual subject to Georgia income tax who reasonably expects to have gross income during the year which exceeds (1) personal exemption, plus (2) credits for dependents, plus (3) estimated deductions, plus (4) $1,000 of income not subject to withholding. Estimated tax required from persons not regarded as farmers or fishermen shall be filed on or before April 15 of the taxable year, except if the above requirements are first met on or after April 1 and before June 1, estimated tax must be filed by June 15; on or after June 1 but before September 1, by September 15; and on or after September 1, by January 15 of the following year. Individuals filing on a fiscal year basis ending after December 31 must file on corresponding dates. Other State’s Tax Return If you claim a credit for taxes paid to another state(s), you must include a copy of your return filed with that state along with your Georgia return. No credit for taxes paid to another state will be allowed unless the other state’s return is enclosed with the Georgia return. Filing for Dependents (children, etc.) If the parent or guardian prepared the minor child or dependent’s return, the Department recommends that the parent or guardian check the box allowing the preparer to discuss the return with the Department. If this is not done and the parent did not sign the return on the child's behalf as allowed by IRS Publication 929, then the parent or guardian will have to be included on a Power of Attorney Page 10

Page 11 (Form RD-1061) prepared by the minor in order for the Department to discuss the return with the parent or guardian. Filing for Deceased Taxpayers The surviving spouse, administrator, or executor may file a return on behalf of a taxpayer who dies during the taxable year. When filing, use the same filing status that was used on the Federal income tax return. The due date for filing is the same as for Federal purposes. Note: To have a refund check in the name of a deceased taxpayer reissued, mail Georgia Form GA-5347, a copy of the death certificate, and the information specified on Georgia Form GA-5347 along with the check to the address on the form. Form 500 for Instructions Lines 1 - 3: Print or type your name(s), address (includ- ing apartment number if applicable) and social security number(s) in the spaces provided. Do not write both a street address and post office box in the address field. Line 4: Enter the appropriate number for your residency status.  1 - You lived in Georgia the entire year, regardless of temporary living arrangements.  2 - You lived in Georgia part of the year. Note: List the dates you lived in Georgia and you must complete Schedule 3 to calculate Georgia taxable income. 3 - You did not live in Georgia or if one spouse is a resident and one is a part-year resident or nonresident. Note: You must complete Schedule 3 to calculate Georgia taxable income. Line 5: Enter the appropriate letter for your filing sta- tus. Use the same status that is on your Federal return. Spouse* *Use filing status D if your filing status is qualifying surviving spouse on your Federal return. Georgia recognizes same sex marriage. Exceptions:  One spouse is a resident and the other is a nonresident without any Georgia-source income, your Georgia return may be filed jointly or separately with each spouse claiming the appropriate exemptions and deductions. Line 6a - 6b: Check the appropriate box  6a for yourself  6b if you claim your spouse and you file jointly. Line 6c: Enter the total number of exemption boxes checked. Lines 7a - b: Exemptions and Dependents FORM 500 INSTRUCTIONS Include all completed schedules with your Georgia return. Complete your Federal return before starting your Georgia return. Your Federal return contains information that should be included on your Georgia return. 7a: Enter the total number of dependents. Do not include yourself or your spouse or dependent unborn children. A dependent is determined in the same manner as was deter- mined when dependents were allowed for Federal income tax purposes except that a dependent also includes those unborn with a detectable human heartbeat. Use Form 500, Schedule 1, Line 12, to claim the dependent personal exemption for unborn children with a detectable heartbeat. If married filing separate, only one spouse may claim the dependent and the prior Federal rules (those when dependents were allowed) are used to determine who is entitled to claim the dependent. 7b: List the requested information about your dependents in the spaces provided. Line 8: Enter Federal adjusted gross income from Form 1040. Do not use Federal taxable income. Note: If the amount on Form 500, Line 8 is $40,000 or more, or less than the total income on your W-2s you must submit a copy of your Federal Form 1040 pages 1, 2 and Schedule 1. The Federal Schedule 1 must be included if a copy was submitted with your federal return. Line 9: You must adjust your Federal adjusted gross income if you have income that is taxable by the Federal Government but not taxable to Georgia or vice versa. You must document your adjustments on Schedule 1 and enter the total amount here. There are certain adjustments that must be added if applicable and some adjustments that may be subtracted. Please see pages 14 - 16 for more information about additions and subtractions. Note: Part-year residents and nonresidents must omit Lines 9 -14 and follow the Schedule 3 instructions that begin on page 18. Line 10: Enter Georgia adjusted gross income (net total of Line 8 and Line 9). Lines 11a-c: Standard Deductions (Leave Lines 11a-c blank if you itemize deductions) Note: If you use the standard deduction on your Federal return, you must use the Georgia standard deduction on your Georgia return. Line 11a: Enter the standard deduction that corresponds to your marital status.  Single/Head of Household/Qualifying Surviving Spouse..................$5,400  Married Filing Separate................... $3,550  Married Filing Joint.......................... $7,100  Additional Deduction....................... $1,300 Line 11b: Enter any additional deductions on Line 11b.  A - Single;  B - Married filing joint;  C - Married filing separate;  D - Head of Household or Qualifying Surviving

Page 12 FORM 500 INSTRUCTIONS (continued) Note: The additional deduction applies if you and/ or your spouse are age 65 or over and/or blind. Line 11c: Enter the total standard deduction on Line 11c. Lines 12a-c: Itemized Deduction (Leave Lines 12a-c blank if you use the standard deduction) Note: If you itemize deductions on your Federal return, or if you are married filing separate and your spouse itemizes deductions, you must itemize deductions on your Georgia return. Include a copy of Federal Schedule A with your Georgia return. Line 12a: Enter the itemized deductions from your Federal Schedule A. Line 12b: Enter adjustments for income taxes other than Georgia and investment interest expense for the production of income exempt from Georgia tax. Line 12c: Subtract Line 12b from Line 12a, enter total. Note: For all taxpayers (full year, part year, and nonresident), if state & local income taxes were limited on the federal return to $10,000 ($5,000 MFS), the following formula should be used to determine the disallowed other state income taxes: Other state income taxes divided by the total taxes on line 5d of schedule A multiplied by the lesser of the amount on line 5d of schedule A or $10,000 ($5,000 if married filing separate). For part year and nonresidents on the schedule 3, the same computation should be used in arriving at the amount of itemized deductions that would then be subject to proration using the part-year/nonresident income ratio on form 500 Schedule 3 Line 9. Do not include state taxes paid by entities that pay income tax at the entity level. Line 13: Subtract Line 11c or 12c from Line 10, enter total. Lines 14a-c: Exemption and Dependent Totals Lines 14a: Multiply the number of exemptions on Line 6c by the filing status totals listed below and enter the total.  $2,700 for filing status: A - Single or D - Head of Household or Qualifying Surviving Spouse $3,700 for filing status: B - Married Filing Joint or C - Married filing separate Line 14b: Multiply the number of dependents Line 7a by $3,000 and enter the total. Line 14c: Enter the grand total of Lines 14a and 14b. Line 15a: Subtract Line 14c from Line 13 (or enter Schedule 3, Line 14) to get your Georgia taxable income before GA Net Operating Losses (NOLs). Line 15b: Georgia NOL Utilized Net operating losses (NOLs) for tax years 2018 and later that are applied to Georgia income cannot exceed 80% of Georgia income before NOLs. Use the schedule below to compute the net operating losses that can be used in the current year. 1. NOL carry forward available for current year from years before 2018 ____________ 2. NOL carry forward available for current year from years 2018 and later ____________ 3. Income before GA NOL (Line 15a of Form 500) ____________ 4. NOL from line 1 applied to current year ____________ 5. NOL from line 2 applied to current year (cannot exceed 80% of Line 3) ____________ 6. Total NOL applied - add Lines 4 and 5, also enter on Line 15b of Form 500 ____________ Note: Before determining how much NOL can be carried from the current year to the next year, the income from the current year must be recomputed using the "Net Operating Loss Carryover" schedule and the related instructions on Form 500-NOL. Line 15c: Subtract Line 15b from Line 15a. Line 16: Take the amount from Line 15c and use the rate schedule on page 55 to determine your tax liability. Line 17: Complete the Low Income Credit Worksheet on page 21 to determine your credit amount. Enter the amount from Line 6 of the worksheet on the form. Note: You may claim the low income credit if your Federal adjusted gross income is less than $20,000 and you are not claimed or eligible to be claimed as a dependent on another taxpayer’s Federal or Georgia income tax return. Part-year residents may only claim the credit if they were residents at the end of the tax year. Taxpayers filing a separate return for a taxable year in which a joint return could have been filed can only claim the credit that would have been allowed had a joint return been filed. You cannot claim this credit if you are an inmate in a correctional facility. This credit must be claimed on or before the end of the 12th month following the close of the tax year. The credit cannot exceed the taxpayer’s income tax liability. Line 18: Enter the other state(s) tax credit used. If you paid tax to more than one state, use the total of the other state’s income and the worksheet on page 20 to calculate the Other State’s Tax Credit. N o t e : Yo u m u s t i n c l u d e a c o p y o f t h e return filed with the other state(s) with your Georgia return or the credit will not be allowed. Line 19: Enter the amount of credits used from the last line of the IND-CR Summary Worksheet. IND-CR forms are included within the form. Line 20: Enter the amount of credits used from Schedule 2. The return must be filed electronically if series 100 tax credits are claimed or generated. If claiming credit code 125 (QEE) enter your SSN and not the FEIN of the SSO. See page 22 for more information regarding credits. Line 21: Add Lines 17-20 to get the amount for total credits used. Amount cannot exceed Line 16.

Page 13 Line 22: Subtract Line 21 from Line 16. If zero or less, enter zero. Line 23: Enter Georgia income tax withheld from W-2s and 1099s where Georgia income tax was withheld. Note: Attach/Include a copy of these statements with your return or this amount will not be allowed. Line 24: Enter Georgia income tax withheld on G2-A, G2-FL, G2-LP, and/or G2-RP. Include a copy of these statements with your return or this amount will not be allowed. Note: Please complete the Income Statement Details Section. Only report income on which Georgia tax was withheld. Enter income form W-2s, 1099s, and G-2As on Line 4 GA Wages/Income. For other statements complete Line 4 using the income reported from Form G2-RP Line 12 or Line 13; Form G2-LP Line 11, or for Form G2-FL enter zero. Line 25: Enter estimated tax payments, including amounts credited from a previous return, and any payments made electronically or with Form IT 560. Line 26: Enter Schedule 2B Refundable Tax Credits. The return must be filed electronically to claim these credits. Line 27: Add Lines 23, 24, 25, and 26 and enter the total amount. Line 28: If Line 22 is more than Line 27, subtract Line 27 from Line 22 to calculate the balance due. Line 29: If Line 27 is more than Line 22, subtract Line 22 from Line 27 to calculate your overpayment. Line 30: Enter the amount you want credited to next year's estimated tax. Lines 31 - 39: Enter the amount you want to donate to the charities listed on the form. Note: Amount cannot be less than $1. Line 40: Enter the estimated tax penalty from Form 500 UET. If you were eligible for an estimated tax penalty exception on Form 500 UET, please check the “500 UET Exception Attached” box, include the revised penalty on Line 40 of the Form 500, and include the 500 UET with the return. Note: If the revised penalty is zero, enter zero. Line 41: Enter the amount of late payment and/or late filing penalty. Line 42: Enter the amount of interest. Line 43: Add Lines 28 and 31 through 42 and enter the total amount due. Mail your return, 525-TV payment voucher, and payment to the address on the Form 500. Line 44: Subtract the sum of Lines 30 through 42 from Line 29 and enter the amount to be refunded to you. Direct Deposit Option Note: If you do not enter Direct Deposit Information or if you are a first time Georgia filer or if you have not filed your taxes in five or more years you will receive your refund via paper check. This applies both to electronic and paper return filers. Line 44a: Complete the direct deposit information  Check the appropriate box (Checking or Savings) for the type of account. Note: Do not check more than one box. You must check the correct box to ensure your direct deposit is accepted.  Enter your nine digit routing number. Note: The first two digits must be 01 through 12 or 21 through 32. Ask your financial institution for the correct routing number to enter on Line 44a if: • The routing number on a deposit slip is different from the routing number on your checks. • The deposit is to a savings account that does not allow you to write checks or • Your checks state they are payable through a financial institution different from the one at which you have your checking account.  Enter your account number from left to right and leave unused boxes blank. Include hyphens, but omit spaces and special symbols. Note: The account number can be up to 17 characters (both numbers and letters). Example On the sample check below, the routing number is 807100013. John Doe would use that routing number unless their financial institution instructed them to use a different routing number for direct deposits. The account number is 978653421. Do not include the check number. On the sample check below, the check number is 5678. Direct Deposit Rejects If any of the following apply, your direct deposit request will be re- jected and a check will be mailed:  Any numbers or letters are crossed out or whited out.  An invalid checking, savings, or routing number was entered. Your financial institution will not allow a joint refund to be depos- ited to an individual account. The State of Georgia is not responsible if a financial institution rejects a direct deposit.  You request a deposit of your refund to an account that is not in your name (such as your tax preparer’s own account). FORM 500 INSTRUCTIONS (continued)

SCHEDULE 1 ADDITIONS AND SUBTRACTIONS Signature Section Please sign and date your return. If filing a joint return you and your spouse must sign and date the return. If applicable, the paid preparer should also sign the return. If the taxpayer and/or spouse is deceased, check the "Deceased checkbox" and provide the date of death. Schedule 1 Instructions Lines 1 - 6: Enter your additions to income (see Additions section for detailed information). Lines 7 - 13: Enter your subtractions from income (see pages 14 - 16 Subtractions section for detailed information). Note: A taxpayer with multiple additions (Schedule 1, Line 5) and subtractions (Schedule 1, Line 12) should include a separate worksheet listing all adjustments and write the total for those lines respectively. Lines 14: Enter your total net adjustments here and on Line 9 of page 2 of Form 500. Note: Please complete and include your Retirement Income Exclusion calculation (Page 2 of Schedule 1), if you entered information on Schedule 1, Lines 7a, 7d, 7c, and/or 7f. Also, please complete and include the Military Retirement Income Exclusion calculation (Page 3 of Schedule 1) if you entered information on Schedule 1, Lines 7b and/or 7e. Additions The following adjustments must be added if applicable tion relating to the credit. See Regulation 560-7-8-.47. 560-7-8-.57 for more information. 12. For the , the deduction relating to the credit. See Regulation 560-7-8-.60 for more information. Note: If the contribution relating to the above credits is treated as a deduction of state taxes, then the follow- ing formula should be used to determine the disallowed state income taxes: Contribution treated as state income taxes divided by the total taxes on line 5d of schedule A multiplied by the lesser of the amount on line 5d of schedule A or $10,000 ($5,000 if married filing separate). Note: Also, for both other state income taxes and when the contribution relating to the above credits is treated as a deduction of state taxes, the federally taxable state income tax refund that is later received may be eligible to be reduced. The reduction equals the federally taxable refund times the proportion that was used to figure out how much of the deduction had to be reduced in the year of the deduction (Contribution treated as state income taxes divided by the total taxes on line 5d of schedule A). Note: If a taxpayer receives a state refund and is not required to include the refund in Federal AGI since they were subject to Federal Alternative Minimum Tax, they are not required to include the refund for Georgia purposes. HB 1302 refunds are not taxable for Georgia individual income tax purposes but may be federally taxable. Note: Georgia does not allow the 20% qualified business income deduction. (I.R.C. Section 199A). However, since Georgia starts with Federal AGI, no adjustment is necessary on the Georgia return. 13. For owners of a pass-through entity or entities that have elected to pay tax at the entity level see 560- 7-3-.03(9)(a). Note: Enter your allocable share of loss that was apportioned and allocated at the entity level on Schedule 1, line 5.Use description PTEADD. Subtractions The following adjustments may be SUBTRACTED: The retirement exclusion is $65,000 for taxpayers who are 65 years of age or older. The exclusion is available for the taxpayer and his/her spouse; however, each must qualify on a separate basis. If both spouses qualify, each spouse may claim the amounts above. Income from property that is jointly owned should be allocated to each taxpayer at 50% of the total value. Up 9. For the , the deduc- Page 14 10. For the Land Conservation credit, the deduction re- lating to the credit. See Regulation 560-7-8-.50 for more information. 11. For the tax credit, the deduction relating to the credit. See Regulation 1. Interest received from non-Georgia municipal bonds and dividends received from mutual funds that derived income from non-Georgia municipal bonds. These may only be reduced by direct and indirect interest expenses which are attributable to the income and which have not already been deducted in arriving at Federal adjusted gross income or itemized deductions. 2. Loss carryovers from years when you were not subject to Georgia income tax. 3. Lump sum distributions from employee benefit plans reported on IRS Form 4972. 4. Depreciation because of differences in Georgia and Federal law during tax years 1981 through 1986. 5. Adjustments due to Federal tax changes (see dor. georgia.gov/rules-policies/income-tax/income-tax-federal- tax-changes). 6. Net operating loss carryover deducted on federal return. 7. Payments for more than $600 in a taxable year made to employees which are not authorized employees and which are not excepted by Code Section 48-7-21.1. An authorized em- ployee is someone legally allowed to work in the United States. 8. Taxable portion of withdrawals on the Path2College 529 Plan (see Regulation 560-7-4-.04). 1. Retirement income. The maximum retirement income exclusion is $35,000 for taxpayers who are: (A) 62 - 64 years of age, or (B) less than 62 and permanently disabled to such an extent that they are unable to perform any type of gainful employment

Page 15 to $4,000 of the maximum allowable exclusion may be earned income. Use the instructions on page 17 and complete Form 500, Schedule 1, Page 2. 2. Military retirement income. Beginning January 1, 2022, $17,500 of military retirement income can be excluded for taxpayers under 62 years of age and an additional $17,500 can be excluded for such taxpayers with more than $17,500 of earned income in Georgia. The exclusion is available for the taxpayer and his/her spouse; however, each must qualify on a separate basis. If both spouses qualify, each spouse may claim the amounts above. 3. Dependent personal exemption for unborn children with a detectable human heartbeat. Amount of $3,000 for each unborn child with a detectable human heartbeat at any time during the tax year. For tax year 2022, the amount is only available for each unborn child with a detectable human heartbeat at any time on or after July 20, 2022, and through December 31, 2022. Note: The unborn dependent exemption cannot be claimed if the child is born during the same tax year. 4. Interest and dividends on U.S. Government bonds and other U.S. obligations. These must be reduced by direct and indirect interest expenses which are attributable to the income. Note: Interest received from the Federal National Mortgage Association, Government National Mortgage Association, Federal Home Loan Mortgage Corporation, and from repurchase agreements is taxable and should not be subtracted. Schedule 1 Subtractions (continued) the Sub S election is not recognized by Georgia or another state or for Georgia resident partners in a partnership or members in an LLC where such entities' income has been taxed at the entity level by another state. This adjustment is only allowed for the portion of income on which the tax was actually paid by the corporation or partnership to another state(s). The subtraction amount is calculated as follows: 1. Determine the Georgia taxable net income received from the entity. This should include any income, gains, losses and deductions from the entity which are separately reported and included on the taxpayer's return including any guaranteed payments received from a partnership. This does not include wages paid to the partner, shareholder, or member. However, if such wages are taxed by another state, the partner, shareholder, or member may be eligible for the other state(s) tax credit. 2. Multiply the above income by the entity's apportionment ratio in such other state. Only states which have a tax on the entity which is on or measured by income are eligible for the subtraction. Income subject to the Texas Margin Tax is eligible for this subtraction. Please see Code Section 48-7-27(d) and Regulation 560-7-4-.01 for more information. In cases where the Sub S election is recognized by another state(s) the income should not be subtracted. Credit for taxes paid to other states may apply. 13. Adjustment for teachers retired from the Teacher’s Re- tirement System of Georgia for contributions paid between July 1, 1987 and December 31, 1989 that were reported to and taxed by Georgia. 14. Amount claimed by employers in food and beverage estab- lishments who took a credit instead of a deduction on the Federal return for FICA tax paid on employee cash tips. 15. An adjustment of 10% of qualified payments to minority subcontractors or $100,000, whichever is less, per taxable year by individuals, corporations or partnerships that are party to state contracts. For more information call the Department of Adminis- trative Services at 404-657-6000 or visit their website: http://doas. ga.gov/state-purchasing/suppliers. 16. Deductible portion of contributions to the Path2College 529 Plan. The deduction is limited on a return to the amount contrib- uted but cannot exceed $4,000 per beneficiary unless a married filing joint return is filed then the amount cannot exceed $8,000 per beneficiary. 17. Adjustments due to Federal tax changes (see dor.georgia. gov/rules-policies/income-tax/income-tax-federal-tax-changes). 18. Combat zone pay exclusion. See page 10 for more infor- mation. 19. Up to $10,000 of unreimbursed travel expenses, lodging ex- penses and lost wages incurred as a direct result of a taxpayer’s donation of all or part of a kidney, liver, pancreas, intestine, lung or bone marrow during the taxable year. 5. Social security or railroad retirement (tier 1 and tier 2) paid by the Railroad Retirement Board included in Federal adjusted gross income. 6. Salaries and wages reduced from Federal taxable income because of the Federal Jobs Tax Credit. 7. Individual retirement account, Keogh, SEP and SUB-S plan withdrawals where tax has been paid to Georgia because of the difference between Georgia and Federal law for tax years 1981 through 1986. 8. Depreciation because of differences in Georgia and Federal law during tax years 1981 through 1986. 9. Dependent’s unearned income included in parents’ Federal adjusted gross income. 10. Income tax refunds from states other than Georgia included in Federal adjusted gross income. Do not subtract Georgia income tax refunds. 11. Income from any fund, program or system which is specifically exempted by Federal law or treaty. 12. Adjustment to Federal adjusted gross income for Georgia resident shareholders for Subchapter S income where

Page 16 Schedule 1 Subtractions (continued) 20. An amount equal to 100 percent of the premium paid by the taxpayer during the taxable year for high deductible health plans as defined by Section 223 of the Internal Revenue Code. The amount may only be deducted to the ex- tent the deduction has not been included in federal adjusted income and the expenses have not been provided from a health reimbursement arrangement and have not been included in itemized deductions. In the event the taxpayer claims the expenses as itemized deductions, the taxpayer should multiply the expense by the ratio of total allowed itemized deductions after the federal limitation to the total allowed itemized deductions before the federal limitation to determine the amount that is not allowed to be deducted pursuant to this paragraph. For example, the taxpayer has $1,000 in high deductible health insurance premiums. They also have $7,000 of other medical expenses which means they have total medical expenses of $8,000. After the limitation, the taxpayer is only allowed to deduct $2,000 of medical expenses. The $1,000 deduction must be reduced by $250 ($2,000/$8,000 x $1,000), and the taxpayer is allowed to deduct $750. 21. Federally taxable interest received on Georgia municipal bonds designated as “Build America Bonds” under Section 54AA of the Internal Revenue Code of 1986. “Recovery Zone Economic Development Bonds” under Section 1400U-2 of the Internal Revenue Code or any other bond treated as a ‘Qualified Bond” under Section 6431(f) of the Internal Revenue Code are considered “Build America Bonds” for this purpose. 22. Federally taxable interest received on Georgia municipal bonds issued by the State of Georgia and certain authorities or agencies of the State of Georgia for which there is a special exemption under Georgia law from Georgia tax on such interest. 23. Interest eliminated from federal itemized deductions due to the Federal Form 8396 credit. 24. An amount equal to 100 percent of the payments made to and received by a disabled first responder pursuant to Code Section 45-9-85 (Payment of indemnification for death or disability) provided that and to the extent such amounts are included in the taxpayer's federal adjusted gross income and are not otherwise exempt from the tax imposed by this article under any other provision of law. The term 'disabled first responders' means a law enforcement officer, fireman, publicly employed emergency medical technician, or a surviving spouse of such an individual, receiving payments pursuant to Code Section 45-9-85 (Payment of indemnification for death or disability) due to total permanent disability, organic brain damage, or death occurring in the line of duty. 25. For a firefighter, payments received pursuant to O.C.G.A. § 25-3-23(b)(2) (certain insurance benefits related to cancer) to the extent such amounts are included in the taxpayer's federal adjusted gross income and are not otherwise exempt on the Georgia return. 26. For a firefighter, an amount equal to 100% of any premium paid by the firefighter during the taxable year for coverage pursuant to O.C.G.A. § 25-3-23(b)(2) (premiums paid to continue coverage by a firefighter that departs employment) to the extent such deduction has not been included in the taxpayer's federal adjusted gross income and is not otherwise deductible on the Georgia return. 27. Income received by a surviving family member that is based on the service record of a deceased veteran without regard to the age of the surviving family member. 28. For taxable years beginning on or after January 1, 2019, and ending on or before December 31, 2023, a subtraction is allowed for certain disaster relief payments. The payments that qualify are those that are received from a federal disaster relief or assistance grant program administered by Georgia or its instrumentalities or the United States Department of Agriculture but only if the federal grant program was established specifically to address agricultural losses suffered due to Hurricane Michael during the 2018 calendar year. Also, the subtraction is only allowed to the extent the income is included in federal adjusted gross income. Finally, any amounts that came from a pass-through entity are also eligible. 29. For owners of a pass-through entity or entities that have elected to pay tax at the entity level, see 560-7-3-.03(9) (a). Note: Enter your allocable share of income that was taxed at the entity level on Schedule 1, Line 12. Use description PTEDED. Note regarding ABLE PROGRAMS - NO DEDUCTION is allowed as a subtraction item for any contribution made pursuant to the Georgia ABLE Program or any other state ABLE programs.

Page 17 Part-year/Nonresident Retirement Exclusion Example Schedule 3: Ln 1 Wages Ln 2 Interest and Dividends Ln 3 Business (income or loss) Ln 4 Other (income or loss) Ln 5 Total (Total Lines 1 thru 4) Ln 6 Total Adjustments from Form 1040 Ln 7 Sch 1 Retirement Exclusion (from step 2 below) Ln 8 GA AGI Column A 68,300 82,500 82,500 0 0 0 0 325,150 100,000 225,150 475,950 228,300 247,650 -12,000 -12,000 0 -65,000 -29,992 -35,008 398,950 186,308 212,642 Step 1 Determine the Everywhere and Georgia Parts of Retirement Exclusion Step 2 Determine the Part-year/Nonresident Retirement Exclusion Allowed Everywhere Georgia Earned Portion Ln 1 Wages Ln 2 Other Earned Income Ln 3 Total Earned Income (Use in step 2) Ln 4 Max Earned Income Ln 5 Smaller of Ln 3 or 4 Ln 6 Interest Ln 7 Dividend Ln 8 Alimony Ln 9 Capital Gains Ln 10 Other Income Ln 11 Taxable IRA Ln 12 Taxable Pensions Ln 13 Rent, Royalty, etc. Ln 14 Unearned Income - (Total Line 6 to 13) (Use in step 2) Earned Income Ratio Georgia 22,500 Everywhere 68,300 0.3294 Max Earned Income Georgia Earned Income Portion Unearned Portion

Total Max Exclusion Portion Used on Earned Income Remaining Allowed on Unearned 4,000 4,000 1,318 4,000 82,500 0 65,000 4,000 30,450 30,450 61,000 75,150 0 Unearned Income Ratio Georgia 225,150 24,850 0 Everywhere 407,650 0.5523 194,700 194,700 407,650 225,150 Total Retirement Exclusion Allowed from GA Income 33,690 35,008 Georgia Unearned Income Portion 68,300 Column B Column C 45,800 22,500 0 0 22,500 68,300 22,500 RETIREMENT INCOME EXCLUSION Social security and railroad retirement paid by the Railroad Retirement Board, exempt interest, or other income that is not taxable to Georgia should not be included in the retirement income exclusion calculation. Income or losses should be allocated to the person who owns the item. If any item is held jointly, the income or loss should be allocated to each taxpayer at 50%. Part-year residents and nonresidents must prorate the retirement income exclusion. The earned income portion and the un- earned income portion must be separately prorated. The earned income portion shall be prorated using the ratio of Georgia source earned income to total earned income computed as if the taxpayer were a resident of Georgia for the entire year. The unearned portion shall be prorated using the ratio of Georgia source unearned retirement income to total unearned retirement income computed as if the taxpayer were a resident of Georgia for the entire year. *Retirement income does not include income received directly or indirectly from lotteries, gambling, illegal sources or similar income. ** Rental, Royalty or Partnership income that is subject to FICA tax or Self employment tax should be included on line 2 not Line 13. Trade or business income from an S Corp in which the taxpayer or their spouse materially participated should be included on Line 2 not Line 13. Note: The date of birth is required for Retirement Income Exclusion. If you are using the retirement income exclusion for disability, the date of disability is required.

Page 18 Schedule 2: Credit Usage and Carryover (Series 100) Return must be electronically filed. 1. Georgia tax credits (Series 100) must be claimed on Schedule 2. Refundable credits are claimed on schedule 2B. Currently only the Timber Tax credit is refundable but is not refundable if it was purchased. For a list of tax credit codes (series 100) see page 22. Please see the Tax Credit Summaries on the Department’s website (dor.ga.gov/tax- credit-summaries) regarding Line 10 credits that can be sold. Note: Series 200 tax credit codes are claimed on IND-CR. 2. If claiming credit code 125 (QEE) enter your SSN and not the FEIN of the SSO. 3. A return is required to be electronically filed if the return allocates, claims, utilizes, or includes in any manner a series 100 credit (see page 22). 4. Total Schedule 2 credits used for this tax year, and enter the total on Line 20 of Form 500 or 500X. 5. The taxpayer must indicate which credits are being used. The total amount used from all Schedule 2s, the IND-CR, and from the other state(s) tax credit, and from the low income credit cannot exceed the tax liability listed on Line 16 of Form 500 or 500X. 6. If a credit is eligible for carryover to this tax year, complete the schedule even if the credit is not used in this tax year. 7. If the credit originated with more than one person or com- pany, enter separate information for each. 8. Credit certificate numbers are issued by the Department of Revenue for preapproved credits. If applicable, enter the Department of Revenue credit certificate number where indicated. 9. See the relevant forms, statutes, and regulations to deter- mine how the credit is allocated to the owners, to determine when carryovers expire, and to see if the credit is limited to a certain percentage of tax. 10. Before the Georgia tax credit carryovers are applied to the next tax year, the amount must be reduced by any amounts elected to be applied to withholding in the current tax year (for businesses only) and by any carryovers that have expired. 11. For the credit generated this year, list the Company/ Individual Name, FEIN/SSN, and Credit Certificate number, if applicable. Purchased credits should also be included. If the credit originated with this taxpayer, enter this taxpayer's name and SSN. 12. Disregarded Single Member LLC Credit Instructions. If the taxpayer owns a disregarded single member LLC, the single member LLC should be disregarded for filing purposes. All credits should be claimed on the owner’s return. All tax credit forms should be filed in the name of the single member LLC but included with the owner’s return. This is necessary so that the returns can be processed and the credits flow to the proper taxpayer. Note: Credit certificate numbers are issued by the Depart- ment for preapproved credits. Once a credit is pre-approved, an official letter will be issued by the Department which will contain the certificate number to the generator of the credit. If the credit is allowed to be transferred, a new certificate number will be issued from the Department to the recipient of the transferred credit. If you do not have a certificate number this field should be left blank. Schedule 3: Part Year and Nonresidents Note: Include copies of applicable returns and schedules with your Georgia return. LINES 1 - 4, Column A: List your income as if you were a Georgia resident. LINES 1 - 4, Column B: List your income not taxable to Georgia. LINES 1 - 4, Column C: List your Georgia taxable income. LINE 5, Columns A, B, and C: Enter the total of Lines 1- 4 in Columns A, B, and C respectively. LINES 6 - 7, Column A: List adjustments from your federal return on Line 6; list adjustments allowed by Georgia law on Line 7. See the Line 9 instructions on pages 14-16 for adjustments. LINES 6 - 7, Column B: List adjustments that do not apply to Georgia residency or do not apply because of taxable income earned as a nonresident. LINES 6 - 7, Column C: List adjustments from the Federal return that apply to Georgia on Line 6; list Georgia adjustments on Line 7. See the Line 9 instructions on pages 14-16 for adjustments. LINES 8, Columns A, B, and C: Subtract Line 6 from Line 5 in each column; and add or subtract Line 7 from Line 5 in each column. Enter the total for each column on Line 8 A, B, and C respectively. LINE 9: Divide Line 8, Column C by Line 8, Column A to calculate the ratio of Georgia income to total income. The percentage on Schedule 3, Line 9 is zero if Georgia adjusted gross income (AGI) is zero or negative. If the adjusted Federal AGI is zero or negative, the Line 9 percentage is 100%. The percentage is also considered to be 100% if both adjusted Federal and Georgia AGI are zero or negative. In this case, the taxpayer is entitled to the full exemption amount and deductions. LINE 10a and 10b: If itemizing, enter the amount from Federal Schedule A reduced by income taxes paid to other states and expense for the production of non-Georgia income. Include a copy of Federal Schedule A with your Georgia income tax return. If using the standard deduction, enter the amount for your filing status as indicated below.  Single/Head of Household/Qualifying  Married Filing Joint........................................$7,100  Married Filing Separate.................................$3,550  Additional Deduction for Blind and/or 65 or older: $1,300 LINES 11a: Multiply Form 500, Line 6c by $2,700 for filing status A or D or multiply by $3,700 for filing status B or C. LINES 11b: Multiply Form 500, Line 7a by $3,000 and enter the total. LINE 12: Add Lines 10a, 10b, 11a, and 11b. LINE 13: Multiply Line 12 by the ratio on Line 9. LINE 14: Subtract Line 13 from Line 8, Column C. This is your Georgia taxable income. Enter here and on Form 500 Line 15a. Fill in Line 15b if applicable and Line 15c. Use the tax rate schedule in this booklet to determine your tax and enter on Form 500, Line 16. Follow the instructions beginning on page 12 to complete Lines 16 through 44a of Form 500. FORM 500 SCHEDULES 2 AND 3 INSTRUCTIONS Surviving Spouse.............................$5,400

YOUR SOCIAL SECURITY NUMBER

EXAMPLE FOR COMPLETING SCHEDULE 3 Basis for Example: A husband and wife are both part-year residents of Georgia who file a joint return. Their Federal adjusted gross income is $52,000 consisting of $48,000 in salary and $4,000 of interest. They have one child and adjustments to income totaling $2,500. They became Georgia residents on April 1. Their Schedule 3 would be completed as follows: 8 4 0 0

1 0 1 4 5 6 3 3 5 4

7 4 0 0

0 9 5

4 3 0 4 6 2 5 0 0

2 0 1 4 0

9 7 3 9 5

3 2 0 0 0 2 0 0

0 - 5 0 0 5 0 0 9 4 5 0 0 0 1 0 4

9 7 3 0 9 3 7 8 9 8 X 7 1 0 0 7 4 0

0 3 0 0

0 7 1 5 0

0 3 1 8 2

2 5 2 2 7 1 2 1 1 9 8 7 6 5 3 2 4

Income earned in another state as a Georgia resident is taxable but other state(s) 3. BUSINESS INCOME OR (LOSS) 8. ADJUSTED GROSS INCOME: 3. BUSINESS INCOME OR (LOSS) 2. INTEREST AND DIVIDENDS 8. ADJUSTED GROSS INCOME: 7. TOTAL ADJUSTMENTS FROM FORM 500, 2. INTEREST AND DIVIDENDS

(COLUMN B) 3. BUSINESS INCOME OR (LOSS) 1. WAGES, SALARIES, TIPS, etc DO NOT USE LINES 9 THRU 14 OF PAGES 2 AND 3 FORM 500 or 500X 8. ADJUSTED GROSS INCOME: 7. TOTAL ADJUSTMENTS FROM FORM 500, 6. TOTAL ADJUSTMENTS FROM FORM 1040 2. INTEREST AND DIVIDENDS 7. TOTAL ADJUSTMENTS FROM FORM 500, 6. TOTAL ADJUSTMENTS FROM FORM 1040 6. TOTAL ADJUSTMENTS FROM FORM 1040 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 1. WAGES, SALARIES, TIPS, etc SCHEDULE 1 4. OTHER INCOME OR (LOSS) LINE 5 PLUS OR MINUS LINES 6 AND 7 SCHEDULE 1 4. OTHER INCOME OR (LOSS) 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 LINE 5 PLUS OR MINUS LINES 6 AND 7 1. WAGES, SALARIES, TIPS, etc 4. OTHER INCOME OR (LOSS) FEDERAL INCOME AFTER GEORGIA ADJUSTMENT 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 SCHEDULE 1 LINE 5 PLUS OR MINUS LINES 6 AND 7 RESIDENTS AND NONRESIDENTS. SCHEDULE 3 COMPUTATION OF GEORGIA TAXABLE INCOME FOR ONLY PART-YEAR INCOME NOT TAXABLE TO GEORGIA GEORGIA INCOME (COLUMN C) tax credit may apply. See IT-511 Tax Booklet.

12. Total Deductions and Exemptions:

12. 11b. Enter the number on Line 7a. from Form 500 or 500X multiply by $3,000... 11b. Add Lines 10a, 10b, 11a, and 11b......... 11a. Enter the number on Line 6c. from Form 500 or 500X multiply by $2,700 for filing status A or D or multiply by $3,700 for filing status B or C

10b. Additional Standard Deduction

11. Personal Exemption from Form 500 (See IT-511 Tax Booklet) 11a. 13. 14. Enter here and on Line 15a, Page 3 of Form 500 or Form 500X........................ 14. Income before GA NOL: Subtract Line 13 from Line 8, Column C 9. 10a. Itemized or Standard Deduction (See IT-511 Tax Booklet)................... 10a. % Not to exceed 100% 13. Multiply Line 12 by Ratio on Line 9 and enter result .......................................... (COLUMN A) Self: 65 or over? Blind? Spouse: 65 or over? Blind? Total x 1,300= 10b. 9. RATIO: Divide Line 8, Column C by Line 8, Column A. Enter percentage..........

. . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , - Georgia Form500 (Rev. 08/02/22) Schedule 3 Part-Year Nonresident 2022 Page 19

Page 20 WORKSHEET FOR OTHER STATE(S) TAX CREDIT Georgia allows a credit for tax paid to another state on income taxable to Georgia and the other state. Use these worksheets to compute the other state(s) tax credit for full-year and part-year residents. Do not file these worksheets with your return. Keep them for your records. Enter the Total Tax Credit on Form 500 Line 18. Include a copy of tax return(s) filed with other state(s). The credit is for state (including Washington DC) and U.S. local income tax only. The tax must have been imposed on net income. No other income taxes such as foreign local, foreign city, foreign province, foreign country, U.S. Possession, etc., qualify for this credit. FULL-YEAR RESIDENTS 1. Other state(s) adjusted gross income $ __________________ 2. Georgia adjusted gross income (Line 10, Form 500) $ __________________ 3. Ratio: Line 1 divided by Line 2 __________________ % 4. Georgia standard or itemized deductions $ __________________ 5. Georgia personal exemption and credit for dependents from Form 500, Line 14c $ __________________ 6. Total of Line 4 and Line 5 $ __________________ 7. Line 6 multiplied by ratio on Line 3 $___________________ 8. Income for computation of credit (Line 1 less Line 7) $___________________ 9. Tax at Georgia rates (use tax rate schedule in this booklet) $___________________ 10. Tax shown on return(s) filed with other state(s)* $___________________ 11. Total Tax Credit (Lesser of Line 9 or Line 10) to be entered on Line 18 of Form 500 $___________________ PART-YEAR RESIDENTS 1. Income earned in another state(s) while a Georgia resident $___________________ 2. Georgia adjusted gross income (Line 8, Column C of Form 500, Schedule 3) $ __________________ 3. Ratio: Line 1 divided by Line 2 __________________ % 4. Georgia standard or itemized deductions and Georgia personal exemption and credit for dependents after applying the ratio on Schedule 3 (Line 13, Schedule 3, Form 500) $ __________________ 5. Line 4 multiplied by ratio on Line 3 $___________________ 6. Income for computation of credit (Line 1 less Line 5) $___________________ 7. Tax at Georgia rates (use tax rate schedule in this booklet) $___________________ 8. Tax shown on return(s) filed with other state(s) for income taxed by Georgia* $___________________ 9. Total Tax Credit (Lesser of Line 7 or Line 8) to be entered on Line 18 of Form 500 $___________________ * The amount entered must be reduced by credits that have been allowed by the other states.

LOW INCOME CREDIT WORKSHEET the close of the tax year for which the credit may be claimed. 1. Enter the amount from Form 500, Line 8 or Form 500EZ, Line 1....................................................................... $ 2. Enter the number of exemptions. Exemptions are self, spouse and natural or legally adopted children.......... Note: For purposes of the low income credit, dependents do not include those unborn with a detectable human heartbeat. 3. Enter 1 if you or your spouse is 65 or older; enter 2 if you and your spouse are 65 or older.............................. 4. 5. Find the credit that corresponds to your income in the table below and enter on line 17b of Form 500, 6. Credit Table: Federal Adjusted Gross Income Credit Under $6,000 $6,000 but not more than $7,999 $8,000 but not more than $9,999 $10,000 but not more than $14,999 $15,000 but not more than $19,999 $26 $20 $14 $ 8 $ 5 SCHEDULE FOR ESTIMATING GEORGIA INCOME TAXES $ . $ . $ . $ $ . $ . 7. Applicable Military Retirement Exclusion $ . $ . $ . 10.. Personal exemption and exemption for dependents 11. Standard or Itemized deductions $ . $ . $ . $ . $ . $ . 16. Estimated Tax due this year (Subtract Lines 14 and 15 from Line 12) (See 500ES) $ . Page 21 1. Federal Adjusted gross income expected during the current year 2. Additions to income (See instructions on page 14) 3. Balance 4. Social Security (See subtraction instructions on page 14) 5. Railroad Retirement (See subtraction instructions on page 14) 6. Applicable Retirement Exclusion 8. Other deductions (See instructions on pages 14-16) 9. Balance (Subtract Lines 4 - 8 from Line 3) 14. Withholding Tax and other credits 15. Amount from prior year’s return to be credited to this year’s estimate 12. Taxable income (Subtract Lines 10 and 11 from Line 9) 13. Tax on amount on Line 12 (see Georgia tax rate schedule)

Page 22 The following credits from the Taxpayer or from the ownership of a S Corp, LLC, LLP, or Partnership Interest which will be reflected on the Individual’s K-1 must be listed on Form 500, Schedule 2. The entity information and credit type code must be included. Additional documentation for claiming a credit is required where indicated. NOTE: Credit code numbers are subject to change annually. Current code numbers are listed below. See Form IND-CR for information about additional tax credits. NOTE: A return is required to be filed electronically if the return generates, allocates, claims, utilizes, or includes in any manner a Series 100 tax credit. Refundable credits are claimed on Schedule 2B. Currently only the Timber Tax Credit (145) is refundable but not if it was purchased. Disregarded Single Member LLC Credit Instructions. If the taxpayer owns a disregarded single member LLC, the single member LLC should be disregarded for filing purposes. All credits should be claimed on the owner’s return. All tax credit forms should be filed in the name of the single member LLC but included with the owner’s return. This is necessary so that the returns can be processed and the credits flow to the proper taxpayer. For additional information on the below-listed credits, please visit the Georgia Department of Revenue website at dor.georgia. gov/documents/tax-credits. TAX CREDITS Code Name of Credit 102 - Employer’s Credit for Approved Employee Re- training 103 - Employer’s Jobs Tax Credit 104 - Employer’s Credit for Purchasing Child Care Property 105 - Employer’s Credit for Providing or Sponsoring Child Care for Employees 106 - Manufacturer’s Investment Tax Credit 107 - Optional Investment Tax Credit 108 - Qualified Transportation Credit (only carryover can be used) 109 - Low Income Housing Credit 111 - Business Enterprise Vehicle Credit 112 - Research Tax Credit 113 - Headquarters Tax Credit 114 - Port Activity Tax Credit 115 - Bank Tax Credit 116 - Low Emission Vehicle Credit (only carryover can be used) 117 - Zero Emission Vehicle Credit (only carryover can be used) 118 - New Facilities Job Credit 119 - Electric Vehicle Charger Credit 120 - New Manufacturing Facilities Property Credit 121 - Historic Rehabilitation Credit for Historic Homes 122 - Film Tax Credit (Use code 133 if the credit is for a Qualified Interactive Entertainment Production Com- pany) 124 - Land Conservation Credit Code Name of Credit 126 - Seed-Capital Fund Credit 128 - Wood Residual Credit 130 - Quality Jobs Tax Credit 131 - Alternate Port Activity Tax Credit - tainment Production Company 135 - Historic Rehabilitation Tax Credit for any Other Tax Credit 138 - Postproduction Film Tax Credit 139 - Small Postproduction Film Tax Credit 141 - Musical Tax Credit 142 - Rural Zone Tax Credit 143 - Agribusiness and Rural Jobs Tax Credit 144 - Post- Consumer Waste Materials Tax Credit 145 - Timber Tax Credit 146 - Railroad Track Maintenance Tax Credit 147 - Personal Protective Equipment Manufacturer Jobs Tax Credit 148 - Life Sciences Manufacturing Job Tax Credit 149 - Historic Rehabilitation Tax Credit for Historic less

EXAMPLE OF HOW TO FILL OUT A TAX CREDITS SCHEDULE FOR CREDITS THAT DO NOT REQUIRE PRE-APPROVAL If receiving the same credit type from multiple entities, you must complete one tax credit schedule for each credit code. For the credit generated this tax year, list the Company Name and ID number if applicable. If the credit originated with this taxpayer, enter this taxpayer’s name and ID#. Only enter a certificate number if the Department has provided a letter with your unique certificate number because the credit is preapproved. Purchased credits and credits received from an allocation from a pass-through entity should also be included on this schedule. If a credit is purchased from a previous year the credit should be claimed as a previous year credit on line 2. Page 23

EXAMPLE OF HOW TO FILL OUT A TAX CREDITS SCHEDULE FOR CREDITS THAT REQUIRE PRE-APPROVAL If receiving the same credit type from multiple entities, you must complete one tax credit schedule for each credit code. For the credit generated this tax year, list the Company Name and ID number if applicable. If the credit originated with this taxpayer, enter this taxpayer’s name and ID#. Only enter a certificate number if the Department has provided a letter with your unique certificate number because the credit is preapproved. Purchased credits and credits received from an allocation from a pass-through entity should also be included on this schedule. If a credit is purchased from a previous year the credit should be claimed as a previous year credit on line 2. Page 24

Page 25 The Georgia Wildlife Conservation Fund protects and preserves Georgia’s nongame wild- life, including bald eagles, sea turtles, and other animals that are not hunted, trapped or fished. Georgia Department of Natural Resources / 2070 U.S. Hwy 278 S.E. / Social Circle, GA 30025 / 706-557-3333 / http://georgiawildlife.com The Georgia Fund for Children and Elderly provides programs for preschool children with spe- cial needs plus home-delivered meals and transportation for elders. DHS Division Aging Services / 404-657-5258 / http://aging.georgia.gov/georgia-fund-children-and-elderly ; DCH / Division of Public Health / MCH / Children and Youth with Special Needs / 404-657-2700 / http://dph.georgia.gov The Georgia Cancer Research Fund supports innovative and promising research on all types of cancer. Funds often provide seed money for pilot projects to help scientists obtain data needed to win grants from national cancer organizations. Georgia Center for Oncology Research and Education / 50 Hurt Plaza, Suite 1415 / Atlanta, GA 30303 / 404-588-4083 The Georgia Land Conservation Program provides funds for land conservation to protect natural resources and increase the state’s economic competitiveness. Georgia Environmental Finance Authority / 233 Peachtree St NE, Suite 900 / Atlanta, GA 30303 The Georgia National Guard Foundation Inc. provides emergency relief assistance to the soldiers and airmen of the Georgia National Guard and other qualified members of the Georgia Depart- ment of Defense. Georgia National Guard Foundation/ 1000 Halsey Ave. BLDG. 447/ Marietta, GA 30060 / 678-569-5704 / http://georgiaguardfamily.org/ The Dog and Cat Sterilization Fund provides financial support for the sterilization of dogs and cats, as well as education to the public about the healthy benefits of animal sterilization. DCSF / 19 Martin Luther King Jr. Drive SW / Atlanta, GA 30334 / 404-656-4914 / http://agr.georgia.gov The Saving the Cure Fund is designed to encourage the donation, collection and storage of stem cells from postnatal tissue and fluid; make such stem cells available for medical research and treatment; promote principled and ethical stem cell research; and to encourage stem cell research with immediate clinical and medical applications. Realizing Educational Achievement Can Happen (REACH) Program provides low-income academically promising students with the academic, social, and financial support needed to graduate from high school, access college, and achieve post-secondary success. Georgia Student Finance Authority / 2082 East Exchange Place / Tucker, GA 30084 / 770-724-9248 / https://reachga.org/ The Public Safety Memorial Grant Program administered by the Georgia Student Finance Authority, provides educational aid to children whose parents are/were public safety employees and were disabled or killed in the line of duty, Recipients attend eligible colleges and universities in Georgia. Georgia Student Finance Authority / 2082 East Exchange Place / Tucker, GA 30084 / (800) 505-4732 / www.gafutures.org Pick an amount and make it count by donating on your State Income Tax Return form to one or more of the following Checkoff Georgia charitable organizations.

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Please Please print print your your numbers numbers like like this this in in black black or or blue blue ink: ink: Georgia Form 500 (Rev. 06/22/22) Individual Income Tax Return Georgia Department of Revenue 2022(Approved booklet version) Page 1 Fiscal Year Beginning rFis sion) cal Year STATE ISSUED YOUR DRIVER’S LICENSE/STATE ID Ending YOUR FIRST NAME MI YOUR SOCIAL SECURITY NUMBER 1. LAST NAME (For Name Change See IT-511 Tax Booklet) SUFFIX SPOUSE’S FIRST NAME MI SPOUSE’S SOCIAL SECURITY NUMBER DEPARTMENT USE ONLY LAST NAME SUFFIX ADDRESS (NUMBER AND STREET or P.O. BOX) (Use 2nd address line for Apt, Suite or Building Number)

CHECK IF ADDRESS HAS CHANGED

2. CITY (Please insert a space if the city has multiple names) STATE ZI P CODE 3. (COUNTRY IF FOREIGN) Residency Status 4. Enter your Residency Status with the appropriate number ..... ................................................................................................... 4. 1. FULL- YEAR RESIDENT 2. PART- YEAR RESIDENT T O 3. NONRESIDENT Omit Lines 9 thru 14 and use Form 500 Schedule 3 if you are a part-year or nonresident filer. Filing Status 5. Enter Filing Status with appropriate letter (See IT-511 Tax Booklet)............................................................................... .... .... 5. 6. Number of exemptions (Check appropriate box(es) and enter total in 6c.) 6a. Yourself 6b. Spouse 6c. 7a. Number of Dependents (Enter details on Line 7b., and DO NOT include yourself or your spouse)...................................... 7a. This Page (1) is required for processing A. Single B. Married filing joint C. Married filing separate (Spouse’s social security number must be entered above) D. Head of Household or Qualifying Surviving Spouse

Georgia Form500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER Pag e 2 2022

7b. Dependents (If you have more than 4 dependents, attach a list of additional dependents) If amount on line 8, 9, 10, 13 or 15 is negative, use the minus sign (-). Example -3456.

INCOME COMPUTATIONS First Name, MI. Last Name Social Security Number Relationship to You First Name, MI. Last Name Social Security Number Relationship to You First Name, MI. Last Name Social Security Number Relationship to You First Name, MI. Last Name Social Security Number Relationship to You

. 00 , , . 00 . 00 . 00 . 00 . 00 , , , , , , , . 00 . 00 . 00 . 00 , , , , , , , , 9. Adjustments from Form 500 Schedule 1 (See IT-511 Tax Booklet) ....................... 10. Georgia adjusted gross income (Net total of Line 8 and Line 9)............................. 8. Federal adjusted gross income (From Federal Form 1040)..................................... 8. (Do not use FEDERAL TAXABLE INCOME) If the amount on Line 8 is $40,000 or more, or your gross income is less than your W-2s you must include a copy of your Federal Form 1040 Pages 1, 2, and Schedule 1. 10. 9. 11. Standard Deduction (Do not use FEDERAL STANDARD DEDUCTION).............. (See IT-511 Tax Booklet) c. Total Standard Deduction (Line 11a + Line 11b)................................................... b. Self: 65 or over? Blind? Spouse: 65 or over? Blind? Total x 1,300=......................... Use EITHER Line 11c OR Line 12c (Do not write on both lines) 11c. 11b. 11a. 12. Total Itemized Deductions used in computing Federal Taxable Income. If you use itemized deductions, you must include Federal Schedule A. a. Federal Itemized Deductions (Schedule A- Form 1040)............................... b. Less adjustments: (See IT-511 Tax Booklet) ................................................ 12a. 12c. 12b. c. Georgia Total Itemized Deductions..................................................................

13. Subtract either Line 11c or Line 12c from Line 10; enter balance.......................... 13.

This Page (2) is required for processing

Georgia Form500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER

2022

(INCOME STATEMENT A)

(INCOME STATEMENT B)

(INCOME STATEMENT C)

.

INCOME STATEMENT DETAILS Only enter income on which Georgia tax was withheld. Enter income from W-2s, 1099s, and G2-As on Line 4 GA Wages/Income. For other income statements complete Line 4 using the income reported from Form G2-RP Line 12 or 13; Form G2-LP Line

11, or for Form G2-FL enter zero. Pag e 3

.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 , , , , , , , , , , , , , , , .00 .00 , , , , . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , ,

1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE:

W -2 G2-A G2-LP G2-A W -2 G2-LP G2-A W -2 G2-LP 1099 G2-FL G2-RP 1099 G2-FL G2-RP 1099 G2-FL G2-RP 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. GA WAGES / INCOME 5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. GA TAX WITHHELD INCOME STATEMENT DETAILS Only enter income on which Georgia tax was withheld. Enter income from W-2s, 1099s, and G2-As on Line 4 GA Wages/Income. For other income statements complete Line 4 using the income reported from Form G2-RP Line 12 or 13; Form G2-LP Line

11, or for Form G2-FL enter zero.

14a. Enter the number from Line 6c.

Multiply by $2,700 for filing status A or D 14a. 14b.

Enter the number from Line 7a. or multiply by $3,700 for filing status B or C Multiply by $3,000.......................................... 14b. 14c. 14c. Add Lines 14a. and 14b. Enter total ......................................................

16. 16. 17a. 17b. 17.

Low Income Credit 17c. ........................ 18. 19.

Other State(s) Tax Credit (Include a copy of the other state(s) return) ....... 18. C redits used from IND-CR Summary Worksheet ........................................ 19. 20. Total Credits Used from Schedule 2 Georgia Tax Credits (must be filed electronically) 20. 21. 21. 22. 22. Balance (Line 16 less Line 21) if zero or less than zero, enter

zero .......... Total Credits Used (sum of Lines 17-20) cannot ex ceed Line 16

........................

..... 15a. 15a. Income before GA NOL (Line 13 less Line 14c or Schedule 3, Line 14)..... 15b. 15b. Georgia NOL utilized (Cannot exceed Line 15a or the amount after applying the 80% limitation, see IT-511 Tax Booklet for more information).... 15c. 15c. Georgia Taxable Income (Line 15a less Line 15b)..................................... Tax (Use Tax Table or Tax Rate Schedule in the IT-511 Tax Booklet) .......

PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 4. This Page (3) is required for processing

Georgia Form500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER

2022 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID (INCOME STATEMENT E)

2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 1. WITHHOLDING TYPE: 3. EMPLOYER/PAYER STATE WITHHOLDING ID 4. GA WAGES / INCOME 1. WITHHOLDING TYPE: 5. GA TAX WITHHELD 5. GA TAX WITHHELD 4. GA WAGES / INCOME 1. WITHHOLDING TYPE: 5. GA TAX WITHHELD 4. GA WAGES / INCOME

(INCOME STATEMENT F)

(INCOME STATEMENT D) W- 2 1099 G2-A G2-FL G2-LP G2-RP W- 2 1099 G2-A G2-FL G2-LP G2-RP W- 2 1099 G2-A G2-FL G2-LP G2-RP

Page 4

. 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , , , , , , , , , , , Estimated Tax paid for 2022 and Form IT-560 ......................................... 25. 23. 24. Other Georgia Income Tax Withheld

........................................................ 24. (Enter Tax Withheld Only and include W-2s and/or 1099s) 23. (Must include G2-A, G2-FL, G2-LP and/or G2-RP) Georgia Income Tax Withheld on Wages and 1099s ............................. 28. If Line 22 exceeds Line 27, subtract Line 27 from Line 22 and enter

balance due............................................................................................... 28. 26. overpayment .............................................................................................. 27. 29. If Line 27 exceeds Line 22, subtract Line 22 from Line 27 and enter 29. 30. Amount to be credited to 2023 ESTIMATED TAX ................................. 31. 32. Georgia Wildlife Conservation Fund (No gift of less than $1.00)............. Georgia Fund for Children and Elderly (No gift of less than $1.00)........ 33. Georgia Cancer Research Fund (No gift of less than $1.00) ................. 34. Georgia Land Conservation Program (No gift of less than $1.00)........... 35. 36 . Georgia National Guard Foundation (No gift of less than $1.00) ............. Dog & Cat Sterilization Fund (No gift of less than $1.00)....................... Saving the Cure Fund (No gift of less than $1.00)................................. (No gift of less than $1.00) Realizing Educational Achievement Can Happen (REACH) Program ............. 38. 37. 37. 31. 30. 32. 33. 34. 35. 36. 38. 25. 26. Schedule 2B Refundable Tax Credits.......................................................... (Cannot be claimed unless filed electronically) 27. Total prepayment credits (Add Lines 23, 24, 25 and 26)........................... This Page (4) is required for processing

Georgia Form500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER 2022 44. 40.

Form 500 UET (Estimated tax penalty) 500 UET exception attached 40. Routing 43. (If you owe) Add Lines 28, 31 thru 42 .................................................... THIS IS YOUR REFUND......................................................................... Number Account

Type: Checking

Savings Number MAKE CHECK PAYABLE TO GEORGIA DEPARTMENT OF REVENUE, Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740399 ATLANTA, GA 30374-0399

43. 44. (If you are due a refund) Subtract the sum of Lines 30 thru 42 from Line 29 If you do not enter Direct Deposit information or if you are a first time filer you will be issued a paper check. 44a. Direct Deposit (U.S. Accounts Only) Mail pages 1-5 and any applicable schedules, forms, documentation. DO NOT staple pages.

I/We declare under the penalties of perjury that I/we have examined this return (including accompanying schedules and statements) and to the best of my/our knowledge and belief, it is true, correct, and complete. If prepared by a person other than the taxpayer(s), this declaration is based on all information of which the preparer has knowledge.

39. Public Safety Memorial Grant (No gift of less than $1.00)....................... 39.

YOUR SOCIAL SECURITY NUMBER

Pag e 5

Taxpayer’s Signature Spouse’s Signature (Check box if deceased) (Check box if deceased) By providing my e-mail address I am authorizing the Georgia Department of Revenue to electronically notify me at the below e-ma il address regarding any updates to my account(s). Taxpayer’s E-mail Address Preparer’s Firm Name Signature of Preparer Name of Preparer Other Than Taxpayer

I authorize DOR to discuss this return with the named preparer. Taxpayer’s Phone Number Spouse’s Signature Date Preparer’s Phone Number Preparer’s FEIN Preparer’s SSN/PTIN/SIDN . 00 . 00 , . 00 , , , , Spouse’s Date of Death Taxpayer’s Date of Death Taxpayer’s Signature Date . 00 , , 41. Penalty: Late Payment and/or Late Filing.................................................... 41. . 00 , , 42. Interest ........................................................................................................ 42. . 00 , , Refund Due Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740380 ATLANTA, GA 30374-0380 This Page (5) is required for processing

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YOUR SOCIAL SECURITY NUMBER Schedule 1 Page 1 Georgia Form500 (Rev. 06/22/22) Schedule 1 Adjustments to Income 2022(Approved booklet version) SCHEDULE 1 ADJUSTMENTS to INCOME BASED on GEORGIA LAW See IT-511 Tax Booklet .00 .00 , , , , .00 , , .00 .00 .00 , , , , , , .00 .00 .00 .00 .00 , , , , , , , , , , 10.

2. 3. 1. 5. 4. 6. 14. 11. 9. 8. 13. ADDITIONS to INCOME 1. Interest on Non-Georgia Municipal and State Bonds ................................... 2. Lump Sum Distributions .........................................................................................

3. Reserved......................................................................................................................

6. Total Additions (Enter sum of Lines 1-5 here).............................................. Other (Specify) 4. Net operating loss carryover deducted on Federal return....................................... 5. SUBTRACTION from INCOME (See IT-511 Tax Booklet) 7. Retirement Income Exclusion 8. Social Security Benefits (Taxable portion from Federal return).................... 9. Path2College 529 Plan ..............................................................................

10. Interest on United States Obligations (See IT-511 Tax Booklet ) 11. Reserved .................................................................................................. 12. Other Adjustments (Specify) 13. Total Subtractions (Enter sum of Lines 7-12 here) ....................................... 14. Net Adjustments (Line 6 less Line 13). Enter Net Total here and on

Line 9 of Page 2 (+ or -) of Form 500 or 500 X ..........................................

Taxpayer Date of Birth: .00 , 7a. a. Retirement Income Exclusion - Complete Schedule 1, page 2. b. Military Retirement Income Exclusion (Must be under 62 years of age) - Complete Schedule 1, page 3. . .00 , 7b.

.00 , 7c. Type of Disability:

c. Date of Disability:

12. Spouse Date of Birth: .00 , 7d. d. Retirement Income Exclusion - Complete Schedule 1, page 2. e. Military Retirement Income Exclusion (Must be under 62 years of age) - Complete Schedule 1, page 3. . .00 , 7e.

.00 , 7f. Type of Disability:

f. Date of Disability:

Required for Retirement Income Exclusion and Military Retirement Income Exclusion Required for Retirement Income Exclusion and Military Retirement Income Exclusion

Schedule 1 Page 2 Georgia Form500 (Rev. 06/22/22) Schedule 1 Adjustments to Income 2022 YOUR SOCIAL SECURITY NUMBER SCHEDULE 1 RETIREMENT INCOME EXCLUSION See IT-511 Tax Booklet (Approved booklet version) . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 4 0 0 0 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 4 0 0 0 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , *If age 62-64 or less than age 62 and permanently disabled enter $35,000, or if age 65 or older enter $65,000. (TAXPAYER) (SPOUSE) SCHEDULE 1 RETIREMENT INCOME EXCLUSION See IT-511 Tax Booklet 1. 2. Salary and wages...................................... 3. 4.

Other Earned Income (Losses)..................... Total Earned Income.................................... zero .......................................................... 6. Interest Income......................................... Maximum Earned Income........................... 7. Dividend Income ....................................... 9. 8. Alimony...................................................... 10. 5. Smaller of Line 3 or 4; if zero or less, enter

Capital Gains (Losses)............................... 11. Taxable IRA Distributions......................... 12. Other Income (Losses).............................. (See IT-511 Tax Booklet) Taxable Pensions ..................................... Income (Losses).....(See IT-511 Tax Booklet) 13. Rental, Royalty, Partnership, S Corp, etc. enter zero ................................................ 15. 14. Total of Lines 6 through 13; if zero or less, Add Lines 5 and 14 .................................... 16. Maximum Allowable Exclusion* .................. 17. Smaller of Lines 15 and 16; enter here and on Form 500, Schedule 1, Lines 7a & d for Retire- ment Exclusion or Lines 7c & f for Retirement Exclusion for Disability............................

Schedule 1 Page 3 Georgia Form500 (Rev. 06/22/22) Schedule 1 Adjustments to Income 2022 YOUR SOCIAL SECURITY NUMBER (Approved booklet version) SCHEDULE 1 MILITARY RETIREMENT INCOME EXCLUSION

See IT-511 Tax Booklet . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , (TAXPAYER) (SPOUSE)

See IT-511 Tax Booklet 1. Taxable Military Retirement from 1099-R 2. Base Military Exclusion............................. 3. Enter the smaller of Line 1 or Line 2 .........

If your taxable military retirement is less than 17,501 STOP HERE and enter line 3 on Schedule 1, Line 7b and 7e. 4. Taxable Georgia Salary and Wages............... 5. Other Earned Georgia Income.......................

6. Total Georgia Earned Income.........................

7. Total additional Military Exclusion allowed....... 8. Enter the smaller of Line 1 or Line 7. Enter this amount on Schedule 1, Lines 7b and e....... 1 7 5 0 0 1 7 5 0 0 1. Do you have any military retirement income? Do I Qualify for Military Retirement Exclusion? No. You do not qualify. Do not complete this page. Yes. You may qualify if you meet the age requirements. 2. Are you under the age of 62? No. You do not qualify. Do not complete this page. Yes. You qualify for Military Retirement Income Exclusion. Complete this page.

If your Georgia earned income is less than 17,501 STOP HERE and enter line 3 on Schedule 1, Line 7b and 7e. 3 5 0 0 0 3 5 0 0 0 3. Include this page with your Form 500/500X, if applicable.

YOUR SOCIAL SECURITY NUMBER Schedule 3 Page 1 Georgia Form500 (Rev. 06/22/22) Schedule 3 Part-Year Nonresident 2022 (Approved booklet version) Income earned in another state as a Georgia resident is taxable but other state(s)

(COLUMN B)

FEDERAL INCOME AFTER GEORGIA ADJUSTMENT

RESIDENTS AND NONRESIDENTS. SCHEDULE 3 COMPUTATION OF GEORGIA TAXABLE INCOME FOR ONLY PART-YEAR INCOME NOT TAXABLE TO GEORGIA GEORGIA INCOME (COLUMN C) tax credit may apply. See IT-511 Tax Booklet.

(COLUMN A) DO NOT USE LINES 9 THRU 14 OF PAGES 2 AND 3 FORM 500 or 500X . . 00 . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , , ,

% Not to exceed 100%

10a. Itemized or Standard Deduction (See IT-511 Tax Booklet)........................................................ 10a. 9. RATIO: Divide Line 8, Column C by Line 8, Column A enter percentage ....... 9.

14. Income before GA NOL: Subtract Line 13 from Line 8, Column C Enter here and on Line 15a, Page 3 of Form 500 or Form 500X........................ 14.

13. Multiply Line 12 by Ratio on Line 9 and enter result............................................ 13.

11a. Enter the number on Line 6c from Form 500 or Form 500X multiply by $2,700 for filing status A or D or multiply by $3,700 for filing status B or C..................................... 11a. 11b. Enter the number on Line 7a from Form 500 or Form 500X multiply by $3,000 .. 11b. 12. Total Deductions and Exemptions: Add Lines 10a, 10b, 11a, and 11b ............ 12. 10b. Additional Standard Deduction Self: 65 or over? Blind? Spouse: 65 or over? Blind? Total X 1,300= 10b. 11. Personal Exemptions from Form 500 or Form 500X (See IT-511 Tax Booklet) 3. BUSINESS INCOME OR (LOSS) 3. BUSINESS INCOME OR (LOSS) 2. INTEREST AND DIVIDENDS 7. TOTAL ADJUSTMENTS FROM FORM 500, 2. INTEREST AND DIVIDENDS

7. TOTAL ADJUSTMENTS FROM FORM 500, 7. TOTAL ADJUSTMENTS FROM FORM 500, 6. TOTAL ADJUSTMENTS FROM FORM 1040 6. TOTAL ADJUSTMENTS FROM FORM 1040 1. WAGES, SALARIES, TIPS, etc SCHEDULE 1 4. OTHER INCOME OR (LOSS) SCHEDULE 1 4. OTHER INCOME OR (LOSS) 1. WAGES, SALARIES, TIPS, etc

SCHEDULE 1

. 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 8. ADJUSTED GROSS INCOME: 8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 LINE 5 PLUS OR MINUS LINES 6 AND 7 . 00 . 00 . 00 , , , , , ,

3. BUSINESS INCOME OR (LOSS) 1. WAGES, SALARIES, TIPS, etc 6. TOTAL ADJUSTMENTS FROM FORM 1040 2. INTEREST AND DIVIDENDS 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 4. OTHER INCOME OR (LOSS) 5. TOTAL INCOME: TOTAL LINES 1 THRU 4

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YOUR SOCIAL SECURITY NUMBER Form IND-CR 201 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 1 Page (Rev. 06/22/22) (Approved booklet version) Disabled Person Home Purchase or Retrofit Credit - Tax Credit 201 O.C.G.A.§ 48-7-29.1 provides a disabled person credit equal to the lesser of $500 per residence or the taxpayer’s income tax

liability for the purchase of a new single-family home that contains all of the accessibility features listed below. It also provides a credit equal to the lesser of the cost or $125 to retrofit an existing single-family home with one or more of these features. The disabled person must be the taxpayer or the taxpayer’s spouse if a joint return is filed. Qualified features are: One no-step entrance allowing access into the residence. Interior passage doors providing at least a 32-inch-wide opening. Reinforcements in bathroom walls allowing installation of grab bars around the toilet, tub, and shower, where such facilities are provided. Light switches and outlets placed in accessible locations. To qualify for this credit, the disabled person must be permanently disabled and have been issued a permanent parking permit by the Department of Revenue or have been issued a special permanent parking permit by the Department of Revenue. This credit can be carried forward 3 years. For more information, see Regulation 560-7-8-.44. 1. Credit remaining from previous years............................................................................. 1. – Include with Form 500 or 500X, if this schedule is applicable.– 2. 2. 3. 4. Potential carryover to next tax year (Line 1 plus Line 2 less Line 3) .............................. 4. Purchase of a home that contains all four accessibility features OR total of accessibility features added to retrofit a home (up to $125 per feature) cannot exceed $500 per residence................................................................................................................... 00 , . 00 , . 00 , . 00 , . 3.

Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 1)..........................................................................................................

Form IND-CR 202 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. – Child and Dependent Care Expense Credit - Tax Credit 202

O.C.G.A. § 48-7-29.10 provides taxpayers with a credit for qualified child & dependent care expenses. The credit is a percentage of the credit claimed and allowed under Internal Revenue Code § 21 and claimed by the taxpayer on the taxpayer’s Federal income tax return. This credit cannot be carried forward. The credit is computed as follows: 1. Amount of child & dependent care expense credit claimed on Federal Form 1040. 2. Georgia allowable rate ...................................................................................... 3. Allowable Child & Dependent Care Expense Credit (Line 1 x .30)............................ 4.Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 2)..................................................................................................................... 1. 2. 4. 3. 30% . 00 , . 00 , . 00 ,

YOUR SOCIAL SECURITY NUMBER Form IND-CR 203 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version)

– Include with Form 500 or 500X, if this schedule is applicable. – Georgia National Guard/Air National Guard Credit - Tax Credit 203

O.C.G.A. § 48-7-29.9 provides a tax credit for Georgia residents who are members of the National Guard or Air National Guard and are on active duty full time in the United States Armed Forces, or active duty training in the United States Armed Forces for a period of more than 90 consecutive days. The credit shall be claimed and allowed in the year in which the majority of such days are served. In the event an equal number of consecutive days are served in two calendar years, then the exclusion shall be claimed and allowed in the year in which the ninetieth day occurs. The credit shall apply with respect to each taxable year in which such member serves for such qualifying period of time. The credit cannot exceed the amount expended for qualified life insurance premiums nor the taxpayer’s income tax liability. Qualified life insurance premiums are the premiums paid for insurance coverage through the service member’s Group Life Insurance Program administered by the United States Department of Veterans Affairs. Any unused tax credit is allowed to be carried forward to the taxpayer’s succeeding year’s tax liability. 1. Credit remaining from previous years....................................................... 1. 2. Enter amount of qualified life insurance premiums ............................................ 2. 3.Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 3)...................................................................................... 3. 4. Carryover to next tax year (Line 1 plus Line 2 less Line 3)......................... 4. . 00 , , . 00 , , . 00 , , . 00 , ,

YOUR SOCIAL SECURITY NUMBER Form IND-CR 204 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. – Qualified Caregiving Expense Credit - Tax Credit 204

O.C.G.A. § 48-7-29.2 provides a qualified caregiving expense credit equal to 10 percent of the cost of qualified caregiving expenses for a qualifying family member. The credit cannot exceed $150. Qualified services include Home health agency services, personal care services, personal care attendant services, homemaker services, adult day care, respite care, or health care equipment and other supplies which have been determined by a physician to be medically necessary. Services must be obtained from an organization or individual not related to the taxpayer or the qualifying family member. The qualifying family member must be at least age 62 or been determined disabled by the Social Security Administration. A qualifying family member includes the taxpayer or an individual who is related to the taxpayer by blood, marriage or adoption. Qualified caregiving expenses do not include expenses that were subtracted to arrive at Georgia net taxable income or for which amounts were excluded from Georgia net taxable income. There is no carryover or carry-back available. The credit cannot exceed the taxpayer’s income tax liability. For more information, see Regulation 560-7-8-.43. Additional Qualifying Family Member Name, if applicable: Qualifying Family Member Name: Age, if 62 or over If disabled, date of disability Name: SS# Relationship Age, if 62 or over If disabled, date of disability Name: SS# Relationship 3. 1. Qualified caregiving expenses........................................................................... 2. Percentage limitation....................................................................................... 3. Line 1 multiplied by Line 2................................................................................ 4. Maximum credit............................................................................................... 5. Enter the lesser of Line 3 or Line 4 ...................................................................... 2. 1. 4. 5. 6. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 4)....................................................................................................................

6. . 00 , . 00 , . 00 , . 00 , 1 5 0 . 00 10%

YOUR SOCIAL SECURITY NUMBER Form IND-CR 206 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. – 3. Amount of the disaster assistance received................................................. 4. Maximum credit........................................................................................ 5. Enter the lesser of Line 3 or Line 4................................................................. Disaster Assistance Credit - Tax Credit 206 O.C.G.A. § 48-7-29.4 provides for a credit for a taxpayer who receives disaster assistance during a taxable year from the Georgia Emergency Management and Homeland Security Agency or the Federal Emergency Management Agency. The amount of the credit is equal to $500 or the actual amount of the disaster assistance, whichever is less. The credit cannot exceed the taxpayer’s income tax liability. Any unused tax credit can be carried forward to the succeeding years’ tax liability but cannot be carried back to the prior years’ tax liability. The approval letter from the disaster assistance agency must be enclosed with the return.

The following types of assistance qualify: Grants from the Department of Human Services’ Individual and Family Grant Program. Grants from GEMA/HS and/or FEMA. Loans from the Small Business Administration that are due to disasters declared by the President or Governor. Disaster assistance agency 2. Date assistance was received.................................................................... 2. 3. 4. 5. 6. Credit used this tax year (enter here and include in IND-CR Summary Worksheet Line 6).......................................................................................... 6. 7. Carryover to next tax year (Line 1 plus Line 5 less Line 6) ............................ 7. 1. Credit remaining from previous years............................................................ 1. . 00 . 00 , . 00 , . 00 , . 00 , . 00 , 0 0 5 , , , , ,

YOUR SOCIAL SECURITY NUMBER

Form IND-CR 207 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version) Rural Physicians Credit - Tax Credit 207

2. The physician must practice and reside in a rural county. For taxable years beginning on or after January 1, 2003, a physician qualifies for the credit if they practice in a rural county and reside in a county contiguous to a rural county. A rural county is defined as one with 65 or fewer persons per square mile according to the United States Decennial Census of 1990 or any future such census. For taxable years beginning on or after January 1, 2012, the United States Decennial Census of 2010 is used. For taxable years beginning on or after January 1, 2022, the United States Decennial Census of 2020 is used (see regulation 560-7-8-.20 for transition rules). A listing of rural counties for purposes of the rural physicians credit may be obtained at the following web page: dor.georgia.gov

3. The physician must be licensed to practice medicine in Georgia, primarily admit patients to a rural hospital, and practice in the fields of family practice, obstetrics and gynecology, pediatrics, internal medicine, or general surgery. A rural hospital is defined as an acute-care hospital located in a rural county that contains 80 or fewer beds. For taxable years beginning on or after January 1, 2003, a rural hospital is defined as an acute-care hospital located in a rural county that contains 100 or fewer beds. For more information, see Regulation 560-7-8-.20.

1. County of residence 2. County of practice 3. Type of practice 4. Date started working as a rural physician 5. Number of hospital beds in the rural hospital 1. County of residence 2. County of practice 3. Type of practice 4. Date started working as a rural physician 5. Number of hospital beds in the rural hospital O.C.G.A. § 48-7-29 provides for a $5,000 tax credit for rural physicians. The tax credit may be claimed for not more than five years. There is no carryover or carry-back available. The credit cannot exceed the taxpayer’s income tax liability. In order to qualify, the physician must meet the following conditions: Taxpayer Spouse Only enter the information for the taxpayer and/or the spouse if they are a rural physician.

6. Rural physicians credit, enter $5,000 per rural physician......... 6. 7. 7. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 7)..................................................... . 00 , . 00 , , , – Include with Form 500 or 500X, if this schedule is applicable.

– 1. The physician must have started working in a rural county after July 1, 1995. If the physician worked in a rural county prior to that date, a period of at least three years must have elapsed before the physician returns to work in a rural county.

YOUR SOCIAL SECURITY NUMBER Form IND-CR 208 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. –

Georgia Code Section 48-7-29.15 provides an income tax credit for the adoption of a qualified foster child. The amount of the credit is $2,000 per qualified foster child per taxable year, commencing with the year in which the adoption becomes final, and ending in the year in which the adopted child attains the age of 18. This credit applies to adoptions occurring in the taxable years beginning on or after January 1, 2008 and before January 1, 2021. Any unused credit can be carried forward until used. Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2008 and before January 1, 2021

1. Credit remaining from previous years.................................................. 1. 2. Enter $2,000 per qualified foster child.................................................. 2. 3. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 8)................................................................................. 3. 4. Carryover to next year (Line 1 plus Line 2 less Line 3)........................ 4. . 00 , . 00 , . 00 , . 00 ,

YOUR SOCIAL SECURITY NUMBER

Form IND-CR 209 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. –

A taxpayer is allowed the tax credit for a purchase of one eligible single-family residence made between June 1, 2009 and November 30, 2009. The credit amount is the lesser of 1.2 percent of the purchase price of the eligible single-family residence or $1,800.00. The amount of the tax credit that may be claimed and allowed in a single tax year cannot exceed the lesser of 1/3 of the credit or the taxpayer’s income tax liability. Any unused tax credit can be carried forward but cannot be carried back. Eligible Single-Family Residence Tax Credit - Tax Credit 209 O.C.G.A. § 48-7-29.17 provides taxpayers a credit for the purchase of an eligible single-family residence located in Georgia. An eligible single-family residence is a single-family structure (including a condominium unit as defined in O.C.G.A.§ 44-3-71) that is occupied for residential purposes by a single family, that is: a) Any residence (including a new residence, one occupied at the time of sale, or a previously occupied residence) that was for sale prior to May 11, 2009 and that remained for sale after May 11, 2009; or b) A residence with respect to which a foreclosure event has taken place and which is owned by the mortgagor or the mortgagor’s agent; or c) An owner-occupied residence with respect to which the owner’s acquisition indebtedness was in default on or before March 1, 2009. Acquisition indebtedness is debt incurred in acquiring, constructing, or substantially improving a qualified residence and which is secured by such residence. Refinanced debt is acquisition debt if at least a portion of such debt refinances the principal amount of existing acquisition indebtedness. The taxpayer must have claimed the credit in 2009 in order to claim the unused credit below. 1. 1. Total credit. (Enter amount from 2009 IND-CR, Part 9, Line 5.)............................... 2. Maximum allowed per year................................................................................... 3. Maximum credit allowed, (multiply Line 1 by Line 2)................................................ 3. 2. 4. Enter unused credit (Total credit less amounts used in previous years).................. 5. Credit allowed, lesser of Line 3 or Line 4.................................................................. 4. 5. 6. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 9)........................................................................................................................ 6. 7. Carryover to next tax year (Line 4 less Line 6)............................................................. 7. 33.33% . 00 , . 00 , . 00 , . 00 , . 00 , . 00 ,

Form IND-CR 212 State of Georgia Individual Credit Form Georgia Department of Revenue 2022 YOUR SOCIAL SECURITY NUMBER 1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. – 1. 2. 3. 1. 2. 3. 1. . 00 0 0 5 0 1 0 0 00 00 00 , . 00 . 00 7 5 3 . 00 5 0 7 , . , . , . 00 00 00 , . , . , . . 00 , Community Based Faculty Preceptor Tax Credit - Tax Credit 212 O. C.G.A. § 48-7-29.22 provides an income tax credit for a community based faculty preceptor that conducts a preceptorship rotation(s). This tax credit is applicable for taxable years beginning on or after January 1, 2019 and ending on or before December 31, 2023. For a community based faculty preceptor who is a physician as defined in O.C.G.A. § 43-34-21, the credit shall accrue on a per preceptorship rotation basis in the amount of $500 for the first, second, or third preceptorship rotation and $1,000 for the fourth, fifth, sixth, seventh, eighth, ninth, or tenth preceptorship rotation completed in one calendar year. For a community based faculty preceptor who is an advanced practice registered nurse as defined in O.C.G.A. § 43-26-3 or a physician assistant as defined in O.C.G.A. § 43-34-102, the credit shall accrue on a per preceptorship rotation basis in the amount of $375 for the first, second, or third preceptorship rotation and $750 for the fourth, fifth, sixth, seventh, eighth, ninth, or tenth preceptorship rotation completed in one calendar year. An individual shall not accrue credit for more than ten preceptorship rotations in one calendar year. The credit cannot be carried forward and cannot be carried back. Certification from the Area Health Education Centers Program Office at Augusta University must be enclosed with the return. By filing this form I certify that I did not receive payment during such tax year from any source for the training of a medical student, advanced practice registered nurse student, or physician assistant student. A. Community Based Faculty Preceptor Tax Credit for a physician 1. Number of Rotations (enter no more than 3) X (not to exceed $1,500)................................................... Fourth through Tenth Rotation First through Third Rotation 2. Number of Rotations (enter no more than 7) X (not to exceed $7,000) ............................................................ 3. Add Line 1 and Line 2, Current Year Credit Amount (cannot exceed $8,500)............. B. Community Based Faculty Preceptor Tax Credit for an advanced practice registered nurse or physician assistant. 1. Number of Rotations (enter no more than 3) X (not to exceed $1,125)................................................... First through Third Rotation Fourth through Tenth Rotation 2. Number of Rotations (enter no more than 7) X (not to exceed $5,250)................................................... 3. Add Line 1 and Line 2, Current Year Credit Amount (cannot exceed $6,375)............. 3. C. Community Based Faculty Preceptor Tax Credit Total 1.Credit used this year (enter no more than the total of Line A3 and Line B3)(enter here and include on IND-CR Summary Worksheet Line 10)................................................ 1.

YOUR SOCIAL SECURITY NUMBER Form IND-CR 213 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version) – Include with Form 500 or 500X, if this schedule is applicable. – O.C.G.A. § 48-7-29.15 provides an income tax credit for the adoption of a qualified foster child. This credit applies to adoptions occurring in taxable years beginning on or after January 1, 2021. The amount of the credit is $6,000 per qualified foster child per taxable year, commencing with the year in which the adoption becomes final, for five taxable years and $2,000 per qualified foster child per taxable year thereafter, and ending in the year in which the adopted child attains the age of 18. This credit cannot be carried forward.

Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2021- Tax Credit 213

1. Enter $6,000 per qualified foster child (if in first five taxable years of the adoption)...................................................................................... 1. 2. Enter $2,000 per qualified foster child (for years after first five taxable years of adoption)....................................................................... 2. 3. Add Line 1 and Line 2, Current Year Credit Amount ............................. 3.

4. Credit used this year (enter no more than the amount on line 3)(enter here and include on IND-CR Summary Worksheet Line 11).................. 4. . 00 , . 00 , . 00 ,

YOUR SOCIAL SECURITY NUMBER

Form IND-CR 214 State of Georgia Individual Credit Form Georgia Department of Revenue 2022

1 Page (Rev. 06/22/22) (Approved booklet version) Teacher Recruitment and Retention Credit – Tax Credit 214

A taxpayer who is designated by the Department of Education as a participating teacher in the teacher recruitment and retention program provided for in Code Section 20-2-251 shall be allowed a credit against the tax imposed by Code Section 48-7-20 in an amount equal to $3,000.00 per school year for up to five school years, which must be consecutive. Only teachers who have been designated as qualifying by the Department of Education should complete this form. For more information about the designation: https://www.gadoe.org Please note:

Each designated teacher may claim a credit amount of $3,000.00 per qualifying school year for no more than five school years, which must be consecutive, subject to conditions set forth in Code Section 20-2-251.

The credit taken on any year tax return cannot exceed your tax liability for the year. Any unused amounts of the credit can be carried forward for three years.

For more information, see Georgia Code Sections 20-2-251 and 48-7-29.23. 1. Credit remaining from previous year ................................................................................

1. – Include with Form 500 or 500X, if this schedule is applicable.– 2. 4. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 12) .............................................................................................................................. 2. 4. 5. Potential carryover to next tax year (Line 3 less Line 4)......................................................

5.

Credit generated this tax year .......................................................................................... .

00 , . 00 , . 00 , . 00 , . 3. 3.

Total credit available (Line 1 + Line 2).............................................................................. . 00 , .

Georgia FormIND-CR Summary Worksheet (Rev. 06/22/22) State of Georgia Individual Credit Form Georgia Department of Revenue 2022 YOUR SOCIAL SECURITY NUMBER 1 Page (Approved booklet version) IND-CR SUMMARY SCHEDULE WORKSHEET All applicable IND-CR Schedules (201, etc.) must be attached to Form 500 or Form 500X. Keep IND-CR Summary Worksheet for your records.

1. Only Georgia Individual Tax Credits (series 200) are claimed on Form IND-CR supporting schedules (IND-CR 201 through 214). 2. Enter the amount of credit used for the current tax year from each applicable IND-CR schedules on Lines 1-12. 3. If there is a credit remaining from previous years eligible for carryover for this tax year, the supporting IND-CR schedule must be completed even if the credit is not used for this tax year. 4. The total of Line 13 should be entered on Form 500 or Form 500X, Page 3, Line 19. 5. All applicable IND-CR schedules must be attached to Form 500 or Form 500X for the credit(s) to be allowed on the return. Note: The other state(s) tax credit and low income credit are claimed directly on Form 500. Series 100 Georgia tax credits (except Schedule 2B refundable tax credits) are claimed on Form 500 Schedule 2 and returns that include the series 100 credits must be filed electronically. The total credit amount used from the low income credit, the other state(s) tax credit, all IND-CR schedules, and all Schedule 2s cannot exceed the tax liability listed on Line 16 of Form 500 or 500X. . 00 , . 00 . 00 . 00 . 00 , , , , . 00 . 00 , , . 00 , . 00 . 00 . 00 , , ,

7. Rural Physicians Credit (IND-CR 207, Line 7) ...................................................... 8. Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2008 and Before January 1, 2021 (IND-CR 208, Line 3)...............................................................................................

9. Eligible Single-Family Residence Credit (IND-CR 209, Line 6) ............................. 7. 8. 12. Teacher Recruitment and Retention Credit (IND-CR 214, Line 4).......................... 12. 9. 3. Georgia National Guard /Air National Guard Credit (IND-CR 203, Line 3) ............ 4. Qualified Caregiving Expense Credit (IND-CR 204, Line 6) .................................. 5. Reserved ............................................................................................................... 6. Disaster Assistance Credit (IND-CR 206, Line 6) .................................................. 3. 4. 6. 5. 1. Disabled Person Home Purchase or Retrofit Credit (IND-CR 201, Line 3) ............ 2. Child and Dependent Care Expense Credit (IND-CR 202, Line 4) ........................ 2. 1.

10. Community Based Faculty Preceptor Credit (IND-CR 212, Line C1) .................. 10. 11. Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2021 (IND-CR 213, Line 4)................................

11. . 00 ,

13. Total of Lines 1 through 12 (Enter here and on Form 500/500X, Page 3 Line 19) 13.

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Georgia Form 500EZ (Rev. 05/24/22) Short Individual Income Tax Return Georgia Department of Revenue

2022 (Approved booklet version) e g a P 1 Please Please print print your your numbers numbers like like this this in in black black or or blue blue ink: ink: SPOUSE’S SSN# YOUR SSN# YOUR DRIVER’S LICENSE/STATE ID STATE ISSUED CITY (Please insert a space if the city has multiple names) DEPARTMENT USE ONLY STATE CHECK IF ADDRESS CHANGED ZIP CODE ADDRESS (NUMBER AND STREET or P.O. BOX) (Use 2nd address line for Apt, Suite or Building Number) (COUNTRY IF FOREIGN) 1. Use Federal Adjusted Gross Income, NOT Federal Taxable Income, on Line 1 below 1. 2. Adjusted Gross Income from Federal Form 1040 (Cannot exceed $99,999 for Line 1).......................... 2. 3. 3. 4. If your filing status is single, enter $8,100, married filing joint, enter $14,500 ............................................ 4. Subtract Line 2 from Line 1. If Line 2 is larger than Line 1, enter zero ........................................................... Find the tax on the amount on Line 3. (Use the Tax Rate Schedule in the IT-511 Tax Booklet).....................

5c. 6. 6. Subtract Line 5c from Line 4. If zero or less than zero, enter zero.......................................................... 7. 7. PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 3. 8. 5. Low income tax credit. (Not allowed if you are claimed as a dependent on another return)

Georgia income tax withheld (Enter tax withheld only and include W-2s and 1099s) ......................... 8. 9. If Line 6 is larger than Line 7, subtract Line 7 from Line 6. THE AMOUNT OF TAX YOU OWE ................. 9. 10. 10. 11. If Line 7 is larger than Line 6, subtract Line 6 from Line 7. THE AMOUNT OF YOUR OVERPAYMENT........... 11. Georgia Wildlife Conservation Fund (No gift less than $1.00)................................................................. 12. Georgia Fund for Children and Elderly (No gift less than $1.00)............................................................ 12. 13. Georgia Cancer Research Fund (No gift less than $1.00)....................................................................... 13. 14. Georgia Land Conservation Program (No gift less than $1.00)......................................................................... 14. 15. Georgia National Guard Foundation (No gift less than $1.00)................................................................. 15. 16. Dog and Cat Sterilization Fund (No gift less than $1.00)........................................................................ 16. Saving the Cure Fund (No gift less than $1.00)..................................................................................... SUFFIX SPOUSE’S FIRST NAME MI LAST NAME YOUR FIRST NAME MI LAST NAME (For Name Change See IT-511 Tax Booklet) SUFFIX

, .00 .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 5b. 5a.

Georgia Form 500EZ Short Individual Income Tax Return Georgia Department of Revenue 2022 YOUR SOCIAL SECURITY NUMBER Page 2 Make check for this amount payable to the GEORGIA DEPARTMENT OF REVENUE..................... 22.. (If you owe) Add Line 8 and Line 21. Complete and mail 525-TV with return and payment 22. 18. 20. 20. Interest .................................................................................................................................................... 18. Public Safety Memorial Grant (No gift less than $1.00)......................................................................... 17. Realizing Educational Achievement Can Happen (REACH) Program (No gift less than $1.00).........

17. 23. 23. I/We declare under penalties of perjury that I/we have examined this return (including accompanying schedules and st atements) and to the best of my/our knowledge and belief, it is true, correct and complete. If prepared by a person other than the taxpaye

r(s), this declaration is based on all information of which the preparer has knowledge.

PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 3. This Page (2) is required for processing Spouse’s Signature (If you are due a refund) Subtract Line 21 from Line 9. THIS IS YOUR REFUND.............................. Taxpayer’s Signature (Check box if deceased) (Check box if deceased) Signature of Preparer Name of Preparer Other Than Taxpayer By providing my e-mail address I am authorizing the Georgia Department of Revenue to electronically notify me at the below e-mail address regarding any updates to my account(s). Taxpayer’s E-mail Address Savings

Type: Checking Routing Number Account Number 23a. Direct Deposit (For U.S. Accounts Only)

Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740380 ATLANTA, GA 30374-0380

Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740399 ATLANTA, GA 30374-0399

Taxpayer’s Phone Number I authorize DOR to discuss this return with the named preparer. Spouse’s Signature Date Preparer’s Firm Name Preparer’s SSN/PTIN/SIDN Preparer’s FEIN Preparer’s Phone Number Spouse’s Date of Death Taxpayer’s Date of Death Taxpayer’s Signature Date , .00 , .00 , .00 , .00 , .00

19. 19. Penalty: Late Payment and/or Late Filing ............................................................................................... , .00 21. 21. Add Lines 10 thru Line 20, enter total here................................................................................................ , .00 If you do not enter Direct Deposit information or if you are a first time filer you will be issued a paper check.

Georgia Form 500EZ Short Individual Income Tax Return Georgia Department of Revenue 2022 YOUR SOCIAL SECURITY NUMBER INCOME STATEMENT DETAILS Only enter income on which Georgia tax was withheld. Enter information from W-2s and 1099s in the section below. YOU MAY USE FORM 500EZ IF: WHEN COMPLETING YOUR RETURN PLEASE REMEMBER TO: You are not 65 or over, or blind. Your filing status is single or married filing joint and you do not claim any exemptions other than yourself or yourself and your spouse. Your income does not exceed $99,999 and you do not itemize deductions. You are a full-year Georgia resident. You had wages, salaries, tips, dividends, and interest income only. Do not use this form if you paid or are claiming a credit of estimated tax or the timber tax credit.

You do not have any adjustments to Federal Adjusted Gross Income.

Print or type name(s), address and social security number(s).

Keep numbers inside boxes. Do not use dollar signs, commas or decimals. Round off figures for easier computations. These have been preprinted for your convenience. Sign and date your return. See IT-511 Tax Booklet for signature requirements.

Page 3 . This Page (3) is required for processing (INCOME STATEMENT B)

(INCOME STATEMENT A)

(INCOME STATEMENT C) (INCOME STATEMENT E)

(INCOME STATEMENT D)

(INCOME STATEMENT F)

1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3.

EMPLOYER/PAYER STATE WITHHOLDING ID 4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. GA WAGES / INCOME 5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. GA TAX WITHHELD 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: W-2 1099 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3.

EMPLOYER/PAYER STATE WITHHOLDING ID 4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. GA WAGES / INCOME 5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. GA TAX WITHHELD W-2 1099 W-2 1099 W-2

1099 W-2

1099 W-2

1099 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00

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Georgia Tax Rate Schedule Note: The tax table is not exact and may cause the amounts on the return to be changed. It is recommended to use the tax rate schedule for the exact amount of tax. A taxpayer can use the tax tables starting on page 59 or the Georgia Tax Rate Schedule below. See page 56 and 57 for the worksheet and examples. Single If Georgia Taxable Income Is (Line 15c Form 500/500X or Line 3 Form 500EZ) Amount of Tax Is Column A Column B But not over Column C Column D Column E Over $0 $750 1% of taxable income $750 $2,250 $8.00 Plus 2% of the amount over $750 $2,250 $3,750 $38.00 Plus 3% of the amount over $2,250 $3,750 $5,250 $83.00 Plus 4% of the amount over $3,750 $5,250 $7,000 $143.00 Plus 5% of the amount over $5,250 $7,000 $230.00 Plus 5.75% of the amount over $7,000 Married Filing Joint or Head of Household If Georgia Taxable Income Is (Line 15c Form 500/500X or Line 3 Form 500EZ) Amount of Tax Is Column A Column B But not over Column C Column D Column E Over $0 $1,000 1% of taxable income $1,000 $3,000 $10.00 Plus 2% of the amount over $1,000 $3,000 $5,000 $50.00 Plus 3% of the amount over $3,000 $5,000 $7,000 $110.00 Plus 4% of the amount over $5,000 $7,000 $10,000 $190.00 Plus 5% of the amount over $7,000 $10,000 $340.00 Plus 5.75% of the amount over $10,000 Married Filing Separate If Georgia Taxable Income Is (Line 15c Form 500/500X or Line 3 Form 500EZ) Amount of Tax Is Column A Column B But not over Column C Column D Column E Over $0 $500 1% of taxable income $500 $1,500 $5.00 Plus 2% of the amount over $500 $1,500 $2,500 $25.00 Plus 3% of the amount over $1,500 $2,500 $3,500 $55.00 Plus 4% of the amount over $2,500 $3,500 $5,000 $95.00 Plus 5% of the amount over $3,500 $5,000 $170.00 Plus 5.75% of the amount over $5,000 Page 55

Page 56 A taxpayer can use the tax tables starting on page 59 or the taxpayer may use the Georgia Tax Rate Schedule. The following worksheet is used to compute your tax liability using the Georgia Tax Rate Schedule. Also please see the examples below the worksheet. Georgia Tax Rate Worksheet 1. Amount from Form 500, Line 15c or Form 500EZ, Line 3 $ ____________ 2. Using the tables above, locate your filing status and Georgia taxable income range. Enter the amount from Column E for that Range $____________ 3. Subtract Line 2 from Line 1 $____________ 4. Enter the percentage from Column D % 5. Multiply Line 3 by Line 4 $____________ 6. Enter the amount from Column C $____________ 7. Add Line 5 and Line 6. Enter amount here and on Form 500, Line 16 or Form 500EZ, Line 4. $____________ Example 1: Single Your filing status is Single with a taxable income of $5,125. Your tax amount is $138 based on the calculations below. The amounts were rounded to the nearest dollar. The applicable portion of the Georgia Tax Rate Schedule is as follows: Single If Georgia Taxable Income Is (Line 15c Form 500/500X or Line 3 Form 500EZ) Amount of Tax Is Column A Over Column B But not over Column C Column D Column E $3,750 $5,250 $83.00 Plus 4% of the amount over $3,750 Using the worksheet the tax is computed as follows: 1. Amount from Form 500, Line 15c or Form 500EZ, Line 3 $ 5,125 2. Using the tables above, locate your filing status and Georgia taxable income range. Enter the amount from Column E for that range $ 3,750 3. Subtract Line 2 from Line 1 $ 1,375 4. Enter the percentage from Column D 4 % 5. Multiply Line 3 by Line 4 $ 55 6. Enter the amount from Column C $ 83 7. Add Line 5 and Line 6. Enter amount here and on Form 500, Line 16 or Form 500EZ, Line 4. $ 138

Page 57 Example 2: Married Filing Joint Your filing status is Married Filing Joint with a taxable income of $77,878. Your tax amount is $4,243 based on the calculations below. The amounts were rounded to the nearest dollar. The applicable portion of the Georgia Tax Rate Schedule is as follows: Married Filing Joint or Head of Household If Georgia Taxable Income Is (Line 15c Form 500/500X or Line 3 Form 500EZ) Amount of Tax Is Column A Over Column B But not over Column C Column D Column E $10,000 $340.00 Plus 5.75% of the amount over $10,000 Using the worksheet the tax is computed as follows: 1. Amount from Form 500, Line 15c or Form 500EZ, Line 3 $ 77,878 2. Using the tables above, locate your filing status and Georgia taxable income range. Enter the amount from Column E for that range $ 10,000 3. Subtract Line 2 from Line 1 $ 67,878 4. Enter the percentage from Column D 5.75 % 5. Multiply Line 3 by Line 4 $ 3,903 6. Enter the amount from Column C $ 340 7. Add Line 5 and Line 6. Enter amount here and on Form 500, Line 16 or Form 500EZ, Line 4. $ 4,243

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This amount should be placed on Line 16, Form 500 or Line 4, Form 500EZ GEORGIA INCOME TAX TABLE Note: The tax table is not exact and may cause the amounts on the return to be changed. It is recommended to use the tax rate schedule for the exact amount of tax. Line 15c, Form 500 or Line 15c, Form 500 Line 15c, Form 500 Line 15c, Form 500 Line 15c, Form 500 Married or Married or Line 3, Form Married Married Line 3, Form or Line 3, Form Married or Line 3, Form Filing Line 3, Form 500EZ Filing 500EZ Filing 500EZ Filing 500EZ Filing 500EZ Jointly or Married Jointly or Married Jointly or Married Jointly or Married Jointly or Married At But Less Head of Filing At But Less Head of Filing At But Less Head of Filing At But Less Head of Filing At But Less Head of Filing Least Than House- Sepa- Least Than House- Sepa- Least Than House- Sepa- Least Than House- Sepa- House- Single hold rately Single hold rately Single hold rately Single hold rately Least Than Sepa- Single hold rately 0 7,000 14,000 21,000 28,000 $0 100 0 0 0 7,000 7,100 233 193 288 14,000 14,100 635 573 690 21,000 21,100 1,038 975 1,093 28,000 28,100 1,440 1,378 1,495 100 200 2 2 2 7,100 7,200 239 198 294 14,100 14,200 641 579 696 21,100 21,200 1,044 981 1,099 28,100 28,200 1,446 1,384 1,501 200 300 3 3 3 7,200 7,300 244 203 299 14,200 14,300 647 584 702 21,200 21,300 1,049 987 1,104 28,200 28,300 1,452 1,389 1,507 300 400 4 4 4 7,300 7,400 250 208 305 14,300 14,400 653 590 708 21,300 21,400 1,055 993 1,110 28,300 28,400 1,458 1,395 1,513 400 500 5 5 5 7,400 7,500 256 213 311 14,400 14,500 658 596 713 21,400 21,500 1,061 998 1,116 28,400 28,500 1,463 1,401 1,518 500 600 6 6 6 7,500 7,600 262 218 317 14,500 14,600 664 602 719 21,500 21,600 1,067 1,004 1,122 28,500 28,600 1,469 1,407 1,524 600 700 7 7 8 7,600 7,700 267 223 322 14,600 14,700 670 607 725 21,600 21,700 1,072 1,010 1,127 28,600 28,700 1,475 1,412 1,530 700 800 8 8 10 7,700 7,800 273 228 328 14,700 14,800 676 613 731 21,700 21,800 1,078 1,016 1,133 28,700 28,800 1,481 1,418 1,536 800 900 10 9 12 7,800 7,900 279 233 334 14,800 14,900 681 619 736 21,800 21,900 1,084 1,021 1,139 28,800 28,900 1,486 1,424 1,541 900 1,000 12 10 14 7,900 8,000 285 238 340 14,900 15,000 687 625 742 21,900 22,000 1,090 1,027 1,145 28,900 29,000 1,492 1,430 1,547 1,000 8,000 15,000 22,000 29,000 1,000 1,100 14 11 16 8,000 8,100 290 243 345 15,000 15,100 693 630 748 22,000 22,100 1,095 1,033 1,150 29,000 29,100 1,498 1,435 1,553 1,100 1,200 16 13 18 8,100 8,200 296 248 351 15,100 15,200 699 636 754 22,100 22,200 1,101 1,039 1,156 29,100 29,200 1,504 1,441 1,559 1,200 1,300 18 15 20 8,200 8,300 302 253 357 15,200 15,300 704 642 759 22,200 22,300 1,107 1,044 1,162 29,200 29,300 1,509 1,447 1,564 1,300 1,400 20 17 22 8,300 8,400 308 258 363 15,300 15,400 710 648 765 22,300 22,400 1,113 1,050 1,168 29,300 29,400 1,515 1,453 1,570 1,400 1,500 22 19 24 8,400 8,500 313 263 368 15,400 15,500 716 653 771 22,400 22,500 1,118 1,056 1,173 29,400 29,500 1,521 1,458 1,576 1,500 1,600 24 21 27 8,500 8,600 319 268 374 15,500 15,600 722 659 777 22,500 22,600 1,124 1,062 1,179 29,500 29,600 1,527 1,464 1,582 1,600 1,700 26 23 30 8,600 8,700 325 273 380 15,600 15,700 727 665 782 22,600 22,700 1,130 1,067 1,185 29,600 29,700 1,532 1,470 1,587 1,700 1,800 28 25 33 8,700 8,800 331 278 386 15,700 15,800 733 671 788 22,700 22,800 1,136 1,073 1,191 29,700 29,800 1,538 1,476 1,593 1,800 1,900 30 27 36 8,800 8,900 336 283 391 15,800 15,900 739 676 794 22,800 22,900 1,141 1,079 1,196 29,800 29,900 1,544 1,481 1,599 1,900 2,000 32 29 39 8,900 9,000 342 288 397 15,900 16,000 745 682 800 22,900 23,000 1,147 1,085 1,202 29,900 30,000 1,550 1,487 1,605 2,000 9,000 16,000 23,000 30,000 2,000 2,100 34 31 42 9,000 9,100 348 293 403 16,000 16,100 750 688 805 23,000 23,100 1,153 1,090 1,208 30,000 30,100 1,555 1,493 1,610 2,100 2,200 36 33 45 9,100 9,200 354 298 409 16,100 16,200 756 694 811 23,100 23,200 1,159 1,096 1,214 30,100 30,200 1,561 1,499 1,616 2,200 2,300 38 35 48 9,200 9,300 359 303 414 16,200 16,300 762 699 817 23,200 23,300 1,164 1,102 1,219 30,200 30,300 1,567 1,504 1,622 2,300 2,400 41 37 51 9,300 9,400 365 308 420 16,300 16,400 768 705 823 23,300 23,400 1,170 1,108 1,225 30,300 30,400 1,573 1,510 1,628 2,400 2,500 44 39 54 9,400 9,500 371 313 426 16,400 16,500 773 711 828 23,400 23,500 1,176 1,113 1,231 30,400 30,500 1,578 1,516 1,633 2,500 2,600 47 41 57 9,500 9,600 377 318 432 16,500 16,600 779 717 834 23,500 23,600 1,182 1,119 1,237 30,500 30,600 1,584 1,522 1,639 2,600 2,700 50 43 61 9,600 9,700 382 323 437 16,600 16,700 785 722 840 23,600 23,700 1,187 1,125 1,242 30,600 30,700 1,590 1,527 1,645 2,700 2,800 53 45 65 9,700 9,800 388 328 443 16,700 16,800 791 728 846 23,700 23,800 1,193 1,131 1,248 30,700 30,800 1,596 1,533 1,651 2,800 2,900 56 47 69 9,800 9,900 394 333 449 16,800 16,900 796 734 851 23,800 23,900 1,199 1,136 1,254 30,800 30,900 1,601 1,539 1,656 2,900 3,000 59 49 73 9,900 10,000 400 338 455 16,900 17,000 802 740 857 23,900 24,000 1,205 1,142 1,260 30,900 31,000 1,607 1,545 1,662 3,000 10,000 17,000 24,000 31,000 3,000 3,100 62 52 77 10,000 10,100 405 343 460 17,000 17,100 808 745 863 24,000 24,100 1,210 1,148 1,265 31,000 31,100 1,613 1,550 1,668 3,100 3,200 65 55 81 10,100 10,200 411 349 466 17,100 17,200 814 751 869 24,100 24,200 1,216 1,154 1,271 31,100 31,200 1,619 1,556 1,674 3,200 3,300 68 58 85 10,200 10,300 417 354 472 17,200 17,300 819 757 874 24,200 24,300 1,222 1,159 1,277 31,200 31,300 1,624 1,562 1,679 3,300 3,400 71 61 89 10,300 10,400 423 360 478 17,300 17,400 825 763 880 24,300 24,400 1,228 1,165 1,283 31,300 31,400 1,630 1,568 1,685 3,400 3,500 74 64 93 10,400 10,500 428 366 483 17,400 17,500 831 768 886 24,400 24,500 1,233 1,171 1,288 31,400 31,500 1,636 1,573 1,691 3,500 3,600 77 67 98 10,500 10,600 434 372 489 17,500 17,600 837 774 892 24,500 24,600 1,239 1,177 1,294 31,500 31,600 1,642 1,579 1,697 3,600 3,700 80 70 103 10,600 10,700 440 377 495 17,600 17,700 842 780 897 24,600 24,700 1,245 1,182 1,300 31,600 31,700 1,647 1,585 1,702 3,700 3,800 83 73 108 10,700 10,800 446 383 501 17,700 17,800 848 786 903 24,700 24,800 1,251 1,188 1,306 31,700 31,800 1,653 1,591 1,708 3,800 3,900 87 76 113 10,800 10,900 451 389 506 17,800 17,900 854 791 909 24,800 24,900 1,256 1,194 1,311 31,800 31,900 1,659 1,596 1,714 3,900 4,000 91 79 118 10,900 11,000 457 395 512 17,900 18,000 860 797 915 24,900 25,000 1,262 1,200 1,317 31,900 32,000 1,665 1,602 1,720 4,000 11,000 18,000 25,000 32,000 4,000 4,100 95 82 123 11,000 11,100 463 400 518 18,000 18,100 865 803 920 25,000 25,100 1,268 1,205 1,323 32,000 32,100 1,670 1,608 1,725 4,100 4,200 99 85 128 11,100 11,200 469 406 524 18,100 18,200 871 809 926 25,100 25,200 1,274 1,211 1,329 32,100 32,200 1,676 1,614 1,731 4,200 4,300 103 88 133 11,200 11,300 474 412 529 18,200 18,300 877 814 932 25,200 25,300 1,279 1,217 1,334 32,200 32,300 1,682 1,619 1,737 4,300 4,400 107 91 138 11,300 11,400 480 418 535 18,300 18,400 883 820 938 25,300 25,400 1,285 1,223 1,340 32,300 32,400 1,688 1,625 1,743 4,400 4,500 111 94 143 11,400 11,500 486 423 541 18,400 18,500 888 826 943 25,400 25,500 1,291 1,228 1,346 32,400 32,500 1,693 1,631 1,748 4,500 4,600 115 97 148 11,500 11,600 492 429 547 18,500 18,600 894 832 949 25,500 25,600 1,297 1,234 1,352 32,500 32,600 1,699 1,637 1,754 4,600 4,700 119 100 153 11,600 11,700 497 435 552 18,600 18,700 900 837 955 25,600 25,700 1,302 1,240 1,357 32,600 32,700 1,705 1,642 1,760 4,700 4,800 123 103 158 11,700 11,800 503 441 558 18,700 18,800 906 843 961 25,700 25,800 1,308 1,246 1,363 32,700 32,800 1,711 1,648 1,766 4,800 4,900 127 106 163 11,800 11,900 509 446 564 18,800 18,900 911 849 966 25,800 25,900 1,314 1,251 1,369 32,800 32,900 1,716 1,654 1,771 4,900 5,000 131 109 168 11,900 12,000 515 452 570 18,900 19,000 917 855 972 25,900 26,000 1,320 1,257 1,375 32,900 33,000 1,722 1,660 1,777 5,000 12,000 19,000 26,000 33,000 5,000 5,100 135 112 173 12,000 12,100 520 458 575 19,000 19,100 923 860 978 26,000 26,100 1,325 1,263 1,380 33,000 33,100 1,728 1,665 1,783 5,100 5,200 139 116 179 12,100 12,200 526 464 581 19,100 19,200 929 866 984 26,100 26,200 1,331 1,269 1,386 33,100 33,200 1,734 1,671 1,789 5,200 5,300 143 120 184 12,200 12,300 532 469 587 19,200 19,300 934 872 989 26,200 26,300 1,337 1,274 1,392 33,200 33,300 1,739 1,677 1,794 5,300 5,400 148 124 190 12,300 12,400 538 475 593 19,300 19,400 940 878 995 26,300 26,400 1,343 1,280 1,398 33,300 33,400 1,745 1,683 1,800 5,400 5,500 153 128 196 12,400 12,500 543 481 598 19,400 19,500 946 883 1,001 26,400 26,500 1,348 1,286 1,403 33,400 33,500 1,751 1,688 1,806 5,500 5,600 158 132 202 12,500 12,600 549 487 604 19,500 19,600 952 889 1,007 26,500 26,600 1,354 1,292 1,409 33,500 33,600 1,757 1,694 1,812 5,600 5,700 163 136 207 12,600 12,700 555 492 610 19,600 19,700 957 895 1,012 26,600 26,700 1,360 1,297 1,415 33,600 33,700 1,762 1,700 1,817 5,700 5,800 168 140 213 12,700 12,800 561 498 616 19,700 19,800 963 901 1,018 26,700 26,800 1,366 1,303 1,421 33,700 33,800 1,768 1,706 1,823 5,800 5,900 173 144 219 12,800 12,900 566 504 621 19,800 19,900 969 906 1,024 26,800 26,900 1,371 1,309 1,426 33,800 33,900 1,774 1,711 1,829 5,900 6,000 178 148 225 12,900 13,000 572 510 627 19,900 20,000 975 912 1,030 26,900 27,000 1,377 1,315 1,432 33,900 34,000 1,780 1,717 1,835 6,000 13,000 20,000 27,000 34,000 6,000 6,100 183 152 230 13,000 13,100 578 515 633 20,000 20,100 980 918 1,035 27,000 27,100 1,383 1,320 1,438 34,000 34,100 1,785 1,723 1,840 6,100 6,200 188 156 236 13,100 13,200 584 521 639 20,100 20,200 986 924 1,041 27,100 27,200 1,389 1,326 1,444 34,100 34,200 1,791 1,729 1,846 6,200 6,300 193 160 242 13,200 13,300 589 527 644 20,200 20,300 992 929 1,047 27,200 27,300 1,394 1,332 1,449 34,200 34,300 1,797 1,734 1,852 6,300 6,400 198 164 248 13,300 13,400 595 533 650 20,300 20,400 998 935 1,053 27,300 27,400 1,400 1,338 1,455 34,300 34,400 1,803 1,740 1,858 6,400 6,500 203 168 253 13,400 13,500 601 538 656 20,400 20,500 1,003 941 1,058 27,400 27,500 1,406 1,343 1,461 34,400 34,500 1,808 1,746 1,863 6,500 6,600 208 172 259 13,500 13,600 607 544 662 20,500 20,600 1,009 947 1,064 27,500 27,600 1,412 1,349 1,467 34,500 34,600 1,814 1,752 1,869 6,600 6,700 213 176 265 13,600 13,700 612 550 667 20,600 20,700 1,015 952 1,070 27,600 27,700 1,417 1,355 1,472 34,600 34,700 1,820 1,757 1,875 6,700 6,800 218 180 271 13,700 13,800 618 556 673 20,700 20,800 1,021 958 1,076 27,700 27,800 1,423 1,361 1,478 34,700 34,800 1,826 1,763 1,881 6,800 6,900 223 184 276 13,800 13,900 624 561 679 20,800 20,900 1,026 964 1,081 27,800 27,900 1,429 1,366 1,484 34,800 34,900 1,831 1,769 1,886 6,900 7,000 228 188 282 13,900 14,000 630 567 685 20,900 21,000 1,032 970 1,087 27,900 28,000 1,435 1,372 1,490 34,900 35,000 1,837 1,775 1,892 Page 59

This amount should be placed on Line 16, Form 500 or Line 4, Form 500EZ GEORGIA INCOME TAX Line 15c, Form 500 Line 15c, Form 500 Line 15c, Form 500 Line 15c, Form 500 Line 15c, Form 500 or Married or Married or Line 3, Form Married or Line 3, Form Married or Line 3, Form Married Line 3, Form 500EZ Filing Line 3, Form 500EZ Filing 500EZ Filing 500EZ Filing 500EZ Filing Jointly or Married Jointly or Married Jointly or Married Jointly or Married Jointly or Married At But Less Head of Filing Head of Head of Head of Head of House- At But Less Filing House- At But Less Filing Filing Filing Least Than Sepa- Least Than Sepa- Least Than House- At But Less But Less Sepa- House- At Least Than Sepa- Least Than House- Sepa- Single hold rately Single hold rately Single hold rately Single hold rately Single hold rately 35,000 42,000 49,000 56,000 63,000 35,000 35,100 1,843 1,780 1,898 42,000 42,100 2,245 2,183 2,300 49,000 49,100 2,648 2,585 2,703 56,000 56,100 3,050 2,988 3,105 63,000 63,100 3,453 3,390 3,508 35,100 35,200 1,849 1,786 1,904 42,100 42,200 2,251 2,189 2,306 49,100 49,200 2,654 2,591 2,709 56,100 56,200 3,056 2,994 3,111 63,100 63,200 3,459 3,396 3,514 35,200 35,300 1,854 1,792 1,909 42,200 42,300 2,257 2,194 2,312 49,200 49,300 2,659 2,597 2,714 56,200 56,300 3,062 2,999 3,117 63,200 63,300 3,464 3,402 3,519 35,300 35,400 1,860 1,798 1,915 42,300 42,400 2,263 2,200 2,318 49,300 49,400 2,665 2,603 2,720 56,300 56,400 3,068 3,005 3,123 63,300 63,400 3,470 3,408 3,525 35,400 35,500 1,866 1,803 1,921 42,400 42,500 2,268 2,206 2,323 49,400 49,500 2,671 2,608 2,726 56,400 56,500 3,073 3,011 3,128 63,400 63,500 3,476 3,413 3,531 35,500 35,600 1,872 1,809 1,927 42,500 42,600 2,274 2,212 2,329 49,500 49,600 2,677 2,614 2,732 56,500 56,600 3,079 3,017 3,134 63,500 63,600 3,482 3,419 3,537 35,600 35,700 1,877 1,815 1,932 42,600 42,700 2,280 2,217 2,335 49,600 49,700 2,682 2,620 2,737 56,600 56,700 3,085 3,022 3,140 63,600 63,700 3,487 3,425 3,542 35,700 35,800 1,883 1,821 1,938 42,700 42,800 2,286 2,223 2,341 49,700 49,800 2,688 2,626 2,743 56,700 56,800 3,091 3,028 3,146 63,700 63,800 3,493 3,431 3,548 35,800 35,900 1,889 1,826 1,944 42,800 42,900 2,291 2,229 2,346 49,800 49,900 2,694 2,631 2,749 56,800 56,900 3,096 3,034 3,151 63,800 63,900 3,499 3,436 3,554 35,900 36,000 1,895 1,832 1,950 42,900 43,000 2,297 2,235 2,352 49,900 50,000 2,700 2,637 2,755 56,900 57,000 3,102 3,040 3,157 63,900 64,000 3,505 3,442 3,560 36,000 43,000 50,000 57,000 64,000 36,000 36,100 1,900 1,838 1,955 43,000 43,100 2,303 2,240 2,358 50,000 50,100 2,705 2,643 2,760 57,000 57,100 3,108 3,045 3,163 64,000 64,100 3,510 3,448 3,565 36,100 36,200 1,906 1,844 1,961 43,100 43,200 2,309 2,246 2,364 50,100 50,200 2,711 2,649 2,766 57,100 57,200 3,114 3,051 3,169 64,100 64,200 3,516 3,454 3,571 36,200 36,300 1,912 1,849 1,967 43,200 43,300 2,314 2,252 2,369 50,200 50,300 2,717 2,654 2,772 57,200 57,300 3,119 3,057 3,174 64,200 64,300 3,522 3,459 3,577 36,300 36,400 1,918 1,855 1,973 43,300 43,400 2,320 2,258 2,375 50,300 50,400 2,723 2,660 2,778 57,300 57,400 3,125 3,063 3,180 64,300 64,400 3,528 3,465 3,583 36,400 36,500 1,923 1,861 1,978 43,400 43,500 2,326 2,263 2,381 50,400 50,500 2,728 2,666 2,783 57,400 57,500 3,131 3,068 3,186 64,400 64,500 3,533 3,471 3,588 36,500 36,600 1,929 1,867 1,984 43,500 43,600 2,332 2,269 2,387 50,500 50,600 2,734 2,672 2,789 57,500 57,600 3,137 3,074 3,192 64,500 64,600 3,539 3,477 3,594 36,600 36,700 1,935 1,872 1,990 43,600 43,700 2,337 2,275 2,392 50,600 50,700 2,740 2,677 2,795 57,600 57,700 3,142 3,080 3,197 64,600 64,700 3,545 3,482 3,600 36,700 36,800 1,941 1,878 1,996 43,700 43,800 2,343 2,281 2,398 50,700 50,800 2,746 2,683 2,801 57,700 57,800 3,148 3,086 3,203 64,700 64,800 3,551 3,488 3,606 36,800 36,900 1,946 1,884 2,001 43,800 43,900 2,349 2,286 2,404 50,800 50,900 2,751 2,689 2,806 57,800 57,900 3,154 3,091 3,209 64,800 64,900 3,556 3,494 3,611 36,900 37,000 1,952 1,890 2,007 43,900 44,000 2,355 2,292 2,410 50,900 51,000 2,757 2,695 2,812 57,900 58,000 3,160 3,097 3,215 64,900 65,000 3,562 3,500 3,617 37,000 44,000 51,000 58,000 65,000 37,000 37,100 1,958 1,895 2,013 44,000 44,100 2,360 2,298 2,415 51,000 51,100 2,763 2,700 2,818 58,000 58,100 3,165 3,103 3,220 65,000 65,100 3,568 3,505 3,623 37,100 37,200 1,964 1,901 2,019 44,100 44,200 2,366 2,304 2,421 51,100 51,200 2,769 2,706 2,824 58,100 58,200 3,171 3,109 3,226 65,100 65,200 3,574 3,511 3,629 37,200 37,300 1,969 1,907 2,024 44,200 44,300 2,372 2,309 2,427 51,200 51,300 2,774 2,712 2,829 58,200 58,300 3,177 3,114 3,232 65,200 65,300 3,579 3,517 3,634 37,300 37,400 1,975 1,913 2,030 44,300 44,400 2,378 2,315 2,433 51,300 51,400 2,780 2,718 2,835 58,300 58,400 3,183 3,120 3,238 65,300 65,400 3,585 3,523 3,640 37,400 37,500 1,981 1,918 2,036 44,400 44,500 2,383 2,321 2,438 51,400 51,500 2,786 2,723 2,841 58,400 58,500 3,188 3,126 3,243 65,400 65,500 3,591 3,528 3,646 37,500 37,600 1,987 1,924 2,042 44,500 44,600 2,389 2,327 2,444 51,500 51,600 2,792 2,729 2,847 58,500 58,600 3,194 3,132 3,249 65,500 65,600 3,597 3,534 3,652 37,600 37,700 1,992 1,930 2,047 44,600 44,700 2,395 2,332 2,450 51,600 51,700 2,797 2,735 2,852 58,600 58,700 3,200 3,137 3,255 65,600 65,700 3,602 3,540 3,657 37,700 37,800 1,998 1,936 2,053 44,700 44,800 2,401 2,338 2,456 51,700 51,800 2,803 2,741 2,858 58,700 58,800 3,206 3,143 3,261 65,700 65,800 3,608 3,546 3,663 37,800 37,900 2,004 1,941 2,059 44,800 44,900 2,406 2,344 2,461 51,800 51,900 2,809 2,746 2,864 58,800 58,900 3,211 3,149 3,266 65,800 65,900 3,614 3,551 3,669 37,900 38,000 2,010 1,947 2,065 44,900 45,000 2,412 2,350 2,467 51,900 52,000 2,815 2,752 2,870 58,900 59,000 3,217 3,155 3,272 65,900 66,000 3,620 3,557 3,675 38,000 45,000 52,000 59,000 66,000 38,000 38,100 2,015 1,953 2,070 45,000 45,100 2,418 2,355 2,473 52,000 52,100 2,820 2,758 2,875 59,000 59,100 3,223 3,160 3,278 66,000 66,100 3,625 3,563 3,680 38,100 38,200 2,021 1,959 2,076 45,100 45,200 2,424 2,361 2,479 52,100 52,200 2,826 2,764 2,881 59,100 59,200 3,229 3,166 3,284 66,100 66,200 3,631 3,569 3,686 38,200 38,300 2,027 1,964 2,082 45,200 45,300 2,429 2,367 2,484 52,200 52,300 2,832 2,769 2,887 59,200 59,300 3,234 3,172 3,289 66,200 66,300 3,637 3,574 3,692 38,300 38,400 2,033 1,970 2,088 45,300 45,400 2,435 2,373 2,490 52,300 52,400 2,838 2,775 2,893 59,300 59,400 3,240 3,178 3,295 66,300 66,400 3,643 3,580 3,698 38,400 38,500 2,038 1,976 2,093 45,400 45,500 2,441 2,378 2,496 52,400 52,500 2,843 2,781 2,898 59,400 59,500 3,246 3,183 3,301 66,400 66,500 3,648 3,586 3,703 38,500 38,600 2,044 1,982 2,099 45,500 45,600 2,447 2,384 2,502 52,500 52,600 2,849 2,787 2,904 59,500 59,600 3,252 3,189 3,307 66,500 66,600 3,654 3,592 3,709 38,600 38,700 2,050 1,987 2,105 45,600 45,700 2,452 2,390 2,507 52,600 52,700 2,855 2,792 2,910 59,600 59,700 3,257 3,195 3,312 66,600 66,700 3,660 3,597 3,715 38,700 38,800 2,056 1,993 2,111 45,700 45,800 2,458 2,396 2,513 52,700 52,800 2,861 2,798 2,916 59,700 59,800 3,263 3,201 3,318 66,700 66,800 3,666 3,603 3,721 38,800 38,900 2,061 1,999 2,116 45,800 45,900 2,464 2,401 2,519 52,800 52,900 2,866 2,804 2,921 59,800 59,900 3,269 3,206 3,324 66,800 66,900 3,671 3,609 3,726 38,900 39,000 2,067 2,005 2,122 45,900 46,000 2,470 2,407 2,525 52,900 53,000 2,872 2,810 2,927 59,900 60,000 3,275 3,212 3,330 66,900 67,000 3,677 3,615 3,732 39,000 46,000 53,000 60,000 67,000 39,000 39,100 2,073 2,010 2,128 46,000 46,100 2,475 2,413 2,530 53,000 53,100 2,878 2,815 2,933 60,000 60,100 3,280 3,218 3,335 67,000 67,100 3,683 3,620 3,738 39,100 39,200 2,079 2,016 2,134 46,100 46,200 2,481 2,419 2,536 53,100 53,200 2,884 2,821 2,939 60,100 60,200 3,286 3,224 3,341 67,100 67,200 3,689 3,626 3,744 39,200 39,300 2,084 2,022 2,139 46,200 46,300 2,487 2,424 2,542 53,200 53,300 2,889 2,827 2,944 60,200 60,300 3,292 3,229 3,347 67,200 67,300 3,694 3,632 3,749 39,300 39,400 2,090 2,028 2,145 46,300 46,400 2,493 2,430 2,548 53,300 53,400 2,895 2,833 2,950 60,300 60,400 3,298 3,235 3,353 67,300 67,400 3,700 3,638 3,755 39,400 39,500 2,096 2,033 2,151 46,400 46,500 2,498 2,436 2,553 53,400 53,500 2,901 2,838 2,956 60,400 60,500 3,303 3,241 3,358 67,400 67,500 3,706 3,643 3,761 39,500 39,600 2,102 2,039 2,157 46,500 46,600 2,504 2,442 2,559 53,500 53,600 2,907 2,844 2,962 60,500 60,600 3,309 3,247 3,364 67,500 67,600 3,712 3,649 3,767 39,600 39,700 2,107 2,045 2,162 46,600 46,700 2,510 2,447 2,565 53,600 53,700 2,912 2,850 2,967 60,600 60,700 3,315 3,252 3,370 67,600 67,700 3,717 3,655 3,772 39,700 39,800 2,113 2,051 2,168 46,700 46,800 2,516 2,453 2,571 53,700 53,800 2,918 2,856 2,973 60,700 60,800 3,321 3,258 3,376 67,700 67,800 3,723 3,661 3,778 39,800 39,900 2,119 2,056 2,174 46,800 46,900 2,521 2,459 2,576 53,800 53,900 2,924 2,861 2,979 60,800 60,900 3,326 3,264 3,381 67,800 67,900 3,729 3,666 3,784 39,900 40,000 2,125 2,062 2,180 46,900 47,000 2,527 2,465 2,582 53,900 54,000 2,930 2,867 2,985 60,900 61,000 3,332 3,270 3,387 67,900 68,000 3,735 3,672 3,790 40,000 47,000 54,000 61,000 68,000 40,000 40,100 2,130 2,068 2,185 47,000 47,100 2,533 2,470 2,588 54,000 54,100 2,935 2,873 2,990 61,000 61,100 3,338 3,275 3,393 68,000 68,100 3,740 3,678 3,795 40,100 40,200 2,136 2,074 2,191 47,100 47,200 2,539 2,476 2,594 54,100 54,200 2,941 2,879 2,996 61,100 61,200 3,344 3,281 3,399 68,100 68,200 3,746 3,684 3,801 40,200 40,300 2,142 2,079 2,197 47,200 47,300 2,544 2,482 2,599 54,200 54,300 2,947 2,884 3,002 61,200 61,300 3,349 3,287 3,404 68,200 68,300 3,752 3,689 3,807 40,300 40,400 2,148 2,085 2,203 47,300 47,400 2,550 2,488 2,605 54,300 54,400 2,953 2,890 3,008 61,300 61,400 3,355 3,293 3,410 68,300 68,400 3,758 3,695 3,813 40,400 40,500 2,153 2,091 2,208 47,400 47,500 2,556 2,493 2,611 54,400 54,500 2,958 2,896 3,013 61,400 61,500 3,361 3,298 3,416 68,400 68,500 3,763 3,701 3,818 40,500 40,600 2,159 2,097 2,214 47,500 47,600 2,562 2,499 2,617 54,500 54,600 2,964 2,902 3,019 61,500 61,600 3,367 3,304 3,422 68,500 68,600 3,769 3,707 3,824 40,600 40,700 2,165 2,102 2,220 47,600 47,700 2,567 2,505 2,622 54,600 54,700 2,970 2,907 3,025 61,600 61,700 3,372 3,310 3,427 68,600 68,700 3,775 3,712 3,830 40,700 40,800 2,171 2,108 2,226 47,700 47,800 2,573 2,511 2,628 54,700 54,800 2,976 2,913 3,031 61,700 61,800 3,378 3,316 3,433 68,700 68,800 3,781 3,718 3,836 40,800 40,900 2,176 2,114 2,231 47,800 47,900 2,579 2,516 2,634 54,800 54,900 2,981 2,919 3,036 61,800 61,900 3,384 3,321 3,439 68,800 68,900 3,786 3,724 3,841 40,900 41,000 2,182 2,120 2,237 47,900 48,000 2,585 2,522 2,640 54,900 55,000 2,987 2,925 3,042 61,900 62,000 3,390 3,327 3,445 68,900 69,000 3,792 3,730 3,847 41,000 48,000 55,000 62,000 69,000 41,000 41,100 2,188 2,125 2,243 48,000 48,100 2,590 2,528 2,645 55,000 55,100 2,993 2,930 3,048 62,000 62,100 3,395 3,333 3,450 69,000 69,100 3,798 3,735 3,853 41,100 41,200 2,194 2,131 2,249 48,100 48,200 2,596 2,534 2,651 55,100 55,200 2,999 2,936 3,054 62,100 62,200 3,401 3,339 3,456 69,100 69,200 3,804 3,741 3,859 41,200 41,300 2,199 2,137 2,254 48,200 48,300 2,602 2,539 2,657 55,200 55,300 3,004 2,942 3,059 62,200 62,300 3,407 3,344 3,462 69,200 69,300 3,809 3,747 3,864 41,300 41,400 2,205 2,143 2,260 48,300 48,400 2,608 2,545 2,663 55,300 55,400 3,010 2,948 3,065 62,300 62,400 3,413 3,350 3,468 69,300 69,400 3,815 3,753 3,870 41,400 41,500 2,211 2,148 2,266 48,400 48,500 2,613 2,551 2,668 55,400 55,500 3,016 2,953 3,071 62,400 62,500 3,418 3,356 3,473 69,400 69,500 3,821 3,758 3,876 41,500 41,600 2,217 2,154 2,272 48,500 48,600 2,619 2,557 2,674 55,500 55,600 3,022 2,959 3,077 62,500 62,600 3,424 3,362 3,479 69,500 69,600 3,827 3,764 3,882 41,600 41,700 2,222 2,160 2,277 48,600 48,700 2,625 2,562 2,680 55,600 55,700 3,027 2,965 3,082 62,600 62,700 3,430 3,367 3,485 69,600 69,700 3,832 3,770 3,887 41,700 41,800 2,228 2,166 2,283 48,700 48,800 2,631 2,568 2,686 55,700 55,800 3,033 2,971 3,088 62,700 62,800 3,436 3,373 3,491 69,700 69,800 3,838 3,776 3,893 41,800 41,900 2,234 2,171 2,289 48,800 48,900 2,636 2,574 2,691 55,800 55,900 3,039 2,976 3,094 62,800 62,900 3,441 3,379 3,496 69,800 69,900 3,844 3,781 3,899 41,900 42,000 2,240 2,177 2,295 48,900 49,000 2,642 2,580 2,697 55,900 56,000 3,045 2,982 3,100 62,900 63,000 3,447 3,385 3,502 69,900 70,000 3,850 3,787 3,905 Note: The tax table is not exact and may cause the amounts on the return to be changed. It is recommended to use the tax rate schedule for the exact amount of tax. Page 60

This amount should be placed on Line 16, Form 500 or Line 4, Form 500EZ GEORGIA INCOME TAX Line 15c, Form 500 Line 15c, Form 500 Line 15c, Form 500 or Line 3, Form Married Line 15c, Form 500 Married or Line 3, Form Married or Line 3, Form Married Line 15c, Form 500 Married 500EZ Filing or Line 3, Form 500EZ Filing 500EZ Filing 500EZ Filing or Line 3, Form 500EZ Filing Jointly or Married Jointly or Married Jointly or Married Jointly or Married Jointly or Married At But Less Head of Filing Head of Filing House- At But Less House- At But Less Head of Filing At But Less Head of Filing At But Less Head of Filing Least Than Sepa- Least Than Sepa- Least Than House- Sepa- Least House- Sepa- House- Sepa- Single hold rately Single hold rately Single hold rately Than Single hold rately Least Than Single hold rately 70,000 77,000 84,000 91,000 98,000 70,000 70,100 3,855 3,793 3,910 77,000 77,100 4,258 4,195 4,313 84,000 84,100 4,660 4,598 4,715 91,000 91,100 5,063 5,000 5,118 98,000 98,100 5,465 5,403 5,520 70,100 70,200 3,861 3,799 3,916 77,100 77,200 4,264 4,201 4,319 84,100 84,200 4,666 4,604 4,721 91,100 91,200 5,069 5,006 5,124 98,100 98,200 5,471 5,409 5,526 70,200 70,300 3,867 3,804 3,922 77,200 77,300 4,269 4,207 4,324 84,200 84,300 4,672 4,609 4,727 91,200 91,300 5,074 5,012 5,129 98,200 98,300 5,477 5,414 5,532 70,300 70,400 3,873 3,810 3,928 77,300 77,400 4,275 4,213 4,330 84,300 84,400 4,678 4,615 4,733 91,300 91,400 5,080 5,018 5,135 98,300 98,400 5,483 5,420 5,538 70,400 70,500 3,878 3,816 3,933 77,400 77,500 4,281 4,218 4,336 84,400 84,500 4,683 4,621 4,738 91,400 91,500 5,086 5,023 5,141 98,400 98,500 5,488 5,426 5,543 70,500 70,600 3,884 3,822 3,939 77,500 77,600 4,287 4,224 4,342 84,500 84,600 4,689 4,627 4,744 91,500 91,600 5,092 5,029 5,147 98,500 98,600 5,494 5,432 5,549 70,600 70,700 3,890 3,827 3,945 77,600 77,700 4,292 4,230 4,347 84,600 84,700 4,695 4,632 4,750 91,600 91,700 5,097 5,035 5,152 98,600 98,700 5,500 5,437 5,555 70,700 70,800 3,896 3,833 3,951 77,700 77,800 4,298 4,236 4,353 84,700 84,800 4,701 4,638 4,756 91,700 91,800 5,103 5,041 5,158 98,700 98,800 5,506 5,443 5,561 70,800 70,900 3,901 3,839 3,956 77,800 77,900 4,304 4,241 4,359 84,800 84,900 4,706 4,644 4,761 91,800 91,900 5,109 5,046 5,164 98,800 98,900 5,511 5,449 5,566 70,900 71,000 3,907 3,845 3,962 77,900 78,000 4,310 4,247 4,365 84,900 85,000 4,712 4,650 4,767 91,900 92,000 5,115 5,052 5,170 98,900 99,000 5,517 5,455 5,572 71,000 78,000 85,000 92,000 99,000 71,000 71,100 3,913 3,850 3,968 78,000 78,100 4,315 4,253 4,370 85,000 85,100 4,718 4,655 4,773 92,000 92,100 5,120 5,058 5,175 99,000 99,100 5,523 5,460 5,578 71,100 71,200 3,919 3,856 3,974 78,100 78,200 4,321 4,259 4,376 85,100 85,200 4,724 4,661 4,779 92,100 92,200 5,126 5,064 5,181 99,100 99,200 5,529 5,466 5,584 71,200 71,300 3,924 3,862 3,979 78,200 78,300 4,327 4,264 4,382 85,200 85,300 4,729 4,667 4,784 92,200 92,300 5,132 5,069 5,187 99,200 99,300 5,534 5,472 5,589 71,300 71,400 3,930 3,868 3,985 78,300 78,400 4,333 4,270 4,388 85,300 85,400 4,735 4,673 4,790 92,300 92,400 5,138 5,075 5,193 99,300 99,400 5,540 5,478 5,595 71,400 71,500 3,936 3,873 3,991 78,400 78,500 4,338 4,276 4,393 85,400 85,500 4,741 4,678 4,796 92,400 92,500 5,143 5,081 5,198 99,400 99,500 5,546 5,483 5,601 71,500 71,600 3,942 3,879 3,997 78,500 78,600 4,344 4,282 4,399 85,500 85,600 4,747 4,684 4,802 92,500 92,600 5,149 5,087 5,204 99,500 99,600 5,552 5,489 5,607 71,600 71,700 3,947 3,885 4,002 78,600 78,700 4,350 4,287 4,405 85,600 85,700 4,752 4,690 4,807 92,600 92,700 5,155 5,092 5,210 99,600 99,700 5,557 5,495 5,612 71,700 71,800 3,953 3,891 4,008 78,700 78,800 4,356 4,293 4,411 85,700 85,800 4,758 4,696 4,813 92,700 92,800 5,161 5,098 5,216 99,700 99,800 5,563 5,501 5,618 71,800 71,900 3,959 3,896 4,014 78,800 78,900 4,361 4,299 4,416 85,800 85,900 4,764 4,701 4,819 92,800 92,900 5,166 5,104 5,221 99,800 99,900 5,569 5,506 5,624 71,900 72,000 3,965 3,902 4,020 78,900 79,000 4,367 4,305 4,422 85,900 86,000 4,770 4,707 4,825 92,900 93,000 5,172 5,110 5,227 99,900 100,000 5,575 5,512 5,630 72,000 79,000 86,000 93,000 $100,000 or over 5,578 5,515 5,633 72,000 72,100 3,970 3,908 4,025 79,000 79,100 4,373 4,310 4,428 86,000 86,100 4,775 4,713 4,830 93,000 93,100 5,178 5,115 5,233 $100,000 ####### 72,100 72,200 3,976 3,914 4,031 79,100 79,200 4,379 4,316 4,434 86,100 86,200 4,781 4,719 4,836 93,100 93,200 5,184 5,121 5,239 72,200 72,300 3,982 3,919 4,037 79,200 79,300 4,384 4,322 4,439 86,200 86,300 4,787 4,724 4,842 93,200 93,300 5,189 5,127 5,244 Plus 5.75% of the amount over 100,000 72,300 72,400 3,988 3,925 4,043 79,300 79,400 4,390 4,328 4,445 86,300 86,400 4,793 4,730 4,848 93,300 93,400 5,195 5,133 5,250 72,400 72,500 3,993 3,931 4,048 79,400 79,500 4,396 4,333 4,451 86,400 86,500 4,798 4,736 4,853 93,400 93,500 5,201 5,138 5,256 72,500 72,600 3,999 3,937 4,054 79,500 79,600 4,402 4,339 4,457 86,500 86,600 4,804 4,742 4,859 93,500 93,600 5,207 5,144 5,262 72,600 72,700 4,005 3,942 4,060 79,600 79,700 4,407 4,345 4,462 86,600 86,700 4,810 4,747 4,865 93,600 93,700 5,212 5,150 5,267 72,700 72,800 4,011 3,948 4,066 79,700 79,800 4,413 4,351 4,468 86,700 86,800 4,816 4,753 4,871 93,700 93,800 5,218 5,156 5,273 72,800 72,900 4,016 3,954 4,071 79,800 79,900 4,419 4,356 4,474 86,800 86,900 4,821 4,759 4,876 93,800 93,900 5,224 5,161 5,279 72,900 73,000 4,022 3,960 4,077 79,900 80,000 4,425 4,362 4,480 86,900 87,000 4,827 4,765 4,882 93,900 94,000 5,230 5,167 5,285 73,000 80,000 87,000 94,000 73,000 73,100 4,028 3,965 4,083 80,000 80,100 4,430 4,368 4,485 87,000 87,100 4,833 4,770 4,888 94,000 94,100 5,235 5,173 5,290 73,100 73,200 4,034 3,971 4,089 80,100 80,200 4,436 4,374 4,491 87,100 87,200 4,839 4,776 4,894 94,100 94,200 5,241 5,179 5,296 73,200 73,300 4,039 3,977 4,094 80,200 80,300 4,442 4,379 4,497 87,200 87,300 4,844 4,782 4,899 94,200 94,300 5,247 5,184 5,302 73,300 73,400 4,045 3,983 4,100 80,300 80,400 4,448 4,385 4,503 87,300 87,400 4,850 4,788 4,905 94,300 94,400 5,253 5,190 5,308 73,400 73,500 4,051 3,988 4,106 80,400 80,500 4,453 4,391 4,508 87,400 87,500 4,856 4,793 4,911 94,400 94,500 5,258 5,196 5,313 73,500 73,600 4,057 3,994 4,112 80,500 80,600 4,459 4,397 4,514 87,500 87,600 4,862 4,799 4,917 94,500 94,600 5,264 5,202 5,319 73,600 73,700 4,062 4,000 4,117 80,600 80,700 4,465 4,402 4,520 87,600 87,700 4,867 4,805 4,922 94,600 94,700 5,270 5,207 5,325 73,700 73,800 4,068 4,006 4,123 80,700 80,800 4,471 4,408 4,526 87,700 87,800 4,873 4,811 4,928 94,700 94,800 5,276 5,213 5,331 73,800 73,900 4,074 4,011 4,129 80,800 80,900 4,476 4,414 4,531 87,800 87,900 4,879 4,816 4,934 94,800 94,900 5,281 5,219 5,336 73,900 74,000 4,080 4,017 4,135 80,900 81,000 4,482 4,420 4,537 87,900 88,000 4,885 4,822 4,940 94,900 95,000 5,287 5,225 5,342 74,000 81,000 88,000 95,000 74,000 74,100 4,085 4,023 4,140 81,000 81,100 4,488 4,425 4,543 88,000 88,100 4,890 4,828 4,945 95,000 95,100 5,293 5,230 5,348 74,100 74,200 4,091 4,029 4,146 81,100 81,200 4,494 4,431 4,549 88,100 88,200 4,896 4,834 4,951 95,100 95,200 5,299 5,236 5,354 74,200 74,300 4,097 4,034 4,152 81,200 81,300 4,499 4,437 4,554 88,200 88,300 4,902 4,839 4,957 95,200 95,300 5,304 5,242 5,359 74,300 74,400 4,103 4,040 4,158 81,300 81,400 4,505 4,443 4,560 88,300 88,400 4,908 4,845 4,963 95,300 95,400 5,310 5,248 5,365 74,400 74,500 4,108 4,046 4,163 81,400 81,500 4,511 4,448 4,566 88,400 88,500 4,913 4,851 4,968 95,400 95,500 5,316 5,253 5,371 74,500 74,600 4,114 4,052 4,169 81,500 81,600 4,517 4,454 4,572 88,500 88,600 4,919 4,857 4,974 95,500 95,600 5,322 5,259 5,377 74,600 74,700 4,120 4,057 4,175 81,600 81,700 4,522 4,460 4,577 88,600 88,700 4,925 4,862 4,980 95,600 95,700 5,327 5,265 5,382 74,700 74,800 4,126 4,063 4,181 81,700 81,800 4,528 4,466 4,583 88,700 88,800 4,931 4,868 4,986 95,700 95,800 5,333 5,271 5,388 74,800 74,900 4,131 4,069 4,186 81,800 81,900 4,534 4,471 4,589 88,800 88,900 4,936 4,874 4,991 95,800 95,900 5,339 5,276 5,394 74,900 75,000 4,137 4,075 4,192 81,900 82,000 4,540 4,477 4,595 88,900 89,000 4,942 4,880 4,997 95,900 96,000 5,345 5,282 5,400 75,000 82,000 89,000 96,000 75,000 75,100 4,143 4,080 4,198 82,000 82,100 4,545 4,483 4,600 89,000 89,100 4,948 4,885 5,003 96,000 96,100 5,350 5,288 5,405 75,100 75,200 4,149 4,086 4,204 82,100 82,200 4,551 4,489 4,606 89,100 89,200 4,954 4,891 5,009 96,100 96,200 5,356 5,294 5,411 75,200 75,300 4,154 4,092 4,209 82,200 82,300 4,557 4,494 4,612 89,200 89,300 4,959 4,897 5,014 96,200 96,300 5,362 5,299 5,417 75,300 75,400 4,160 4,098 4,215 82,300 82,400 4,563 4,500 4,618 89,300 89,400 4,965 4,903 5,020 96,300 96,400 5,368 5,305 5,423 75,400 75,500 4,166 4,103 4,221 82,400 82,500 4,568 4,506 4,623 89,400 89,500 4,971 4,908 5,026 96,400 96,500 5,373 5,311 5,428 75,500 75,600 4,172 4,109 4,227 82,500 82,600 4,574 4,512 4,629 89,500 89,600 4,977 4,914 5,032 96,500 96,600 5,379 5,317 5,434 75,600 75,700 4,177 4,115 4,232 82,600 82,700 4,580 4,517 4,635 89,600 89,700 4,982 4,920 5,037 96,600 96,700 5,385 5,322 5,440 75,700 75,800 4,183 4,121 4,238 82,700 82,800 4,586 4,523 4,641 89,700 89,800 4,988 4,926 5,043 96,700 96,800 5,391 5,328 5,446 75,800 75,900 4,189 4,126 4,244 82,800 82,900 4,591 4,529 4,646 89,800 89,900 4,994 4,931 5,049 96,800 96,900 5,396 5,334 5,451 75,900 76,000 4,195 4,132 4,250 82,900 83,000 4,597 4,535 4,652 89,900 90,000 5,000 4,937 5,055 96,900 97,000 5,402 5,340 5,457 76,000 83,000 90,000 97,000 76,000 76,100 4,200 4,138 4,255 83,000 83,100 4,603 4,540 4,658 90,000 90,100 5,005 4,943 5,060 97,000 97,100 5,408 5,345 5,463 76,100 76,200 4,206 4,144 4,261 83,100 83,200 4,609 4,546 4,664 90,100 90,200 5,011 4,949 5,066 97,100 97,200 5,414 5,351 5,469 76,200 76,300 4,212 4,149 4,267 83,200 83,300 4,614 4,552 4,669 90,200 90,300 5,017 4,954 5,072 97,200 97,300 5,419 5,357 5,474 76,300 76,400 4,218 4,155 4,273 83,300 83,400 4,620 4,558 4,675 90,300 90,400 5,023 4,960 5,078 97,300 97,400 5,425 5,363 5,480 76,400 76,500 4,223 4,161 4,278 83,400 83,500 4,626 4,563 4,681 90,400 90,500 5,028 4,966 5,083 97,400 97,500 5,431 5,368 5,486 76,500 76,600 4,229 4,167 4,284 83,500 83,600 4,632 4,569 4,687 90,500 90,600 5,034 4,972 5,089 97,500 97,600 5,437 5,374 5,492 76,600 76,700 4,235 4,172 4,290 83,600 83,700 4,637 4,575 4,692 90,600 90,700 5,040 4,977 5,095 97,600 97,700 5,442 5,380 5,497 76,700 76,800 4,241 4,178 4,296 83,700 83,800 4,643 4,581 4,698 90,700 90,800 5,046 4,983 5,101 97,700 97,800 5,448 5,386 5,503 76,800 76,900 4,246 4,184 4,301 83,800 83,900 4,649 4,586 4,704 90,800 90,900 5,051 4,989 5,106 97,800 97,900 5,454 5,391 5,509 76,900 77,000 4,252 4,190 4,307 83,900 84,000 4,655 4,592 4,710 90,900 91,000 5,057 4,995 5,112 97,900 98,000 5,460 5,397 5,515 Note: The tax table is not exact and may cause the amounts on the return to be changed. It is recommended to use the tax rate schedule for the exact amount of tax. Page 61

STATE OF GEORGIA DEPARTMENT OF REVENUE TAXPAYER SERVICES DIVISION 1800 CENTURY BLVD. NE ATLANTA, GA 30345-3205