Filing Requirements 9 Form 500 Instructions 11-13 Mailing Addresses 5

Return Filing Tips 6 What's New 7 Tax returns due April 15, 2024 IT 511 Rev. 06.12.24 Brian P. Kemp Frank M. O'Connell Governor Revenue Commissioner Georgia Department of Revenue 2023 Individual Income Tax 500 and 500EZ Forms and General Instructions WHAT'S INSIDE? Checkoff Georgia/Donations............................................... .............................................................. ..................................................... ........................................................... ........................................................... .............................................................. ..................................... ................................................................ ......................... .................................. ......... 29

Free Electronic Filing 4 General Information 7-8 Georgia Tax Center 2 Low Income Tax Credit Worksheet 25 Message from Commissioner O'Connell 1 Other State's Tax Credit Worksheet 24 Part-year Resident and Nonresident Instructions 18-19 Payment Options................................................................. ............................................................. .......................................... ........................................... ................................................................. ......................... .............. ..................................................................... .............................................................. ......................................................... ..................................................................... .......................................................................... .............................................................. 4 Penalty and Interest 7 Requesting an Extension to File 7 Retirement Income Exclusion 17 Form 500 Net Operating Loss Instructions 20 Schedule For Estimating Georgia Income Taxes 25 Tax Credits 26-28 Tax Rate Schedule 59 Taxpayer's Assistance. 3 Tax Tables .63-65 Where's My Refund 4 Forms in tax booklet: Form 500, Form 500EZ, and Form IND-CR ELECTRONIC FILING • Qualified taxpayers can file electronically for free! • Receive your refund by direct deposit! • File fast and securely from your home PC! ON-LINE PAYMENTS The Georgia Department of Revenue accepts Visa, American Express, MasterCard, and Discover credit cards for payment of: √ 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 Follow us on Facebook and X formerly Twitter • Check refund status • Make payments • See page 2 for more information on GTC Visit dor.georgia.gov for more information about these and other topics of interest.

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 will not 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 Customer Contact 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 Bill of Rights. Frank M. O'Connell Revenue Commissioner Page 1

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 who 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 Social Security Number (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) • View your 1099-G electronically • 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 docu- mentation and authorization. For more information see: https://dor.georgia.gov/taxes/information-tax-professionals/third-party-filers 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 2

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 Where's My Refund • View the Taxpayer Bill of Rights • Find Georgia Regulations Customer Contact Center: 1-877-423-6711 https://dor.georgia.gov/taxes/taxes-individuals 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/taxes/tax-rules-and-policies for more information on: • Federal Tax Changes/Conformity with Federal Changes • Regulations • Rules and Policies For legislative information see dor.georgia.gov/about-department-revenue/office-general- counsel/legislation-summaries. 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/taxes/ tax-rules-and-policies/income-tax-federal-tax-changes Page 3

to determine eligibil- ity. For more information on Installment Payment Agreements, visit our website at FREE ELECTRONIC FILING 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 soft listed on our website dor.georgia.gov/ approved-software-providers

. 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. Page 4 Where's My Refund? Check the status of your refund online at gtc.dor.ga.gov or 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 ap- plies 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 no- tices. Credit card payments can be made online. There is a convenience fee for this service that is paid directly to the credit card processing company. For more information on payments, visit our web- site at https://dor.georgia.gov/taxes/how-do-i-make- tax-payment or contact the Taxpayer 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 paymentplan@dor.ga.gov https://dor.georgia. gov/installment-agreements-faq.

_______________________________________________________________________________________ Note: Sending your return by certified mail delays the processing of your return and your refund. 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 are 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 Page 5

Filing Checklist • Have you considered filing your return electronically? It is safe and convenient to file electroni- cally. For more information, visit dor.georgia.gov/why-should-i-file-electronically • Checked that the Social Security Number(s) on the return are accurate and complete • Added all the dependents' information, if applicable • Checked math and calculations  Amounts are 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 returns. • Signed and dated the return • Both spouses signed the joint return, even if only one spouse earned the income • Note: Anyone paid to prepare the return must also sign the return • Completed and included all schedules and IND-CRs that are applicable • Note: Schedule 2 credits must be filed electronically • Mailed the return to the correct address 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. Round to the nearest dollar. • 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 6

GENERAL INFORMATION What's New • New Tax Credits: Qualified Foster Child Donation and Qualified Law Enforcement credit. See Tax Summary for more details dor.georgia.gov/tax-credit- summaries • New Charitable Contribution: Disabled Veterans' Scholarship Fund: See Checkoff Georgia page for more details. • Revised Dependent Section: The dependent section of the form has been updated to include the unborn dependent exemption on Line 7b. Note: There are certain requirements for claiming the unborn dependent. See page 11 for more details on claiming the unborn dependent. • Depreciation Adjustment: Schedule 1, Lines 3 and 11 have been updated to show the difference in depre- ciation adjustments between Georgia and Federal law. • Organ Donation Expenses Deduction Increase: For tax years beginning on or after January 1, 2023, the maximum deduction for unreimbursed travel expenses, lodging expenses, and lost wages incurred as a direct result of an organ donation is now $25,000. • Net Operating Loss- New Schedule 4: Beginning in tax year 2023, the Net Operating loss is included in the Form 500/500X as Schedule 4.The stand-alone form 500-NOL should only be used for years prior to tax year 2023. • Qualified Education Expense and Qualified Ru- ral Hospital Expense Tax: These credits have been revised, for more information, see

https://dor.georgia. gov/tax-credit-summaries. • 2024 Income Tax Changes: Effective January 1, 2024, the income tax rate will be 5.39%. Additionally, personal exemptions have been repealed except for the $4,000 dependent exemption. Finally, Georgia standard deductions have increased to $24,000 for Married Filing Joint returns and $12,000 for Single, Head of Household, and Married Filing Separate returns. The Department encourages taxpayers to review their estimated tax payments and wage withholdings for 2024. When to File. Calendar year taxpayers are required to file on or before April 15, 2024. 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 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 infor- mation 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. Electronic filing is required for the following: • 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 26) Penalty and 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 extend the date for making the payment. Additional penalties may apply as follows: • 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. Page 7

GENERAL INFORMATION • 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 that accrues beginning July 1, 2016 accrues at an annual rate equal to the Federal Reserve prime rate plus 3 percent. The interest rate will be reviewed and may be adjusted in January of each subsequent calen- dar year. For more information on Penalties and Interest, see: https://dor.georgia.gov/penalty-and-interest-rates 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 submit 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 then 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 included if a copy was submitted with your federal return). • You itemize deductions - submit a copy of Federal Form 1040 Schedule A. • 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). Address Changes. You must notify the Department Page 8 of your address change. Notification of an address change can be made through GTC inside a logon, or by calling 1-877-423-6711 or writing the new address on your tax return and checking the address change box. Name Changes. The Department currently re- quires a copy of one of the following documents plus a copy of a photo ID reflecting name change. • Legal document reflecting name change: • Superior Court order/decree/certificate • Marriage Certificate/Divorce decree • Social Security Card Valid photo ID issued reflecting name change: • US State issued ID card (front and back) • US Passport These documents should be submitted with your tax return. Innocent Spouse Relief. Individuals who were granted innocent spouse relief by the In- ternal Revenue Service may be eligible for relief from liability for Georgia tax, interest and penalty. Individual Retirement Accounts. The provi- sions 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 re- port 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 Audits Whenever a Federal audit or other Federal adjustment results in a change in net income for any year, you are required to furnish under sepa- rate 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 re- fund, the refund must be claimed within one year of the

FILING REQUIREMENTS 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 as- sessment 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 in- come sourced to this state, whether distributed or not, from Partnerships, Limited Liability Companies and S Corporations. Withholding should be report- ed 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 derived. You are required to file a Georgia income tax return if: •

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 4. Both under 65, one blind $15,800

5. 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 legal residence is Georgia, even if you are absent from or live outside the State temporarily. A credit for taxes paid to another state is allowed. See the worksheet on page 24 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. Married part-year residents with income earned in Georgia whose spouse is a nonresident can file a separate return claiming their own allowable exemptions, dependents and deductions, or file a joint return. 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 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's required to pay tax on the income, but only if the prior year’s income exceeds the lesser of: 5 percent of the income received by the person in all places during the Page 9

FILING REQUIREMENTS current taxable year; or $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 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 203. Nonresidents. Military person 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 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 estimated tax 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 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 (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. Page 10

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. Form 500 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. • A - Single • B - Married Filing Joint; • C - Married Filing Separate; • D - Head of Household or Qualifying Surviving Spouse* *Use filing status D if your filing status is qualifying surviving spouse on your Federal return. Georgia recognizes same sex marriage. Exceptions: • If 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 - c: Dependents • 7a: Enter the total number of qualified dependents. Do not include yourself, your spouse, and/or dependent un- born children. Georgia follows the Federal rules for qualified dependents. If married filing separate, only one spouse may claim the dependent and the prior Federal rules (those when Federal exemptions for dependents) are used to determine who is entitled to claim the dependent. • 7b: Enter the number of unborn dependents. Note: The Unborn Dependent Exemption cannot be claimed if the child is born during the same tax year. If the child is born during the tax year include that dependent on Line 7a. not 7b. For more information see https://dor.georgia.gov/life- act-guidance. Page 11 • 7c: Enter the total number of dependents. Add Line 7a and Line 7b for the total for 7c. • 7d: List the requested information about your qualified dependents in the spaces provided. Do not include yourself, spouse and/or unborn dependents in this section. 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 greater than $40,000 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 skip 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. 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)

____________ ____________ FORM 500 INSTRUCTIONS (continued) 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 on Line 7c by $3,000 and enter the total. Line 14c: Add 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 Georgia 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 following worksheet to compute the net operating losses that can be used in the current year. 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 Schedule 4 and the related instructions. 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 ____________ Page 12 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 ____________ Line 15c: Subtract Line 15b from Line 15a. Line 16: Take the amount from Line 15c and use the Tax Rate Schedule starting on page 59 to determine your tax liability. Line 17: Complete the Low Income Credit Worksheet on page 25 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 24 to calculate the Other State’s Tax Credit. Note: You must include a copy of the 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. The IND-CRs are located between Schedule 3 and Schedule 4 of the Form 500. You must include any include any applicable IND-CR forms when submitting your return. 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 Social Security Number and not the Federal Employer Identification Number of the Student Scholarship Organization. See page 26 for more information regarding credits. Line 21: Add Lines 17-20 to get the amount for total credits used. The amount cannot exceed Line 16.

FORM 500 INSTRUCTIONS (continued) Line 22: Subtract Line 21 from Line 16. If zero or less, enter zero. Line 23: Only enter Georgia income tax withheld from W-2s and 1099s. 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. Attach/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 through 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 - 40: Enter the amount you want to donate to the charities listed on the form. Amounts must be rounded to the nearest dollar and cannot be less than $1. Line 41: 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. If the revised penalty is zero, enter zero. Line 42: Enter the amount of late payment and/or late filing penalty. Line 43: Enter the amount of interest. Line 44: Add Lines 28 and 31 through 43 and enter the total amount due. Mail your return, 525-TV payment voucher, and payment to the address on the Form 500. Line 45: Subtract the sum of Lines 30 through 43 from Line 29 and enter the amount to be refunded to you. Direct Deposit Option Note: If you are a first time Georgia filer or if you have not filed Georgia taxes in five or more years, you will receive your refund via paper check. This applies both to electronic and paper return filers. Line 45a: Complete the direct deposit information • Check the appropriate box (Checking or Savings) for the type of account. 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. 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 45a 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. 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 depos- its. 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 may be rejected 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 deposited to an individual account. The State of Georgia is not responsible if a financial institution rejects a direct deposit. Signature Section Please sign and date your return. If filing a joint return you and your spouse must sign and date the return. The paid preparer should also sign the return. If the taxpayer and/or spouse is deceased, check the box under the taxpayer's signature and provide the date of death. Page 13

For the Qualified Rural Hospital Organization Expense tax credit, the deduction relating to the credit. See Regulation 560-7-8-.57 for more information. SCHEDULE 1 INSTRUCTIONS 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 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 line respectively. Line 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 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). 9. For the Qualified Education Expense credit, the de- duction relating to the credit. See Regulation 560-7-8-.47. 10. For the Land Conservation credit, the deduction Page 14 relating to the credit. See Regulation 560-7-8-.50 for more information. 11. 12. For the Qualified Education Donation tax credit, the deduction relating to the credit. See Regulation 560-7-8-.60 for more information. 13. For the Qualified Foster Care Donation tax credit, the deduction relating to the credit. See regulation 560-7-8.68 for more information. 14. For the Qualified Law Enforcement Donation tax credit, the deduction relating to the credit. See regulation 560-7-8.69 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: When 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 in- come 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. Surplus 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. 15. 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: 1. Retirement income. The maximum retirement income exclusion is $35,000 for taxpayers who are: (A) 62 - 64 years of age, or

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. Schedule 1 Subtractions (continued) (B) less than 62 and permanently disabled to such an extent that they are unable to perform any type of gainful employment The maximum retirement income 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 to $4,000 of the maximum allowable exclusion may be earned income. See the instructions on page 17 and complete Form 500, Schedule 1, Page 2. Part-year and nonresident filers are required to prorate the amount of retirement exclusion. For more information on how to calculate the prorated exclusion amount, see the instructions on page 17. 2. Military Retirement Income. Up to $17,500 of military retire- ment income can be excluded for taxpayers under 62 years of age. 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. Part-year residents and nonresidents are allowed to claim the military retirement income exclusion of $17,500 against the total military retirement income they received, but these taxpayers can only claim the additional military retirement exclusion of $17,500 after meeting the earned income threshold with Georgia-source earned income. 3. Depreciation because of differences in Georgia and Federal law during tax years 1981 through 1986. 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. 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, and SEP 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. Dependent’s unearned income included in parents’ Federal adjusted gross income. 9. Income tax refunds from states other than Georgia included in Federal adjusted gross income. Do not subtract Georgia income tax refunds. 10. Income from any fund, program or system which is specifically exempted by Federal law or treaty. 11. Adjustment to Federal adjusted gross income for Georgia resident shareholders for Subchapter S income where 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. 12. 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. 13. The amount claimed by employers in food and beverage establishments who took a credit instead of a deduction on the Federal return for FICA tax paid on employee cash tips. 14. 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 15. Page 15

Federally taxable interest received on Georgia municipal bonds issued by the State of Georgia and certain au- thorities or agencies of the State of Georgia for which there is a special exemption under Georgia law from Georgia tax on such interest. Schedule 1 Subtractions (continued) 16. Adjustments due to Federal tax changes (see dor.georgia.gov/rules-policies/income-tax/income-tax-federal-tax-chang- es). 17. Combat Zone Pay Exclusion. See page 10 for more information. 18. Organ Donation Expense Deduction up to $25,000 of unreimbursed travel expenses, lodging expenses 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. 19. An amount equal to 100 percent of the premium paid by the taxpayer during the taxable year for high de- ductible health plans as defined by Section 223 of the Internal Revenue Code. The amount may only be deducted to the extent the deduction has not been included in federal adjusted income and the expenses have not been pro- vided 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 limita- tion 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. 20. 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. 21. 22. Interest eliminated from federal itemized deductions due to the Federal Form 8396 credit. 23. An amount equal to 100 percent of the payments made to and received by a disabled first responder pursuant to to O.C.G.A. § 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 to O.C.G.A. § 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. 24. 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. 25. For a firefighter, an amount equal to 100% of any premium paid by the firefighter during the taxable year for cov- erage 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. 26. 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. 27. For taxable years beginning on or after January 1, 2019, and ending on or before December 31, 2023, a subtrac- tion 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. 28. For owners of a pass-through entity or entities that have elected to pay tax at the entity level, see rule 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. For more information see https://dor.georgia.gov/hb-149-pass-through-entity-tax-faq. Note regarding Achieving Better Life Experience (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 16

Schedule 3: Column A Column B Column C Ln 1 Wages 68,300 45,800 22,500 Ln 2 Interest and Dividends 82,500 82,500 0 Ln 3 Business (income or loss) 0 0 0 Ln 4 Other (income or loss) 325,150 100,000 225,150 Ln 5 Total (Total Lines 1 thru 4) 475,950 228,300 247,650

Ln 6 Total Adjustments from Form 1040 -12,000 -12,000 0 Ln 7 Sch 1 Retirement Exclusion (from step 2 below) -65,000 -29,992 -35,008

Ln 8 GA AGI 398,950 186,308 212,642 Everywhere Georgia Ln 1 Wages 68,300 22,500 Ln 2 Other Earned Income Ln 3 Total Earned Income (Use in step 2) 68,300 22,500 Ln 4 Max Earned Income 4,000 Ln 5 Smaller of Ln 3 or 4 4,000 Ln 6 Interest 82,500 0 Ln 7 Dividend 0 0 Ln 8 Alimony Ln 9 Capital Gains 30,450 30,450 Ln 10 Other Income 75,150 0 Ln 11 Taxable IRA Ln 12 Taxable Pensions 24,850 0 Ln 13 Rent, Royalty, etc. 194,700 194,700

Ln 14 Unearned Income - Total Line 6 to 13) (Use in step 2) 407,650 225,150

Unearned Portion 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. Part-year/Nonresident Retirement Exclusion Example Step 1 Determine the Everywhere and Georgia Parts of Retirement Exclusion Step 2 Determine the Part-year/Nonresident Retirement Exclusion Allowed Earned Portion Earned Income Ratio Georgia 22,500 Everywhere 68,300 0.3294 Max Earned Income 4,000 Georgia Earned Income Portion 1,318 Total Max Exclusion 65,000 Portion Used on Earned Income 4,000 Remaining Allowed on Unearned 61,000 Unearned Income Ratio Georgia 225,150 Everywhere 407,650 0.5523 Georgia Unearned Income Portion 33,690 Total Retirement Exclusion Allowed from GA Income 35,008 Page 17

If the credit originated with more than one person or com- pany, enter separate information for each. FORM 500 SCHEDULES 2 AND 3 INSTRUCTIONS Schedule 2: Credit Usage and Carryover (Series 100 Tax Credits) 1. A return is required to be electronically filed if the return claims, utilizes or includes in any manner a Series 100 tax credit. See page 26. 2. Georgia tax credits (Series 100) must be claimed on Sched- ule 2. For a list of tax credit codes (series 100) see page 26. Please see the Tax Credit Summaries on the Department’s website (https://dor.georgia. gov/taxcredit-summaries) regard- ing Line 10 credits that can be sold. 3. Refundable credits are claimed on schedule 2B. Currently only the Timber Tax credit is refundable but is not refundable if it was purchased. Note: Series 200 tax credit codes are claimed on the IND- CR forms. 4. If claiming credit code 125 (QEE) enter your SSN and not the FEIN of the SSO. 5. Total Schedule 2 credits used for this tax year, and enter the total on Line 20 of Form 500 or 500X. 6. 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. 7. 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. 8. 9. Credit certificate numbers are issued by the Department of Revenue for preapproved credits. If applicable, enter the credit certificate number where indicated. 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. 10. 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. 11. 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. 12. 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. 13. 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 Page 18 that the returns can be processed and the credits passed to the proper taxpayer. Schedule 3: Part Year and Nonresidents Include copies of applicable returns and schedules with your Georgia return. Column A must equal Column B plus Column C. 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 ratio cannot be entered as a negative percentage and it cannot exceed 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 Widow(er)..................................................... ........................................ ................................. $5,400 • 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 7c 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.

EXAMPLE FOR COMPLETING SCHEDULE 3

FEDERAL INCOME AFTER GEORGIA ADJUSTMENT (COLUMN A) INCOME NOT TAXABLE TO GEORGIA (COLUMN B)

GEORGIA INCOME (COLUMN C)

1. WAGES, SALARIES, TIPS, e tc , , 48,0 00.00 2. INTEREST AND DIVIDENDS 4,000.00 3. BUSINESS INCOME OR (LOSS) , , . 00 4 . OTHER INCOME OR (LOSS) 00 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 , , . 52,000.0 0 6. TOTAL ADJUSTMENTS FROM FORM 1040 , , 2,00 0 .00 7. TOTAL ADJUSTMENTS FROM FORM 500, SCHEDULE 1 , - 500.00 ,

8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 , 49,5 00.00 10a.

Checkbox unchecked Checkbox unchecked

..

2023 Georgia Form500 (Rev. 08/30/23) Schedule 3 Part-Year Nonresident 2023 (Approved booklet version) 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: YOUR SOCIAL SECURITY NUMBER 987- 6 5- 432 1 DO NOT USE LINES 9 THRU 14 OF PAGES 2AND 3 FORM 500 or 500X SCHEDULE 3 COMPUTATION OF GEORGIA TAXABLE INCOME FOR ONLY PART-YEAR RESIDENTS AND NONRESIDENTS. Column A must equal Column B plus Column C. See IT-511 Tax Booklet for other state(s) tax credits. 1. WAGES, SALARIES, TIPS, etc , , , , 11,453.00 2. INTEREST AND DIVIDENDS , 95 4.00 3. BUSINESS INCOME OR (LOSS) , , . 00 4. OTHER INCOME OR (LOSS) , , . 00 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 12,4 0 7.00 6. TOTAL ADJUSTMENTS FROM FORM 1040 , 2, 000.00 7. TOTAL ADJUSTMENTS FROM FORM 500, SCHEDULE 1 , , . 00 8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 10,4 07.00 1. WAGES, SALARIES, TIPS, etc , , , , , , 36,5 4 7.00 2. INTEREST AND DIVIDENDS 3,046 . 00 3. BUSINESS INCOME OR (LOSS) , , . 00 , , . 00 , , . 00 4. OTHER INCOME OR (LOSS) 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 39, 593. 0 0 6. TOTAL ADJUSTMENTS FROM FORM 1040 7. TOTAL ADJUSTMENTS FROM FORM 500, SCHEDULE 1

- 500.00 8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 39,0 9 3.0 0 RATIO: Divide Line 8, Column C by Line 8, Column A Enter percentage here (% cannot be negative and cannot exceed 100%) 78.98% 9. 9. ....... 7,100.00 Itemized

ndard D or Standard Deduction Checkbox(See IT-511 Tax Booklet).................................... 10a. , 10b. Additional Standard Deduction Self: 65 or over? . 00 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) 11a. Enter the number on Line 6c from Form 500 or Form 500X 2 multiply by $2,700 for filing status A or D or multiply by $3,700 for filing status B or C. 7,40 0. 00 .................................... 11a. , 3,00 0 .00 11b. Enter the number on Line 7c from Form 500 or Form 500X 1 multiply by $3,000 11b. , 17,500. 0 0 12. Total Deductions and Exemptions: Add Lines 10a, 10b, 11a, and 11b ............ 12. , 13,822. 0 0 13. Multiply Line 12 by Ratio on Line 9 and enter result............................................ 13. , 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 50

0X 25,271. 0 0 ........................ 14. , Page 19

FORM 500 NET OPERATING LOSS INSTRUCTIONS Schedule 4: 500 Net Operating Loss Instructions – 2023 tax years and forward What is a Net Operating Loss (NOL)? If your deductions for the year are more than your income for the year, you may have a net operating loss (NOL). Types of Net Operating Loss (NOL): For tax years beginning on or after January 1, 2018, select the type of NOL. Normal Loss: A Normal Loss can only be carried forward until exhausted. Insurance loss (2) year: An Insurance Loss can be carried back two (2) years and carried forward for 20 years or until exhausted. Casualty Loss: A loss resulting from any sudden, unexpected, or unusual event such as a natural disaster or civil disturbance in Georgia. A casualty loss can be carried forward until exhausted. Farm Loss (2) Year: A Farm Loss can be carried back two (2) years and or carried forward until exhausted. General Instructions A Georgia Net Operating Loss (NOL) must be computed separately from any Federal NOL. It is possible to have a Federal NOL, but not a Georgia NOL. In computing the Georgia NOL only amounts attributable to Georgia can be used. The Schedule 4 must be completed and filed with the 500 or 500X return, no later than 3 years from the due date of the loss year income tax return, including any extensions which have been granted. 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 4, page 2 to compute the net operating losses that can be used in the following year. *Note: For taxable years beginning on or after January 1, 2023, use the Schedule 4 Net Operating Loss Application to compute the Individual net operating loss. For taxable years prior to tax year 2022, use the Form 500 NOL return to compute the net operating loss. Within 90 days from the last day of the month in which this return is filed, the Commissioner of Revenue shall make a limited examination of the schedule and disallow without further action any schedule containing errors of computation not correctable or having material omissions. A decrease of tax determined for prior years will first be credited against any unpaid tax and any remaining balance will be refunded to the taxpayer without interest within the 90-day period. **Note: Schedule 4 shall constitute a claim for credit or refund. If the commissioner should determine that the amount credited Page 20 or refunded by an application is in excess of the amount properly attributable to the carryback with respect to which such amount was credited or refunded, the commissioner may assess the amount of the excess as a deficiency as if it were due to a mathematical error appearing on the face of the return. For additional information, see Rule 560-7-4-.01 What must be included when claiming an NOL: 1. Copy of Federal return (1040) including pages 1 and 2. Also include Schedules 1, A, C, D, E or F where a loss is generated. 2. Copy of Federal returns (1040) for the carryback years that includes pages 1 and 2, Schedule 1 and Schedule A and any Schedules that were recalculated in carryback year. 3. Copy of Georgia returns for the carryback or carryforwards years. A copy of Federal Form 1045 should be included for carryback. Be sure to include/attach all required forms listed above and complete all lines of the Schedule 4 that apply. Otherwise, your application may be disallowed. Determine whether you have a Georgia NOL and its amount: Complete the Schedule 4, Net Operating Loss Application. If Line 8 is zero or more, you do not qualify for a Georgia NOL. How to calculate an NOL: Please see Schedule 4, Part I Computation Instructions. When and how to use an NOL Carryback: The carryback period may be waived and the NOL carried forward. Election: A taxpayer is bound by the Federal election to forego the carryback period. A copy of this election should be attached to the Georgia return. If there is a Georgia NOL but no Federal NOL, the taxpayer may make an election “for Georgia purposes only” under the same rules and restrictions as the Federal election. The Schedule 4 should be attached and completed even when the carryback period is foregone. Example: A taxpayer has a large Net Operating Loss in 2017 (both Federal and Georgia). With his timely filed Federal return, he includes a statement that he elects to forgo the carryback period. He must therefore carry his Georgia (as) well as his Federal) NOL forward without first carrying it back. Any portion not absorbed after 20 years is lost. Losses generated 2018 and forward can be used until exhausted, with the exception of insurance losses. Carryback an NOL to a previous year: Schedule 4, page 3 carryback schedule should be left blank when not trying to carryback an NOL. A net operating loss carryback adjustment must be filed on Schedule 4, page 3 for an individual taxpayer that desires a refund of taxes afforded by carryback of a net operating loss. Do not file a 500X return for prior years to apply the carryback of an NOL.

Schedule 4, Part II: NOL Worksheet Instructions Georgia Nonbusiness Income FORM 500 NET OPERATING LOSS INSTRUCTIONS (CONTINUED) Generally, a net operating loss must be carried back (if applicable) and forward in the procedural sequence of taxable periods provided by Section 172 of the Internal Revenue Code of 1986, as defined in Code Section 48-1-2. For taxable years ending on or before December 31, 2017, generally the carryback period is 2 years (with special rules for farmers (5 years), casualty losses (3 years); specified liability loss (10 years), small business loss attributable to federally declared disasters (3 years); etc.) For losses incurred in taxable years ending after December 31, 2017, there is no carryback (with a 2 year carryback for farmers) and unlimited carryover. Insurance Loss has a 2 year carryback, with a 20 year carryforward limitation. Also, Georgia does not follow the following provisions: Line 6: Add Lines 1-5 and enter the amount. • Special carryback rules enacted in 2009. • Special rules relating to Gulf Opportunity Zone public utility casualty losses, I.R.C. Section 1400N(j). • 5 year carryback of NOLs attributable to Gulf Opportunity Zone losses, I.R.C. Section 1400N(k). • 5 year carryback of certain disaster losses, I.R.C. Sections 172(b)(1)(j) and 172(j). • The election to deduct public utility property losses attributable to May 4, 2007 Kansas storms and tornadoes in the fifth tax year before the year of the loss, I.R.C. Section 1400N(o). • For losses incurred in taxable years ending after December 31, 2017. Georgia follows the CARES Act relating to no carryback and unlimited carryforward of net operating losses and also adopts the 2-year carryback for farming losses and the 2-year carryback and 20-year carryforward for certain insurance company net operating losses. • Georgia has adopted the CARES Act for taxable years beginning on or after January 1, 2019 but did not adopt the revised net operating loss provisions in the CARES Act and the modification to the Code Section 461(l) limitation in the CARES Act. How to claim an NOL: The NOL can be taken in future years or carried back to previous tax years. The NOL cannot be taken in the loss year. The loss year is the year in which the NOL occurred. Schedule 4, Part I: Computation Instructions Line 1: Enter amount from Form 500 or 500X, Line 15a. Line 2: Enter amount from Form 500 or 500X, Line 14c for full year residents. For part year and nonresident filers, see Part -Year and Nonresidents instructions. Line 3: Complete Schedule 4, Part II (GA nonbusiness deductions) and enter the total from Line 18. Line 4: Enter as a positive number any Nonbusiness Capital losses over Nonbusiness Capital gains after the $3,000 Federal limitation. (See Federal Form). Line 5: No amount is to be entered. Leave blank. Line 7: Enter IRC Section 461(1) loss eligible to be carried forward only (enter as a negative number). Georgia follows the I.R.C. Section 461(I) loss limitation. However, before the I.R.C. Section 461(i) loss limitation is applied, the taxpayer should compute the business income and deductions pursuant to the I.R.C. as defined for Georgia purposes (with the I.R.C. Section 168(k) disallowance, etc.). Then the 461(I) provisions should be applied. The 461(I) loss that is disallowed and is eligible to be carried forward should be entered on Line 7. (See Federal Form) Line 8: If Line 6 is a negative amount, add Line 6 and Line 7. Enter this amount on Line 8 and above on the amount line for Total Loss(es). Line 6. Loss Amount -39,000 Line 7. IRC Section 461(l) loss eligible to be carried forward only -7,400 Line 8. Total Losses. - 46,400 If line 6 is a positive amount, and there is an amount on Line 7, enter the amount from Line 7 on Line 8. Line 6. Loss Amount 39,000 Line 7. IRC Section 461(l) loss eligible to be carried forward only -7,400 Line 8. Total Losses. -7,400 If Line 8 is zero or more, you do not have an NOL. Line 1: Enter excess of Nonbusiness Capital gains over Nonbusiness Capital losses (See Federal Form). Enter as a positive number. Line 2: Enter Dividends income. Line 3: Enter Interest income. Line 4: Enter Alimony (received). Line 5: Enter Pension/Annuities. Line 6: Enter the nonbusiness portion of the Retirement Income Exclusion (RIE) as a negative number on this line. This should be computed as follows: The total nonbusiness income (as it is defined for NOL purposes) that is included in the retirement exclusion should be divided by the total income that is included in the retirement exclusion. This percentage should then be multiplied by the retirement exclusion. Page 21

FORM 500 NET OPERATING LOSS INSTRUCTIONS (CONTINUED) Example: If the taxpayer has $8,000 in wages (only $4,000 of the wages can be included in the RIE), $20,000 in interest income and $5,000 in S Corp income, the taxpayer would divide $20,000 by $29,000 and then multiply this by the retirement exclusion amount. When computing the percentage, use the following guidelines: 1. If the total nonbusiness income that is included in the RIE is zero or less than zero, the percentage is zero. This would apply even if the total income that is included in the RIE is zero or less than zero. 2. If the total nonbusiness income that is included in the RIE is greater than zero and exceeds the total income that is included in the RIE, the percentage is 100%. This would apply even if the total income that is included in the RIE is zero or less than zero: In situations where two people filed Married Filing Joint, a separate computation should be made to determine each taxpayer’s portion of the RIE that is related to nonbusiness income. Note: Military Retirement Income Exclusion should be entered on Line 9 as a negative number. Line 7: Enter Georgia adjustment for interest on U.S. savings bonds as a negative number on this line. Line 8: Enter Georgia adjustment for Non-Georgia municipal interest as a positive number. Line 9: Enter any other adjustments. Line 10: Add the total of Lines 1-9 and enter total Nonbusiness Income. Georgia Nonbusiness Deductions Line 11: Enter the standard deduction amount from Form 500/500X, Line 11c or enter the itemized deduction amount from Form 500/500X Line 12c less casualty and theft losses, Federal Form 2106 deductions, and state and local income taxes for full year residents. For part-year and nonresident filers, see Part-Year and Nonresident instructions. Line 12: Enter contributions to self-employed pension plan or Keogh (Federal form) amount. Line 13: Enter Alimony Paid, as a positive amount. Line 14: Enter Forfeited interest/penalty on early withdrawal amount. Line 15: Enter contributions on a deductible IRA amount. Line 16: Enter any other adjustments amount. Line 17: Add Lines 11-16 and enter total Nonbusiness Deductions amount. Line 18: Excess of Nonbusiness Deductions (Line 17) less Nonbusiness Income (Line 10). If zero or less, enter zero. Part III: Carryback Computation of Overpayments The following applies only to losses that allow a carryback: • If the loss is being carried forward leave Part III: Carryback blank. • An Insurance loss can be carried back two years. • A Farm loss can be carried back two years. • When carrying back an NOL apply the loss to the oldest applicable tax year first. Line 1: Enter the Federal adjusted gross income excluding the Federal NOL. Line 1 should not be reduced by the Federal or Georgia NOL. Enter the amount from Form 500/500X, Line 8. Line 2: Enter the Net Adjustments from Schedule 1, Line 14. Line 3: For the earliest carryback year, in column (b) enter the NOL from Schedule 4, Part 1, Line 8. Line 4: Add the net total of Lines 1, 2, and 3, for the Georgia adjusted gross income. Line 5: Enter the standard deduction amount from Form 500/500X, Line 11c or the itemized deduction amount from Form 500/500X Line 12c less casualty, and theft losses, Federal form 2106 deductions, and state and local income taxes for full year residents. For part-year and nonresidents, recalculate the prorated deductions after the application of the NOL. See NOL part- year and nonresident instructions. Line 6: Subtract Line 5 from Line 4. Line 7: Enter amount from Form 500/500X, Line 14c for full year residents. For part -year and nonresidents, recalculate the prorated exemptions after the application of the NOL. Line 8: Subtract Line 7 from Line 6 for taxable income. Line 9: Take the amount from Line 8 and use the Georgia Tax Rate Schedule on page 59 to determine your tax liability. Line 10: The credit for taxes paid to other states should be recomputed based on the new Georgia AGI and deductions. Other credits that are based on liability should be adjusted accordingly. Any credits that are not allowed and that are eligible for carryforward can be carried forward. Do not enter more than Line 9. Line 11: Subtract Line 10 from Line 9. Line 12: Enter Line 11 of column (b) in column (a). Line 13: Subtract Line 12 from Line 11. Page 22

FORM 500 NET OPERATING LOSS INSTRUCTIONS (CONTINUED) Part Year and Non Residents: Example: Standard Deduction with Additional Standard Deduction. In computing the Georgia NOL only amounts attributable to Georgia can be used. Part 1, Line 2: For a part-year and nonresident For a part-year and nonresident filers, you must prorate your exemptions. To prorate your exemptions, add Schedule 3, Lines 11a and 11b, then multiply the total by Schedule 3, Line 9. Schedule 3, Line 10a 6,000 Schedule 3, Line 10b + 1,300 Total Deductions = 7,300 Schedule 3, Line 9 x 78.98% Prorated Deductions = 5,766 Column (a). Return as filed or liability as last determined Lines 1 -11: Enter the amounts from your original return or as previously adjusted by you or the Department of Revenue. Part II, Line 11: Part- year and nonresident filers must prorate their deductions based on how the deductions are claimed. • Itemized – Schedule 3, Line 10a: Less casualty, federal form 2106 deductions, and state and local income taxes. Multiply the total by Schedule 3, Line 9. • Standard deductions - Schedule 3: Add Line 10a plus Line 10b, then multiply the total by Schedule 3, Line 9. If Georgia Itemized deductions are claimed, do not prorate, utilize the full amount. Worksheet Schedule 3, Line 10a Schedule 3, Line 10b + Total Deductions = Schedule 3, Line 9 X Prorated Deductions = Example: Itemized Deduction. Schedule 3, Line 10a 15,000 Schedule 3, Line 10b + Total Deductions = 15,000 Schedule 3, Line 9 x 78.98% Prorated Deductions = 11,847 Page 23

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 the Tax Rate Schedule in this booklet) 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 other 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 the 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. Page 24

Federal Adjusted Gross Income Credit Under $6,000 $6,000 but not more than $7,999 $8,000 but not more than $9,999 $26 $20 $14 $10,000 but not more than $14,999 $15,000 but not more than $19,999 $ 8 $ 5

Estimated Tax due this year (Subtract Lines 13 and 14 from Line 12) (See 500ES)

LOW INCOME CREDIT WORKSHEET All claims for the low income credit, including claims on amended returns, must be filed on or before the end of the 12th month following 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 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. Add Lines 2 and 3; enter on Line 17a of Form 500, or if filing the Form 500EZ, Line 5a 5. Find the credit that corresponds to your income in the table below and enter on Line 17b of Form 500, or if filing the Form 500EZ, Line 5b 6. Credit Table:

SCHEDULE FOR ESTIMATING GEORGIA INCOME TAXES (Figures may be rounded off.) Please see the Form 500ES which includes important information regarding how to file and pay estimated tax. 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 7. Other deductions (See instructions on pages 14-16) 8. Balance (Subtract Lines 4 - 7 from Line 3) 9. Exemption for Dependents 10. Standard or Itemized deductions 11. Taxable income (Subtract Lines 9 and 10 from Line 8) 12. Tax on amount on Line 11 (Use applicable tax rate) 13. Withholding Tax and other credits 14. Amount from prior year’s return to be credited to this year’s estimate 15. Page 25

TAX CREDITS 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 credits, please visit the Georgia Department of Revenue website at dor.georgia.gov/documents/ 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 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 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 125 - Qualified Education Expense Credit 126 - Seed-Capital Fund Credit 129 - Qualified Health Insurance Expense Credit 128 - Wood Residual Credit 130 - Quality Jobs Tax Credit 131 - Alternate Port Activity Tax Credit 132 - Qualified Investor Tax Credit Code Name of Credit 133 - Film Tax Credit for a Qualified Interactive Enter- tainment Production Company 135 - Historic Rehabilitation Tax Credit for any Other Certified Structures (not a historic home) 136 - Qualified Rural Hospital Organization Expense Tax Credit 137 - Qualified Parolee Jobs Tax Credit 138 - Postproduction Film Tax Credit 139 - Small Postproduction Film Tax Credit 140 - Qualified Education Donation 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 Homes and Other Certified Structures Earning $300K or less 150 – Qualified Law Enforcement Donation Credit 151 – Qualified Foster Child Donation Credit 152 – Historic Rehabilitation Credit for Historic Homes 2023 and 2024 153 – Historic Rehabilitation for Other Certified Struc- tures 2023 through 2027 Page 26

EXAMPLE OF HOW TO FILL OUT A TAX CREDITS SCHEDULE FO R 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 27

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 28

Pick an amount and make it count by donating on your State Income Tax Return form to one or more of the following The Georgia Wildlife Conservation Fund protects and preserves Georgia’s nongame wild- 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 / 999 Peachtree St. NE, Suite 1415 / Atlanta, GA 30309 / 404-523-8735 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 / 47 Trinity Ave SW, Fifth Floor / Atlanta, GA 30334 The Georgia National Guard Foundation Inc. provides emergency relief assistance to the soldiers - 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 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 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 graduate from high school, access college, and achieve post-secondary success. Georgia Student Finance Authority / 2082 East Exchange Place / Tucker, GA 30084 / 770-724-9252 / 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 Disabled Veterans’ Scholarship Fund administered by the Technical College System of Geor- gia Foundation provides workforce an d educational skills training at its network of 22 technical colleges throughout Georgia. Your donation will provide scholarships to disabled veterans pur- suing their education. TCSG.edu/ 1 800 Century Place NE/ Atlanta GA. 30045 / 404-679-1600/ https://www.tcsg.edu/ Page 29

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sion)

r 6b. MI Please print your numbers like this in black or blue ink: Georgia Form 500 (Rev. 08/30/23) Individual Income Tax Return Please print your numbers like this in black or blue ink: Georgia Department of Revenue 2023(Approved booklet version) Page 1 Fiscal Year Beginning STATE ISSUED YOUR DRIVER’S LICENSE/STATE ID Fiscal Year 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 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 ZIP 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 TO 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 I T -5 1 1 Tax Booklet)............................................................................... .... ...... 5. 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 6. Number of exemptions (Check appropriate box(es) and enter total in 6c.) 6a. Yourself Spouse 6c. s

a. Social Security Number

Federal Itemized Deductions (Schedule A- Form 1040) 12a. b. Less adjustments: (See IT-511 Tax Booklet) 12b. c. Georgia Total

Itemized Deductions 12c. 13. Subtract either Line 11c or Line 12c from Line 10; enter balance 13. Georgia Form 500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER Page 2 2023 ( First Name, MI. Last Name 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 INCOME COMPUTATIONS Social Security Number Relationship to You If amount on line 8, 9, 10, 13 or 15 is negative, use the minus sign (-). Example -3456. . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 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. 9. Adjustments from Form 500 Schedule 1 (See IT-511 Tax Booklet) 9. 10. Georgia adjusted gross income (Net total of Line 8 and Line 9) 10. 11. Standard Deduction (Do not use FEDERAL STANDARD DEDUCTION) 11a. (See IT-511 Tax Booklet) b. Self: 65 or over? Blind? Total x 1,300= 11b. Spouse: 65 or over? Blind? c. Total Standard Deduction (Line 11a + Line 11b). 11c. Use EITHER Line 11c OR Line 12c (Do not write on both lines) 12. Total Itemized Deductions used in computing Federal Taxable Income. If you use itemized deductions, you must include Federal Schedule A. , , , , , , , , , , , , , , , , ,

EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN)

4. GA WAGES / INCOME 5. GA TAX WITHHELD

5. .

(INCOME STATEMENT C)

(INCOME STATEMENT B) 14c. Add Lines 14a. and 14b. Enter total

14c.

INCOME STATEMENT DETAILS INCOME STATEMENT DETAILS Only enter income on which Georgi a tax was witheld. Enter in come f rom W-2s, 1099s, and G2-As on Lin e 4 GA Wag es/Inco me. For other incom e st atement s c omplete Line 4 us ing the i ncome reporte d from Form G2-RP Line 12 or 13 ; Form G 2-LP Line 1, or for Form G 2-FL enter zero. Georgia Form500 Individual Income Tax Return Georgia Department of Revenue 2023 Page 3 14a. Enter the number from Line 6c. Multiply by $2,700 for filing status A or D or multiply by $3,700 for filing status B or C 14a. 14b. Enter the number from Line 7c. Multiply by $3,000.......................................... ...................................................... ..... .... ..................................... .......................... ........................ ....... ........................................ .....................

........ .......... 14b. 15a. Income before GA NOL (Line 13 less Line 14c or Schedule 3, Line 14) 15a. 15b. Georgia NOL utilized (Cannot exceed Line 15a or the amount after applying the 80% limitation, see IT-511 Tax Booklet for more information) 15b. 15c. Georgia Taxable Income (Line 15a less Line 15b) 15c. 16. Tax (Use Tax Rate Schedule in the IT-511 Tax Booklet) 16. 17b. 17. Low Income Credit 17a. 17c. 18. Other State(s) Tax Credit (Include a copy of the other state(s) return) 18. 19. Credits used from IND-CR Summary Worksheet 19. 20. Total Credits Used from Schedule 2 Georgia Tax Credits (must be filed electronically) 20. 21. Total Credits Used (sum of Lines 17-20) cannot exceed Line 16 21. 22. Balance (Line 16 less Line 21) if zero or less than zero, enter zero 22. YOUR SOCIAL SECURITY NUMBER .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 , , , , , , , , , , , , , , , .00 .00 , , , , (INCOME STATEMENT A) 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: W-2 G2-A G2-LP G2-A G2-LP 1099 G2-A G2-LP W-2 W-2 G2-FL G2-FL G2-FL 1099 G2-RP 1099 G2-RP G2-RP 2. EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) 2. 2. SSN SSN SSN 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID . 00 . 00 . 00 . 00 . 00 . 00 , , , , , , , , , , , , 4. GA WAGES / INCOME

4. GA WAGES / INCOME

GA TAX WITHHELD 5. GA TAX WITHHELD PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 4. All Pages (1-5) are required for processing

(INCOME STATEMENT E)

3.

(INCOME STATEMENT F) 1. W-2

(INCOME STATEMENT D) Georgia Form 500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER 2023 Page 4 2. WITHHOLDING TYPE: W-2 G2-A 1099 G2-FL EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN G2-LP G2-RP 1. 2. WITHHOLDING TYPE: G2-A 1099 G2-FL EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN G2-LP G2-RP 1. 2. WITHHOLDING TYPE: W-2 G2-A 1099 G2-FL EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN G2-LP G2-RP EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. 4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. . 00 . 00 , , , , 5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. . 00 . 00 , , , , 23. Georgia Income Tax Withheld on Wages and 1099s (Enter Tax Withheld Only and include W-2s and/or 1099s) ............................. ........................................................

......................................... .......................................................... ........................... ............................................................................................... .............................................................................................. ................................. ............. ........ ................. ........... ............. ....................... ................................. ............. 23. 24. Other Georgia Income Tax Withheld (Must include G2-A, G2-FL, G2-LP and/or G2-RP) 24. 25. Estimated Tax paid for 2023 and Form IT-560 25. 26. Schedule 2B Refundable Tax Credits (Cannot be claimed unless filed electronically)

26. 27. Total prepayment credits (Add Lines 23, 24, 25 and 26) 27. 28. If Line 22 exceeds Line 27, subtract Line 27 from Line 22 and enter balance due 28. 29. If Line 27 exceeds Line 22, subtract Line 22 from Line 27 and enter overpayment 29. 30. Amount to be credited to 2024 ESTIMATED TAX 30. 31. Georgia Wildlife Conservation Fund (No gift of less than $1.00) 31. 32. Georgia Fund for Children and Elderly (No gift of less than $1.00) 32. 33. Georgia Cancer Research Fund (No gift of less than $1.00) 33. 34. Georgia Land Conservation Program (No gift of less than $1.00) 34. 35. Georgia National Guard Foundation (No gift of less than $1.00) 35. 36. Dog & Cat Sterilization Fund (No gift of less than $1.00) 36. 37. Saving the Cure Fund (No gift of less than $1.00) 37. 38. Realizing Educational Achievement Can Happen (REACH) Program (No gift of less than $1.00) 38. EMPLOYER/PAYER STATE WITHHOLDING ID GA WAGES / INCOME GA TAX WITHHELD . 00 . 00 , , , , . , , 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 All Pages (1-5) are required for processing

Georgia Form500 Individual Income Tax Return Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBE R 2023 Pag e 5 ........................... Disabled Veterans Scholarship Fund (No gift of less than $1.00) ................. 500 UET exception attach ed....... 41 . ........... ..... ..... 45. (If you are due a refund) Subtract the sum of Lines 30 thru 43 from Line 29 THIS IS YOUR REFUND......................................................................... 45. , , . 00 Refund Due Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER, PO BOX 740380 ATLANTA, GA 30374-0380 If you do not enter Direct Deposit information or if you are a first time filer you will be issued a paper check. 45a. Direct Deposit (U.S. Accounts Only)

Type: Checking Savings Routing Number Account Number 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. Taxpayer’s Signature (Check box if deceased) Spouse’s Signature (Check box if deceased) Taxpayer’s Date of Death Spouse’s Date of Death Taxpayer’s Signature Date Taxpayer’s Phone Number Spouse’s Signature Date 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 I authorize DOR to discuss this return with the named preparer. Preparer’s Phone Number Signature of Preparer Name of Preparer Other Than Taxpayer Preparer’s FEIN Preparer’s Firm Name Preparer’s SSN/PTIN/SIDN

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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 Schedule 1 Georgia Form500 Page 1 (Rev. 08/30/23) Schedule 1

Adjustments to Income YOUR SOCIAL SECURITY NUMBER 2023(Approved booklet version) See IT-511 Tax Booklet SCHEDULE 1 ADJUSTMENTS to INCOME BASED on GEORGIA LAW ADDITIONS to INCOME 1. Interest on Non-Georgia Municipal and State Bonds ................................... ......................................................................................... .........................................................................................................

... ....................................... .............................................. 1. , , .00 , , .00 , , .00 , , .00 , , .00 , , .00 2. Lump Sum Distributions 2. 3. Depreciation 3. 4. Net operating loss carryover deducted on Federal return 4. 5. Other (Specify) 5. 6. Total Additions (Enter sum of Lines 1-5 here) 6. SUBTRACTION from INCOME (See IT-511 Tax Booklet) 7. Retirement Income Exclusion Taxpayer Required for Retirement Income Exclusion and Military Retirement Income Exclusion , .00 , .00 , .00 , .00 , .00 , .00 , , .00 , , .00 , , .00 , , .00 , , .00 , , .00 , , .00 a. Retirement Income Exclusion - Complete Schedule 1, page 2. 7a. .b. Military Retirement Income Exclusion (Must be under 62 years of age) - Complete Schedule 1, page 3. 7b. Date of Birth: c. Date of Disability:

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

Type of Disability: 8. Social Security Benefits (Taxable portion from Federal return).................... .............................................................................. .................. .................................................................................................. ....................................... ..........................................

8. 9. Path2College 529 Plan

9. 10. Interest on United States Obligations (See IT-511Tax Booklet ) 10. 11. Depreciation 11. 12. Other Adjustments (Specify) 12. 13. Total Subtractions (Enter sum of Lines 7-12 here) 13. 14.

14.

4. Maximum EarnedIncome Book et See IT -511 Tax SC HED ULE 1 RETIREMENT INCOME EXCLUSION Georgia Form500 (Rev. 08/30/23) Schedule 1 Adjustments to Income 2023(Approved booklet version) Schedule 1 Page 2 YOUR SOCIAL SECURITY NUMBER SCHEDULE 1 RETIREMENT INCOME EXCLUSION See IT-511 Tax Bookle t (TAXPAYER) (SPOUSE) 1. Salary and wages

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

, , . 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 , , . 00 2. Other EarnedIncome (Losses) 3. Total EarnedIncome 4,000. 0 0 4,000.0 0 , , 5. The lesser of Line 3 or 4; if zero or less,

enter zero 6. Interest Income 7. DividendIncome 8. Alimony 9. C apitalGains (Losses) 10. Other Income (Losses) (See IT-511 Tax Booklet) 11. Taxable IRA Distributions 12. Taxable Pensions 13. Rental,Royalty, Partnership, S Corp, etc. Income (Losses) (See IT-511 Tax Booklet) 14. Total ofLines6through 13; if zero or less, enter zero 15. AddLines5 and14 16. Maximum Allowable Exclusion * 17. The lesser of Lines15and16; enter here and on Form 500, Schedule 1, Lines 7a. & d for Retirement Exclusion or Lines 7c & f for Retirement Exclusion for Disability *If age 62-64 or less than age 62 and permanently disabled enter $35,000, or if age 65 or older enter $65,000.

S ee IT-511 Tax Book et Schedule 1 Georgia Form500 Page 3 (Rev. 08/30/23) Schedule 1 Adjustments to Income 2023(Approved booklet version) YOUR SOCIAL SECURITY NUMBER SCHEDULE 1

MILITARY RETIREMENT INCOME EXCLUSION See IT-511 Tax Booklet Do I Qualify for Military Retirement Exclusion? 1. Do you have any military retirement income? 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. 3. Include this page with your Form 500/500X, if applicable. (TAXPAYER) (SPOUSE) 1. Taxable Military Retirement from 1099-R , , . 00 , , . 00 , , , , 00 , , 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , , , . 00 , , . 00 17,500.0017,500.00 17,500.0017,500.00 17,500.00 17,500.0017,500.0017,500.0017,500.0017,500. 00 2. Base Military Exclusion

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

. . 3. Enter the lesser 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......................... 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 . 00 3 5 , 0 0 0 . 00 7. Total additional Military Exclusion allowed....... 8. Enter the lesser of Line 1 or Line 7. Enter this amount on Schedule 1, Lines 7b and e.......

INCOME NOT TAXABLE TO GEORGIA (COLUMN B)

4. OTHER INCOME OR (LOSS) 4. OTHER INCOME OR (LOSS)

6. TOTAL ADJUSTMENTS FROM FORM 1040 6. TOTAL ADJUSTMENTS FROM FORM 1040

7. TOTAL ADJUSTMENTS FROM FORM 500, SCHEDULE 1 7. TOTAL ADJUSTMENTS FROM FORM 500, SCHEDULE 1

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

GEORGIA INCOME (COLUMN C) Column A must equal Column B plus Column C.

FEDERAL INCOME AFTER GEORGIA ADJUSTMENT (COLUMN A) Schedule 3 Georgia Form500 Page 1 (Rev. 08/30/23) Schedule 3 Part-Year Nonresident YOUR SOCIAL SECURITY NUMBER 2023 (Approved booklet version) DO NOT USE LINES 9 THRU 14 OF PAGES 2 AND 3 FORM 500 or 500X SCHEDULE 3 COMPUTATION OF GEORGIA TAXABLE INCOME FOR ONLY PART-YEAR RESIDENTS AND NONRESIDENTS. See IT-511 Tax Booklet for other state(s) tax credits. 1. WAGES, SALARIES, TIPS,etc 1. WAGES, SALARIES, TIPS, etc 1. WAGES, SALARIES, TIPS,etc , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 2. INTEREST AND DIVIDENDS 2. INTEREST AND DIVIDENDS 2. INTEREST AND DIVIDENDS 3. BUSINESS INCOME OR (LOSS) 3. BUSINESS INCOME OR (LOSS) 3. BUSINESS INCOME OR (LOSS) 4. OTHER INCOME OR (LOSS) 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 5. TOTAL INCOME: TOTAL LINES 1 THRU 4 6. TOTAL ADJUSTMENTS FROM FORM 1040 7. TOTAL ADJUSTMENTS FROM FORM 500, SCHEDULE 1 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 8. ADJUSTED GROSS INCOME: LINE 5 PLUS OR MINUS LINES 6 AND 7 RATIO: Divide Line 8, Column C by Line 8, Column A Enter percentage here (% cannot be negative and cannot exceed 100%) 9. 9. % . ....... .................................... .... ..................................... .. ............ ............................................ ........................ 10a. Itemized or Standard Deduction (See IT-511 Tax Booklet) 10a. , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 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) 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 7c from Form 500 or Form 500X multiply by $3,000 11b. 12. Total Deductions and Exemptions: Add Lines 10a, 10b, 11a, and 11b

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

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(Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER NORMAL LOSSNORMAL L OSS CASUALTY LOSS , , . 00 , , . 00 INSUR ANCE LOSS (2) YEAR FARM LOSS (2) YEAR , , . 00 , , . 00 , , . 00 pages, Parts, I, II and III use the minus sign (-) for negative amounts. Example -3456. See IT-511 Tax Booklet for detailed instructions. Example

, - 3 , 456.0 0 1. Georgia Income before NOL (Form 500, Line 15a)Georgia Income before NOL (Form 500, Line 15a)Georgia Income before NOL (Form 500, Line 15a) Georgia Income before NOL (Form 500, Line 15a)Georgia Income before NOL (Form 500, Line 15a)Georgia Income before NOL (Form 500, Line 15a)Georgia Income before NOL (Form 500, Line 15a)Georgia Income before NOL (Form 500, Line 15a)

2. 3. 4. 5. 6. 7. 8. Georgia Exemption ( ) .......................................... 1. 2. 3. 4. 5. 6. 7. , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 ............................... Excess Nonbusiness Deductions(NOL Worksheet Part II, Line 18 ) Excess of Nonbusiness Capital losses over Nonbusiness Captial gains after $3,000 Federal limitation (Federal form) Excess of Nonbusiness Capital losses over Nonbusiness Captial gains after $3,000 Federal limitation (Federal form) ................. Excess of Nonbusiness Capital losses over Nonbusiness Captial gains after $3,000 Federal limitation (Federal form) Excess of Nonbusiness Capital losses over Nonbusiness Captial gains after $3,000 Federal limitation (Federal form) Excess of Nonbusiness Capital losses over Nonbusiness Captial gains after $3,000 Federal limitation (Federal form) .......................... .... . .. Total of Lines 1-5. See instructions. Total of Lines 1-5. See instructions. .................... ....................... IRC Section 461(l) loss eligible to be carried forward only (Enter as a negative amount.) (Enter as a negative amount.)(Enter as a negative amount .) Total Loss(es). See instructions. (Must be a negative amount for a loss.) Total Loss(es). See instructions. (Must be a negative amount for a loss.) Total Loss(es). See instructions. (Must be a negative amount for a loss.)Total Loss(es). See instructions. (Must be a negative amount for a loss. ) If no, complete Part I II and attach a copy of Federal Form 1045.

Schedule 4 Georgia Form500 (Rev. 08/30/23) Schedule 4 Net Operating Loss Application 2023 (Approved booklet version) Page 2 YOUR SOCIAL SECURITY NUMBER Part II: NOL Worksheet Georgia Nonbusiness Income 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Excess of Nonbusiness Capital gains over Nonbusiness Capital losses ................... 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 Dividends ....................................................................................................................... Interest .............................................................................................................. Alimony (received) ............................................................................................ Pensions/Annuities ............................................................................................ GA adjustment for retirement exclusion ........................................................... GA adjustment for U.S. Interest ........................................................................ GA adjustment for non-Georgia municipal interest........................................... Other (specify) ................................................... Total Nonbusiness Income (Add Lines 1 - 9) ........................................................ Georgia Nonbusiness Deductions 11. 11. .................. 11. 11. ..................................... 12. 12. Contributions to self-employed 13. Alimony (paid) ................................................................................................... 13. 14. Forfeited interest/penalty on early withdrawal .................................................. 14. 15.15. Contribution to a deductible IRA.......................................................................... 15. ................................................. 16. ............................................ .... 17. 18. Excess of Nonbusiness Deductions (Line 17) less Nonbusiness Income (Line 10) Enter here and on Form 500 Net Operating Loss Application Part 1, Line 3

......... 18. 16. Other (specify) 17. 6) Total Nonbusiness Deductions (Add Lines 11-16 11-1611-1 6 ) .

(Rev. 08/30/23) Schedule 4 (Approved booklet version) (b) , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 *YEAR ENDED (a) Return as filed or liability as last determined 1. Federal adjusted gross income (exclude Federal NOL) 2. Georgia adjustments. See instructions 3. Net operating loss. See instructions 4. Georgia adjusted gross income. Net total of Lines 1, 2 and 3 5. Deductions. See instructions 6. Subtract Line 5 from Line 4 7. Exemptions. See instructions 8. Taxable income. Subtract Line 7 from Line 6 9. Income Tax 10. Credits. See instructions 11. Tax after credits. Subtract Line 10 from Line 9 12. Enter Line 11 column (b) 13. Decrease in tax. Subtract Line 12 from Line 11

Schedule 4 (Rev. 08/30/23) Schedule 4 (Approved booklet version) (b) , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 , , . 00 *YEAR ENDED (a) Return as filed or liability as last

determined 1. Federal adjusted gross income (exclude Federal NOL) 2. Georgia adjustments. See instructions 3. Net operating loss. See instructions 4. Georgia adjusted gross income. Net total of Lines 1, 2 and 3 5. Deductions. See instructions 6. Subtract Line 5 from Line 4 7. Exemptions. See instructions 8. Taxable income. Subtract Line 7 from Line 6 9. Income Tax 10. Credits. See instructions 11. Tax after credits. Subtract Line 10 from Line 9 12. Enter Line 11 column (b) 13. Decrease in tax. Subtract Line 12 from Line 11

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1 Page Form IND-CR 201 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable.– 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. , . 00 , . 00 , . 00 , . 00 1. Credit remaining from previous years............................................................................. 1. 2. 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

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

.......................................................................................................... 3. 4. Potential carryover to next tax year (Line 1 plus Line 2 less Line 3) .............................. 4.

1 Page Form IND-CR 202 State of Georgia Individual Credit Form Georgia Department of Revenue (Rev. 08/30/23) (Approved booklet version) 2023 – 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. 1. , . 00 2. Georgia allowable rate ...................................................................................... 2. 30% 3. Allowable Child & Dependent Care Expense Credit (Line 1 x .30)............................ ..................................................................................................................... 3. , . 00 , . 00 4 . Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 2) 4.

1 Page Form IND-CR 203 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – 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. , , . 00 , , . 00 , , . 00 , , . 00 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.

1 Page Form IND-CR 204 State of Georgia Individual Credit Form Georgia Department of Revenue (Rev. 08/30/23) (Approved booklet version) 2023 YOUR SOCIAL SECURITY NUMBER – 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. Qualifying Family Member Name: Name: SS# Relationship Age, if 62 or over If disabled, date of disability Additional Qualifying Family Member Name, if applicable: Name: SS# Relationship Age, if 62 or over If disabled, date of disability . 00 , 1. Qualified caregiving expenses........................................................................... ....................................................................................... ................................................................................ ............................................................................................... ...................................................................... .................................................................................................................... 1. 2. Percentage limitation 2. 10% 3. Line 1 multiplied by Line 2 3. , . 00 , . 00 , . 00

4. Maximum credit 4. 1 50. 0 0 5. Enter the lesser of Line 3 or Line 4 5. 6. Credit used this tax year (enter here and include on IND-CR Summary Worksheet

Line 4) 6.

, . 00 , . 00 , . 00 , . 00 , . 00 1 Page Form IND-CR 206 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable. – 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 1. Credit remaining from previous years............................................................ .................................................................... ................................................. ........................................................................................ ................................................................. .......................................................................................... ............................

1. 2. Date assistance was received

2. 3. Amount of the disaster assistance received 3. 4. Maximum credit 4. 500.00 5. Enter the lesser of Line 3 or Line 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 Page Form IND-CR 207 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable.

– Rural Physicians Credit - Tax Credit 207 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:

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. 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. Only enter the information for the taxpayer and/or the spouse if they are a rural physician. Taxpayer Spouse 1. County of residence 1. County of residence 2. County of practice 2. County of practice 3. Type of practice 3. Type of practice 4. Date started working as a rural physician 4. Date started working as a rural physician 5. Number of hospital beds in the rural hospital 5. Number of hospital beds in the rural hospital , , 6. Rural physicians credit, enter $5,000 per rural physician......... ..................................................... 6. , . 00 7. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 7) 7. , . 00

1 Page Form IND-CR 208 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable. – Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2008 and before January 1, 2021 - Tax Credit 208 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. 1. Credit remaining from previous years.................................................. .................................................. ................................................................................. ........................ 1. , . 00 2. Enter $2,000 per qualified foster child 2. , . 00 , . 00 , . 00 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.

1 Page Form IND-CR 209 State of Georgia Individual Credit Form Georgia Department of Revenue (Rev. 08/30/23) (Approved booklet version) 2023 YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable. – 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)Aresidence with respect towhich a foreclosure event has taken place and which isowned by themortgagor 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. 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. The taxpayer must have claimed the credit in 2009 in order to claim the unused credit below. . 00 1. 1. Total credit. (Enter amount from 2009 IND-CR, Part 9, Line 5.)............................... ................................................................................... ................................................ .................. .................................................................. ........................................................................................................................ ............................................................. , 2. Maximum allowed per year 2. 33.33% 3. Maximum credit allowed, (multiply Line 1 by Line 2) 3. , . 00 , . 00 , . 00 , . 00 , . 00 4. Enter unused credit (Total credit less amounts used in previous years) 4. 5. Credit allowed, lesser of Line 3 or Line 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.

3. 1 Page Form IND-CR 212 State of Georgia Individual Credit Form Georgia Department of Revenue (Rev. 08/30/23) (Approved booklet version) 2023 YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable. – 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 First through Third Rotation 1. Number of Rotations (enter no more than 3) (not to exceed $1,500) X ................................................... 1. , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 Fourth through Tenth Rotation 2. Number of Rotations (enter no more than 7) (not to exceed $7,000) X 1,0 00.0 0

............................................................ 2. 3. Add Line 1 and Line 2, Current Year Credit Amount (cannot exceed $8,500)............. 3. 500.00 B. Community Based Faculty Preceptor Tax Credit for an advanced practice registered nurse or physician assistant. First through Third Rotation 3 7 5. 00 1. Number of Rotations (enter no more than 3) (not to exceed $1,125) X 1.

................................................... Fourth through Tenth Rotation 750.00 2. Number of Rotations (enter no more than 7) (not to exceed $5,250) X 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. 1.

1 Page Form IND-CR 213 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable. – Adoption of a Foster Child Credit for Adoptions Occurring in Taxable Years Beginning on or After January 1, 2021- Tax Credit 213

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. 1. Enter $6,000 per qualified foster child (if in first five taxable years of the adoption) . 00 , ...................................................................................... 1. 2. Enter $2,000 per qualified foster child (for years after first five taxable years of adoption)

....................................................................... 2. . 00 , 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) . 00 , .................. 4.

1 Page Form IND-CR 214 State of Georgia Individual Credit Form Georgia Department of Revenue 2023 (Rev. 08/30/23) (Approved booklet version) YOUR SOCIAL SECURITY NUMBER – Include with Form 500 or 500X, if this schedule is applicable.– 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. , . 00 , . 00 , . 00 , . 00 , . 00 1. Credit remaining from previous year ................................................................................ .......................................................................................... . .................................. ............................................. .............................................................................................................................. ...................................................... 1. Credit generated this tax year 2. 2. 3. Total credit available (Line 1 + Line 2) 3. 4. Credit used this tax year (enter here and include on IND-CR Summary Worksheet Line 12) 4. 5. Potential carryover to next tax year (Line 3 less Line 4) 5.

Georgia Form IND-CR Summary Worksheet (Rev. 08/30/23) State of Georgia Individual Credit Form 1 Page Georgia Department of Revenue 2023 (Approved booklet version) YOUR SOCIAL SECURITY NUMBER IND-CR SUMMARY SCHEDULE WORKSHEET 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. 1. Disabled Person Home Purchase or Retrofit Credit (IND-CR 201, Line 3) ............ ........................ ............ .................................. ............................................................................................................... .................................................. ...................................................... ............................................................................................... ............................. .................. ................................ ......................... 1. 2. Child and Dependent Care Expense Credit (IND-CR 202, Line 4) 2. 3. Georgia National Guard /Air National Guard Credit (IND-CR 203, Line 3)

. 3. 4. Qualified Caregiving Expense Credit (IND-CR 204, Line 6) 4. 5. Reserved 5. 6. Disaster Assistance Credit (IND-CR 206, Line 6) 6. 7. Rural Physicians Credit (IND-CR 207, Line 7) 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) 8. 9. Eligible Single-Family Residence Credit (IND-CR 209, Line 6) 9. 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. 12. Teacher Recruitment and Retention Credit (IND-CR 214, Line 4) 12. 13. Total of Lines 1 through 12 (Enter here and on Form 500/500X, Page 3 Line 19) 13. , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 , . 00 All applicable IND-CR Schedules (201, etc.) must be attached to Form 500 or Form 500X. Keep IND-CR Summary Worksheet for your records.

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If Line 7 is larger than Line 6, subtract Line 6 from Line 7. THE AMOUNT OF YOUR OVERPAYMENT Please Please print print your your numbers numbers like like this this in in black black or or blue blue ink: ink: Georgia Form 500EZ (Rev. 05/31/23) Short Individual Income Tax Return YOUR SSN# Georgia Department of Revenue 2023 (Approved booklet version) SPOUSE’S SSN# e g a P 1 YOUR DRIVER’S LICENSE/STATE ID STATE ISSUED YOUR FIRST NAME MI LAST NAME (For Name Change See IT-511 Tax Booklet) SUFFIX SPOUSE’S FIRST NAME MI LAST NAME SUFFIX CHECK IF ADDRESS CHANGED ADDRESS (NUMBER AND STREET or P.O. BOX) (Use 2nd address line for Apt, Suite or Building Number) CITY (Please insert a space if the city has multiple names) STATE ZIP CODE (COUNTRY IF FOREIGN) DEPARTMENT USE ONLY Use Federal Adjusted Gross Income, NOT Federal Taxable Income, on Line 1 below 1. Adjusted Gross Income from Federal Form 1040 (Cannot exceed $99,999 for Line 1).......................... ............................................ ...........................................................

..................... .......................................................... ......................... ................. ........... 1. 2. If your filing status is single, enter $8,100, married filing joint, enter $14,500 2. 3. 3. Subtract Line 2 from Line 1. If Line 2 is larger than Line 1, enter zero 4. Find the tax on the amount on Line 3. (Use the Tax Rate Schedule in the IT-511 Tax Booklet) 4. 5. Low income tax credit. (Not allowed if you are claimed as a dependent on another return)

5a. 5b. 5c. 6. Subtract Line 5c from Line 4. If zero or less than zero, enter zero 6. 7. Georgia income tax withheld (Enter tax withheld only and include W-2s and 1099s) PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 3.

7. 8. If Line 6 is larger than Line 7, subtract Line 7 from Line 6. THE AMOUNT OF TAX YOU OWE 8. 9. 9. 10. Georgia Wildlife Conservation Fund (No gift less than $1.00)................................................................. ............................................................ ....................................................................... ......................................................................... ................................................................. ........................................................................ ..................................................................................... 10. 11. Georgia Fund for Children and Elderly (No gift less than $1.00) 11. 12. Georgia Cancer Research Fund (No gift less than$1.00) 12. 13. Georgia Land Conservation Program (No gift less than $1.00) 13. 14. Georgia National Guard Foundation (No gift less than $1.00) 14. 15. Dog and Cat Sterilization Fund (No gift less than $1.00) 15. 16. Saving the Cure Fund (No gift less than $1.00) 16. , .00 , .00 , .00 , .00 .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00 , .00

Georgia Form 500EZ Short Individual Income Tax Return Georgia Department of Revenue 2023 YOUR SOCIAL SECURITY NUMBER

..................... (If you owe) Add Line 8 and Line 22. Complete and mail 525-TV with return and payment Make check for this amount payable to the GEORGIA DEPARTMENT OF REVENUE Interest .................................................................................................................................................... Public Safety Memorial Grant (No gift less than $1.00)......................................................................... 17. 18. 19. 20. 21. 22. 23.. Realizing Educational Achievement Can Happen (REACH) Program

(No gift less than $1.00)......... 17. 18. 19. 20. 21. 22. 23. 24. 24. I/We declare under penalties of perjury that I/we have examined this return (including accompanying schedules and statemen

ts) 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. ALL PAGES (1-3) ARE REQUIRED FOR PROCESSING Spouse’s Signature (If you are due a refund) Subtract Line 22 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

Type: Checking

Routing Number Account Number 24a. 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 Savings

I authorize DOR to discuss this return with the named preparer. 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 Taxpayer’s Phone Number Spouse’s Signature Date , .00 , .00 , .00 , .00 , .00

Penalty: Late Payment and/or Late Filing ............................................................................................... , .00 Add Lines 10 thru

Line

21, 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.

Page 2 Disabled Veterans’ Scholarship Fund (No gift less than $1.00)............................................................. , .00

Georgia Form 500EZ Short Individual Income Tax Return Georgia Department of Revenue 2023 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 . ALL PAGES (1-3) ARE REQUIRED FOR PROCESSING (INCOME STATEMENT B)

(INCOME STATEMENT A) (INCOME STATEMENT C)

(INCOME STATEMENT E)

(INCOME STATEMENT D) (INCOME STATEMENT F)

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

EMPLOYER/PAYER STATE WITHHOLDING ID

GA WAGES / INCOME GA WAGES / INCOME

GA WAGES / INCOME

GA TAX WITHHELD GA TAX WITHHELD

GA TAX WITHHELD

1. 2. 3. 4. 5. WITHHOLDING TYPE: 1. 2. 3. 4. 5. WITHHOLDING TYPE: 1. 2. 3. 4. 5. WITHHOLDING TYPE: W-2 1099 EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN EMPLOYER/PAYER FEDERAL

ID NUMBER (FEIN) SSN EMPLOYER/PAYER FEDERAL ID NUMBER (FEIN) SSN EMPLOYER/PAYER STATE WITHHOLDING ID EMPLOYER/PAYER STATE WITHHOLDING ID

EMPLOYER/PAYER STATE WITHHOLDING ID

GA WAGES / INCOME GA WAGES / INCOME

GA WAGES / INCOME

GA TAX WITHHELD

GA TAX WITHHELD

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

THIS PAGE INTENTIONALLY LEFT BLANK

Georgia Tax Rate Schedule A taxpayer can use the tax tables starting on page 63 or the Georgia Tax Rate Schedule below. See page 60 and 61 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 Over Column B But not over Column C Column D Column E $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 Over Column B But not over Column C Column D Column E $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 Over Column B But not over Column C Column D Column E $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 59

Single

A taxpayer can use the tax tables starting on page 63 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: 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 60

The applicable portion of the Georgia Tax Rate Schedule is as follows: Married Filing Joint or Head of Household

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. 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 Page 61

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Line 15c, Form 500

, 500

,

,

or Married or

Married or

Married or

Married Line 3, Form 500EZ Jointly or Married Jointly or Married Jointly or Married Jointly or Married Head of Head of Head of Head of At But Less

At But Less

At But Less

At But Less

House- Sepa- House- Sepa- House- Sepa- House- Sepa- Than Than Than Than hold rately hold rately hold rately hold rately

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 63 3, Line 15c Form Line 15c Form 500 Line 15c Form 500 Line 3, Form Line 3, Form Line 3, Form Filing 500EZ Filing 500EZ Filing 500EZ Filing Filing Filing Filing Filing Least Least Least Least Single Single Single Single This amount should be placed on Line 16, Form 500 or Line 4, Form 500EZ GEORGIA INCOME TAX TABLE Line 15c, Form 500 or Line Form 500EZ Single Married Filing Jointly or Head of House- hold Married Filing Sepa- rately At Least 0 But Less Than $0 100 0 0 0 100 200 2 2 2 200 300 3 3 3 300 400 4 4 4 400 500 5 5 5 500 600 6 6 6 600 700 7 7 8 700 800 8 8 10 800 900 10 9 12 900 1,000 12 10 14 1,000 1,000 1,100 14 11 16 1,100 1,200 16 13 18 1,200 1,300 18 15 20 1,300 1,400 20 17 22 1,400 1,500 22 19 24 1,500 1,600 24 21 27 1,600 1,700 26 23 30 1,700 1,800 28 25 33 1,800 1,900 30 27 36 1,900 2,000 32 29 39 2,000 2,000 2,100 34 31 42 2,100 2,200 36 33 45 2,200 2,300 38 35 48 2,300 2,400 41 37 51 2,400 2,500 44 39 54 2,500 2,600 47 41 57 2,600 2,700 50 43 61 2,700 2,800 53 45 65 2,800 2,900 56 47 69 2,900 3,000 59 49 73 3,000 3,000 3,100 62 52 77 3,100 3,200 65 55 81 3,200 3,300 68 58 85 3,300 3,400 71 61 89 3,400 3,500 74 64 93 3,500 3,600 77 67 98 3,600 3,700 80 70 103 3,700 3,800 83 73 108 3,800 3,900 87 76 113 3,900 4,000 91 79 118 4,000 4,000 4,100 95 82 123 4,100 4,200 99 85 128 4,200 4,300 103 88 133 4,300 4,400 107 91 138 4,400 4,500 111 94 143 4,500 4,600 115 97 148 4,600 4,700 119 100 153 4,700 4,800 123 103 158 4,800 4,900 127 106 163 4,900 5,000 131 109 168 5,000 5,000 5,100 135 112 173 5,100 5,200 139 116 179 5,200 5,300 143 120 184 5,300 5,400 148 124 190 5,400 5,500 153 128 196 5,500 5,600 158 132 202 5,600 5,700 163 136 207 5,700 5,800 168 140 213 5,800 5,900 173 144 219 5,900 6,000 178 148 225 6,000 6,000 6,100 183 152 230 6,100 6,200 188 156 236 6,200 6,300 193 160 242 6,300 6,400 198 164 248 6,400 6,500 203 168 253 6,500 6,600 208 172 259 6,600 6,700 213 176 265 6,700 6,800 218 180 271 6,800 6,900 223 184 276 6,900 7,000 228 188 282 7,000 7,000 7,100 233 193 288 7,100 7,200 239 198 294 7,200 7,300 244 203 299 7,300 7,400 250 208 305 7,400 7,500 256 213 311 7,500 7,600 262 218 317 7,600 7,700 267 223 322 7,700 7,800 273 228 328 7,800 7,900 279 233 334 7,900 8,000 285 238 340 8,000 8,000 8,100 290 243 345 8,100 8,200 296 248 351 8,200 8,300 302 253 357 8,300 8,400 308 258 363 8,400 8,500 313 263 368 8,500 8,600 319 268 374 8,600 8,700 325 273 380 8,700 8,800 331 278 386 8,800 8,900 336 283 391 8,900 9,000 342 288 397 9,000 9,000 9,100 348 293 403 9,100 9,200 354 298 409 9,200 9,300 359 303 414 9,300 9,400 365 308 420 9,400 9,500 371 313 426 9,500 9,600 377 318 432 9,600 9,700 382 323 437 9,700 9,800 388 328 443 9,800 9,900 394 333 449 9,900 10,000 400 338 455 10,000 10,000 10,100 405 343 460 10,100 10,200 411 349 466 10,200 10,300 417 354 472 10,300 10,400 423 360 478 10,400 10,500 428 366 483 10,500 10,600 434 372 489 10,600 10,700 440 377 495 10,700 10,800 446 383 501 10,800 10,900 451 389 506 10,900 11,000 457 395 512 11,000 11,000 11,100 463 400 518 11,100 11,200 469 406 524 11,200 11,300 474 412 529 11,300 11,400 480 418 535 11,400 11,500 486 423 541 11,500 11,600 492 429 547 11,600 11,700 497 435 552 11,700 11,800 503 441 558 11,800 11,900 509 446 564 11,900 12,000 515 452 570 12,000 12,000 12,100 520 458 575 12,100 12,200 526 464 581 12,200 12,300 532 469 587 12,300 12,400 538 475 593 12,400 12,500 543 481 598 12,500 12,600 549 487 604 12,600 12,700 555 492 610 12,700 12,800 561 498 616 12,800 12,900 566 504 621 12,900 13,000 572 510 627 13,000 13,000 13,100 578 515 633 13,100 13,200 584 521 639 13,200 13,300 589 527 644 13,300 13,400 595 533 650 13,400 13,500 601 538 656 13,500 13,600 607 544 662 13,600 13,700 612 550 667 13,700 13,800 618 556 673 13,800 13,900 624 561 679 13,900 14,000 630 567 685 14,000 14,000 14,100 635 573 690 14,100 14,200 641 579 696 14,200 14,300 647 584 702 14,300 14,400 653 590 708 14,400 14,500 658 596 713 14,500 14,600 664 602 719 14,600 14,700 670 607 725 14,700 14,800 676 613 731 14,800 14,900 681 619 736 14,900 15,000 687 625 742 15,000 15,000 15,100 693 630 748 15,100 15,200 699 636 754 15,200 15,300 704 642 759 15,300 15,400 710 648 765 15,400 15,500 716 653 771 15,500 15,600 722 659 777 15,600 15,700 727 665 782 15,700 15,800 733 671 788 15,800 15,900 739 676 794 15,900 16,000 745 682 800 16,000 16,000 16,100 750 688 805 16,100 16,200 756 694 811 16,200 16,300 762 699 817 16,300 16,400 768 705 823 16,400 16,500 773 711 828 16,500 16,600 779 717 834 16,600 16,700 785 722 840 16,700 16,800 791 728 846 16,800 16,900 796 734 851 16,900 17,000 802 740 857 17,000 17,000 17,100 808 745 863 17,100 17,200 814 751 869 17,200 17,300 819 757 874 17,300 17,400 825 763 880 17,400 17,500 831 768 886 17,500 17,600 837 774 892 17,600 17,700 842 780 897 17,700 17,800 848 786 903 17,800 17,900 854 791 909 17,900 18,000 860 797 915 18,000 18,000 18,100 865 803 920 18,100 18,200 871 809 926 18,200 18,300 877 814 932 18,300 18,400 883 820 938 18,400 18,500 888 826 943 18,500 18,600 894 832 949 18,600 18,700 900 837 955 18,700 18,800 906 843 961 18,800 18,900 911 849 966 18,900 19,000 917 855 972 19,000 19,000 19,100 923 860 978 19,100 19,200 929 866 984 19,200 19,300 934 872 989 19,300 19,400 940 878 995 19,400 19,500 946 883 1,001 19,500 19,600 952 889 1,007 19,600 19,700 957 895 1,012 19,700 19,800 963 901 1,018 19,800 19,900 969 906 1,024 19,900 20,000 975 912 1,030 20,000 20,000 20,100 980 918 1,035 20,100 20,200 986 924 1,041 20,200 20,300 992 929 1,047 20,300 20,400 998 935 1,053 20,400 20,500 1,003 941 1,058 20,500 20,600 1,009 947 1,064 20,600 20,700 1,015 952 1,070 20,700 20,800 1,021 958 1,076 20,800 20,900 1,026 964 1,081 20,900 21,000 1,032 970 1,087 21,000 21,000 21,100 1,038 975 1,093 21,100 21,200 1,044 981 1,099 21,200 21,300 1,049 987 1,104 21,300 21,400 1,055 993 1,110 21,400 21,500 1,061 998 1,116 21,500 21,600 1,067 1,004 1,122 21,600 21,700 1,072 1,010 1,127 21,700 21,800 1,078 1,016 1,133 21,800 21,900 1,084 1,021 1,139 21,900 22,000 1,090 1,027 1,145 22,000 22,000 22,100 1,095 1,033 1,150 22,100 22,200 1,101 1,039 1,156 22,200 22,300 1,107 1,044 1,162 22,300 22,400 1,113 1,050 1,168 22,400 22,500 1,118 1,056 1,173 22,500 22,600 1,124 1,062 1,179 22,600 22,700 1,130 1,067 1,185 22,700 22,800 1,136 1,073 1,191 22,800 22,900 1,141 1,079 1,196 22,900 23,000 1,147 1,085 1,202 23,000 23,000 23,100 1,153 1,090 1,208 23,100 23,200 1,159 1,096 1,214 23,200 23,300 1,164 1,102 1,219 23,300 23,400 1,170 1,108 1,225 23,400 23,500 1,176 1,113 1,231 23,500 23,600 1,182 1,119 1,237 23,600 23,700 1,187 1,125 1,242 23,700 23,800 1,193 1,131 1,248 23,800 23,900 1,199 1,136 1,254 23,900 24,000 1,205 1,142 1,260 24,000 24,000 24,100 1,210 1,148 1,265 24,100 24,200 1,216 1,154 1,271 24,200 24,300 1,222 1,159 1,277 24,300 24,400 1,228 1,165 1,283 24,400 24,500 1,233 1,171 1,288 24,500 24,600 1,239 1,177 1,294 24,600 24,700 1,245 1,182 1,300 24,700 24,800 1,251 1,188 1,306 24,800 24,900 1,256 1,194 1,311 24,900 25,000 1,262 1,200 1,317 25,000 25,000 25,100 1,268 1,205 1,323 25,100 25,200 1,274 1,211 1,329 25,200 25,300 1,279 1,217 1,334 25,300 25,400 1,285 1,223 1,340 25,400 25,500 1,291 1,228 1,346 25,500 25,600 1,297 1,234 1,352 25,600 25,700 1,302 1,240 1,357 25,700 25,800 1,308 1,246 1,363 25,800 25,900 1,314 1,251 1,369 25,900 26,000 1,320 1,257 1,375 26,000 26,000 26,100 1,325 1,263 1,380 26,100 26,200 1,331 1,269 1,386 26,200 26,300 1,337 1,274 1,392 26,300 26,400 1,343 1,280 1,398 26,400 26,500 1,348 1,286 1,403 26,500 26,600 1,354 1,292 1,409 26,600 26,700 1,360 1,297 1,415 26,700 26,800 1,366 1,303 1,421 26,800 26,900 1,371 1,309 1,426 26,900 27,000 1,377 1,315 1,432 27,000 27,000 27,100 1,383 1,320 1,438 27,100 27,200 1,389 1,326 1,444 27,200 27,300 1,394 1,332 1,449 27,300 27,400 1,400 1,338 1,455 27,400 27,500 1,406 1,343 1,461 27,500 27,600 1,412 1,349 1,467 27,600 27,700 1,417 1,355 1,472 27,700 27,800 1,423 1,361 1,478 27,800 27,900 1,429 1,366 1,484 27,900 28,000 1,435 1,372 1,490 28,000 28,000 28,100 1,440 1,378 1,495 28,100 28,200 1,446 1,384 1,501 28,200 28,300 1,452 1,389 1,507 28,300 28,400 1,458 1,395 1,513 28,400 28,500 1,463 1,401 1,518 28,500 28,600 1,469 1,407 1,524 28,600 28,700 1,475 1,412 1,530 28,700 28,800 1,481 1,418 1,536 28,800 28,900 1,486 1,424 1,541 28,900 29,000 1,492 1,430 1,547 29,000 29,000 29,100 1,498 1,435 1,553 29,100 29,200 1,504 1,441 1,559 29,200 29,300 1,509 1,447 1,564 29,300 29,400 1,515 1,453 1,570 29,400 29,500 1,521 1,458 1,576 29,500 29,600 1,527 1,464 1,582 29,600 29,700 1,532 1,470 1,587 29,700 29,800 1,538 1,476 1,593 29,800 29,900 1,544 1,481 1,599 29,900 30,000 1,550 1,487 1,605 30,000 30,000 30,100 1,555 1,493 1,610 30,100 30,200 1,561 1,499 1,616 30,200 30,300 1,567 1,504 1,622 30,300 30,400 1,573 1,510 1,628 30,400 30,500 1,578 1,516 1,633 30,500 30,600 1,584 1,522 1,639 30,600 30,700 1,590 1,527 1,645 30,700 30,800 1,596 1,533 1,651 30,800 30,900 1,601 1,539 1,656 30,900 31,000 1,607 1,545 1,662 31,000 31,000 31,100 1,613 1,550 1,668 31,100 31,200 1,619 1,556 1,674 31,200 31,300 1,624 1,562 1,679 31,300 31,400 1,630 1,568 1,685 31,400 31,500 1,636 1,573 1,691 31,500 31,600 1,642 1,579 1,697 31,600 31,700 1,647 1,585 1,702 31,700 31,800 1,653 1,591 1,708 31,800 31,900 1,659 1,596 1,714 31,900 32,000 1,665 1,602 1,720 32,000 32,000 32,100 1,670 1,608 1,725 32,100 32,200 1,676 1,614 1,731 32,200 32,300 1,682 1,619 1,737 32,300 32,400 1,688 1,625 1,743 32,400 32,500 1,693 1,631 1,748 32,500 32,600 1,699 1,637 1,754 32,600 32,700 1,705 1,642 1,760 32,700 32,800 1,711 1,648 1,766 32,800 32,900 1,716 1,654 1,771 32,900 33,000 1,722 1,660 1,777 33,000 33,000 33,100 1,728 1,665 1,783 33,100 33,200 1,734 1,671 1,789 33,200 33,300 1,739 1,677 1,794 33,300 33,400 1,745 1,683 1,800 33,400 33,500 1,751 1,688 1,806 33,500 33,600 1,757 1,694 1,812 33,600 33,700 1,762 1,700 1,817 33,700 33,800 1,768 1,706 1,823 33,800 33,900 1,774 1,711 1,829 33,900 34,000 1,780 1,717 1,835 34,000 34,000 34,100 1,785 1,723 1,840 34,100 34,200 1,791 1,729 1,846 34,200 34,300 1,797 1,734 1,852 34,300 34,400 1,803 1,740 1,858 34,400 34,500 1,808 1,746 1,863 34,500 34,600 1,814 1,752 1,869 34,600 34,700 1,820 1,757 1,875 34,700 34,800 1,826 1,763 1,881 34,800 34,900 1,831 1,769 1,886 34,900 35,000 1,837 1,775 1,892

This placed on Form 500 or 4, Form GEORGIA TAX Line 15c, 500 or Line Jointly or of hold Filing rately Line 15c, or Jointly or of hold Filing rately Line 15c, or Line Jointly or of hold Filing rately Line 15c, or Line Jointly or of hold Filing rately Line 15c, or Line Jointly or of hold Filing rately At But At But Than At But At But At But

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

This amount should be placed on Line 16, Form or Line 4, Form GEORGIA INCOME Line 15c, Form 500 or Line 3, Form Single Married Jointly or Head of hold Married Filing rately Line , Form 500 or Line 3, Form Single Married Jointly or Head of hold Married Filing rately Line 15c, Form or Line 3, Form Single Married Jointly or Head of hold Married Filing rately Line 15c, Form 500 or Line 3, Form Single Married Jointly or Head of hold Married Filing rately Line 15c, Form or Line 3, Form 500EZ Single Married Jointly or Head of hold Married Filing rately At Least But At But Less Than At Least But Less At Least But Less At Least But Page 65 $100,000####### 500 500EZ TAX 500EZ Filing House- Sepa- 15c 500EZ Filing House- Sepa- 500 500EZ Filing House- Sepa- 500EZ Filing House- Sepa- 500 Filing House- Sepa- Less Than Least Than Than Less Than 70,000 70,000 70,100 3,855 3,793 3,910 70,100 70,200 3,861 3,799 3,916 70,200 70,300 3,867 3,804 3,922 70,300 70,400 3,873 3,810 3,928 70,400 70,500 3,878 3,816 3,933 70,500 70,600 3,884 3,822 3,939 70,600 70,700 3,890 3,827 3,945 70,700 70,800 3,896 3,833 3,951 70,800 70,900 3,901 3,839 3,956 70,900 71,000 3,907 3,845 3,962 71,000 71,000 71,100 3,913 3,850 3,968 71,100 71,200 3,919 3,856 3,974 71,200 71,300 3,924 3,862 3,979 71,300 71,400 3,930 3,868 3,985 71,400 71,500 3,936 3,873 3,991 71,500 71,600 3,942 3,879 3,997 71,600 71,700 3,947 3,885 4,002 71,700 71,800 3,953 3,891 4,008 71,800 71,900 3,959 3,896 4,014 71,900 72,000 3,965 3,902 4,020 72,000 72,000 72,100 3,970 3,908 4,025 72,100 72,200 3,976 3,914 4,031 72,200 72,300 3,982 3,919 4,037 72,300 72,400 3,988 3,925 4,043 72,400 72,500 3,993 3,931 4,048 72,500 72,600 3,999 3,937 4,054 72,600 72,700 4,005 3,942 4,060 72,700 72,800 4,011 3,948 4,066 72,800 72,900 4,016 3,954 4,071 72,900 73,000 4,022 3,960 4,077 73,000 73,000 73,100 4,028 3,965 4,083 73,100 73,200 4,034 3,971 4,089 73,200 73,300 4,039 3,977 4,094 73,300 73,400 4,045 3,983 4,100 73,400 73,500 4,051 3,988 4,106 73,500 73,600 4,057 3,994 4,112 73,600 73,700 4,062 4,000 4,117 73,700 73,800 4,068 4,006 4,123 73,800 73,900 4,074 4,011 4,129 73,900 74,000 4,080 4,017 4,135 74,000 74,000 74,100 4,085 4,023 4,140 74,100 74,200 4,091 4,029 4,146 74,200 74,300 4,097 4,034 4,152 74,300 74,400 4,103 4,040 4,158 74,400 74,500 4,108 4,046 4,163 74,500 74,600 4,114 4,052 4,169 74,600 74,700 4,120 4,057 4,175 74,700 74,800 4,126 4,063 4,181 74,800 74,900 4,131 4,069 4,186 74,900 75,000 4,137 4,075 4,192 75,000 75,000 75,100 4,143 4,080 4,198 75,100 75,200 4,149 4,086 4,204 75,200 75,300 4,154 4,092 4,209 75,300 75,400 4,160 4,098 4,215 75,400 75,500 4,166 4,103 4,221 75,500 75,600 4,172 4,109 4,227 75,600 75,700 4,177 4,115 4,232 75,700 75,800 4,183 4,121 4,238 75,800 75,900 4,189 4,126 4,244 75,900 76,000 4,195 4,132 4,250 76,000 76,000 76,100 4,200 4,138 4,255 76,100 76,200 4,206 4,144 4,261 76,200 76,300 4,212 4,149 4,267 76,300 76,400 4,218 4,155 4,273 76,400 76,500 4,223 4,161 4,278 76,500 76,600 4,229 4,167 4,284 76,600 76,700 4,235 4,172 4,290 76,700 76,800 4,241 4,178 4,296 76,800 76,900 4,246 4,184 4,301 76,900 77,000 4,252 4,190 4,307 77,000 77,000 77,100 4,258 4,195 4,313 77,100 77,200 4,264 4,201 4,319 77,200 77,300 4,269 4,207 4,324 77,300 77,400 4,275 4,213 4,330 77,400 77,500 4,281 4,218 4,336 77,500 77,600 4,287 4,224 4,342 77,600 77,700 4,292 4,230 4,347 77,700 77,800 4,298 4,236 4,353 77,800 77,900 4,304 4,241 4,359 77,900 78,000 4,310 4,247 4,365 78,000 78,000 78,100 4,315 4,253 4,370 78,100 78,200 4,321 4,259 4,376 78,200 78,300 4,327 4,264 4,382 78,300 78,400 4,333 4,270 4,388 78,400 78,500 4,338 4,276 4,393 78,500 78,600 4,344 4,282 4,399 78,600 78,700 4,350 4,287 4,405 78,700 78,800 4,356 4,293 4,411 78,800 78,900 4,361 4,299 4,416 78,900 79,000 4,367 4,305 4,422 79,000 79,000 79,100 4,373 4,310 4,428 79,100 79,200 4,379 4,316 4,434 79,200 79,300 4,384 4,322 4,439 79,300 79,400 4,390 4,328 4,445 79,400 79,500 4,396 4,333 4,451 79,500 79,600 4,402 4,339 4,457 79,600 79,700 4,407 4,345 4,462 79,700 79,800 4,413 4,351 4,468 79,800 79,900 4,419 4,356 4,474 79,900 80,000 4,425 4,362 4,480 80,000 80,000 80,100 4,430 4,368 4,485 80,100 80,200 4,436 4,374 4,491 80,200 80,300 4,442 4,379 4,497 80,300 80,400 4,448 4,385 4,503 80,400 80,500 4,453 4,391 4,508 80,500 80,600 4,459 4,397 4,514 80,600 80,700 4,465 4,402 4,520 80,700 80,800 4,471 4,408 4,526 80,800 80,900 4,476 4,414 4,531 80,900 81,000 4,482 4,420 4,537 81,000 81,000 81,100 4,488 4,425 4,543 81,100 81,200 4,494 4,431 4,549 81,200 81,300 4,499 4,437 4,554 81,300 81,400 4,505 4,443 4,560 81,400 81,500 4,511 4,448 4,566 81,500 81,600 4,517 4,454 4,572 81,600 81,700 4,522 4,460 4,577 81,700 81,800 4,528 4,466 4,583 81,800 81,900 4,534 4,471 4,589 81,900 82,000 4,540 4,477 4,595 82,000 82,000 82,100 4,545 4,483 4,600 82,100 82,200 4,551 4,489 4,606 82,200 82,300 4,557 4,494 4,612 82,300 82,400 4,563 4,500 4,618 82,400 82,500 4,568 4,506 4,623 82,500 82,600 4,574 4,512 4,629 82,600 82,700 4,580 4,517 4,635 82,700 82,800 4,586 4,523 4,641 82,800 82,900 4,591 4,529 4,646 82,900 83,000 4,597 4,535 4,652 83,000 83,000 83,100 4,603 4,540 4,658 83,100 83,200 4,609 4,546 4,664 83,200 83,300 4,614 4,552 4,669 83,300 83,400 4,620 4,558 4,675 83,400 83,500 4,626 4,563 4,681 83,500 83,600 4,632 4,569 4,687 83,600 83,700 4,637 4,575 4,692 83,700 83,800 4,643 4,581 4,698 83,800 83,900 4,649 4,586 4,704 83,900 84,000 4,655 4,592 4,710 84,000 84,000 84,100 4,660 4,598 4,715 84,100 84,200 4,666 4,604 4,721 84,200 84,300 4,672 4,609 4,727 84,300 84,400 4,678 4,615 4,733 84,400 84,500 4,683 4,621 4,738 84,500 84,600 4,689 4,627 4,744 84,600 84,700 4,695 4,632 4,750 84,700 84,800 4,701 4,638 4,756 84,800 84,900 4,706 4,644 4,761 84,900 85,000 4,712 4,650 4,767 85,000 85,000 85,100 4,718 4,655 4,773 85,100 85,200 4,724 4,661 4,779 85,200 85,300 4,729 4,667 4,784 85,300 85,400 4,735 4,673 4,790 85,400 85,500 4,741 4,678 4,796 85,500 85,600 4,747 4,684 4,802 85,600 85,700 4,752 4,690 4,807 85,700 85,800 4,758 4,696 4,813 85,800 85,900 4,764 4,701 4,819 85,900 86,000 4,770 4,707 4,825 86,000 86,000 86,100 4,775 4,713 4,830 86,100 86,200 4,781 4,719 4,836 86,200 86,300 4,787 4,724 4,842 86,300 86,400 4,793 4,730 4,848 86,400 86,500 4,798 4,736 4,853 86,500 86,600 4,804 4,742 4,859 86,600 86,700 4,810 4,747 4,865 86,700 86,800 4,816 4,753 4,871 86,800 86,900 4,821 4,759 4,876 86,900 87,000 4,827 4,765 4,882 87,000 87,000 87,100 4,833 4,770 4,888 87,100 87,200 4,839 4,776 4,894 87,200 87,300 4,844 4,782 4,899 87,300 87,400 4,850 4,788 4,905 87,400 87,500 4,856 4,793 4,911 87,500 87,600 4,862 4,799 4,917 87,600 87,700 4,867 4,805 4,922 87,700 87,800 4,873 4,811 4,928 87,800 87,900 4,879 4,816 4,934 87,900 88,000 4,885 4,822 4,940 88,000 88,000 88,100 4,890 4,828 4,945 88,100 88,200 4,896 4,834 4,951 88,200 88,300 4,902 4,839 4,957 88,300 88,400 4,908 4,845 4,963 88,400 88,500 4,913 4,851 4,968 88,500 88,600 4,919 4,857 4,974 88,600 88,700 4,925 4,862 4,980 88,700 88,800 4,931 4,868 4,986 88,800 88,900 4,936 4,874 4,991 88,900 89,000 4,942 4,880 4,997 89,000 89,000 89,100 4,948 4,885 5,003 89,100 89,200 4,954 4,891 5,009 89,200 89,300 4,959 4,897 5,014 89,300 89,400 4,965 4,903 5,020 89,400 89,500 4,971 4,908 5,026 89,500 89,600 4,977 4,914 5,032 89,600 89,700 4,982 4,920 5,037 89,700 89,800 4,988 4,926 5,043 89,800 89,900 4,994 4,931 5,049 89,900 90,000 5,000 4,937 5,055 90,000 90,000 90,100 5,005 4,943 5,060 90,100 90,200 5,011 4,949 5,066 90,200 90,300 5,017 4,954 5,072 90,300 90,400 5,023 4,960 5,078 90,400 90,500 5,028 4,966 5,083 90,500 90,600 5,034 4,972 5,089 90,600 90,700 5,040 4,977 5,095 90,700 90,800 5,046 4,983 5,101 90,800 90,900 5,051 4,989 5,106 90,900 91,000 5,057 4,995 5,112 91,000 91,000 91,100 5,063 5,000 5,118 91,100 91,200 5,069 5,006 5,124 91,200 91,300 5,074 5,012 5,129 91,300 91,400 5,080 5,018 5,135 91,400 91,500 5,086 5,023 5,141 91,500 91,600 5,092 5,029 5,147 91,600 91,700 5,097 5,035 5,152 91,700 91,800 5,103 5,041 5,158 91,800 91,900 5,109 5,046 5,164 91,900 92,000 5,115 5,052 5,170 92,000 92,000 92,100 5,120 5,058 5,175 92,100 92,200 5,126 5,064 5,181 92,200 92,300 5,132 5,069 5,187 92,300 92,400 5,138 5,075 5,193 92,400 92,500 5,143 5,081 5,198 92,500 92,600 5,149 5,087 5,204 92,600 92,700 5,155 5,092 5,210 92,700 92,800 5,161 5,098 5,216 92,800 92,900 5,166 5,104 5,221 92,900 93,000 5,172 5,110 5,227 93,000 93,000 93,100 5,178 5,115 5,233 93,100 93,200 5,184 5,121 5,239 93,200 93,300 5,189 5,127 5,244 93,300 93,400 5,195 5,133 5,250 93,400 93,500 5,201 5,138 5,256 93,500 93,600 5,207 5,144 5,262 93,600 93,700 5,212 5,150 5,267 93,700 93,800 5,218 5,156 5,273 93,800 93,900 5,224 5,161 5,279 93,900 94,000 5,230 5,167 5,285 94,000 94,000 94,100 5,235 5,173 5,290 94,100 94,200 5,241 5,179 5,296 94,200 94,300 5,247 5,184 5,302 94,300 94,400 5,253 5,190 5,308 94,400 94,500 5,258 5,196 5,313 94,500 94,600 5,264 5,202 5,319 94,600 94,700 5,270 5,207 5,325 94,700 94,800 5,276 5,213 5,331 94,800 94,900 5,281 5,219 5,336 94,900 95,000 5,287 5,225 5,342 95,000 95,000 95,100 5,293 5,230 5,348 95,100 95,200 5,299 5,236 5,354 95,200 95,300 5,304 5,242 5,359 95,300 95,400 5,310 5,248 5,365 95,400 95,500 5,316 5,253 5,371 95,500 95,600 5,322 5,259 5,377 95,600 95,700 5,327 5,265 5,382 95,700 95,800 5,333 5,271 5,388 95,800 95,900 5,339 5,276 5,394 95,900 96,000 5,345 5,282 5,400 96,000 96,000 96,100 5,350 5,288 5,405 96,100 96,200 5,356 5,294 5,411 96,200 96,300 5,362 5,299 5,417 96,300 96,400 5,368 5,305 5,423 96,400 96,500 5,373 5,311 5,428 96,500 96,600 5,379 5,317 5,434 96,600 96,700 5,385 5,322 5,440 96,700 96,800 5,391 5,328 5,446 96,800 96,900 5,396 5,334 5,451 96,900 97,000 5,402 5,340 5,457 97,000 97,000 97,100 5,408 5,345 5,463 97,100 97,200 5,414 5,351 5,469 97,200 97,300 5,419 5,357 5,474 97,300 97,400 5,425 5,363 5,480 97,400 97,500 5,431 5,368 5,486 97,500 97,600 5,437 5,374 5,492 97,600 97,700 5,442 5,380 5,497 97,700 97,800 5,448 5,386 5,503 97,800 97,900 5,454 5,391 5,509 97,900 98,000 5,460 5,397 5,515 98,000 98,000 98,100 5,465 5,403 5,520 98,100 98,200 5,471 5,409 5,526 98,200 98,300 5,477 5,414 5,532 98,300 98,400 5,483 5,420 5,538 98,400 98,500 5,488 5,426 5,543 98,500 98,600 5,494 5,432 5,549 98,600 98,700 5,500 5,437 5,555 98,700 98,800 5,506 5,443 5,561 98,800 98,900 5,511 5,449 5,566 98,900 99,000 5,517 5,455 5,572 99,000 99,000 99,100 5,523 5,460 5,578 99,100 99,200 5,529 5,466 5,584 99,200 99,300 5,534 5,472 5,589 99,300 99,400 5,540 5,478 5,595 99,400 99,500 5,546 5,483 5,601 99,500 99,600 5,552 5,489 5,607 99,600 99,700 5,557 5,495 5,612 99,700 99,800 5,563 5,501 5,618 99,800 99,900 5,569 5,506 5,624 99,900 100,000 5,575 5,512 5,630 $100,000 or over 5,578 5,515 5,633 Plus 5.75% of the amount over 100,000 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.

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