Form 500 - Individual Income Tax Return (2007) - Georgia Department Of Revenue Page 4
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500
Georgia Form
Individual Income Tax Return
Georgia Department of Revenue
2007
YOUR SOCIAL SECURITY NUMBER
SCHEDULE 1 ADJUSTMENTS to INCOME BASED on GEORGIA LAW
(see Tax Booklet on Pages7 and 8)
ADDITIONS to INCOME
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,
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00
1. Interest on Non-Georgia Municipal and State Bonds.....................................
1.
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00
2.
2. Lump Sum Distributions.................................................................................
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00
3.
3. Federal deduction for income attributable to domestic production activities.....
(IRC Section 199)
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4.
4. Other (specify)
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5. Total Additions (enter sum of Lines 1-4 here)..............................................
5.
SUBTRACTION from INCOME
6. Retirement Income Exclusion (see Tax Booklet on Page 12)
a. Self: Date of Birth
Date of Disability:
Type of Disability:
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00
6a.
Date of Disability:
b. Spouse: Date of Birth
Type of Disability:
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6b.
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7. Social Security Benefits (Taxable portion from Federal return)....................
7.
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8. Georgia Higher Education Savings Plan........................................................
8.
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9. Interest on United States Obligations (See Tax Booklet on Page 7) .............
9.
10. Other Adjustments (specify)
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Adjustment
Amount
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Adjustment
Amount
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Adjustment
Amount
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Adjustment
Amount
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00
10.
Total...............................
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11. Total Subtractions (enter sum of Lines 6-10 here)..........................................
11.
12. Net Adjustments (Line 5 less Line 11.
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Enter Net Total here and on Line 9 of Page 2)(+ or -)...................................
12.
Page 4
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