Georgia Form 500 -Individual Income Tax Return - 1999
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4GEORGIA FORM 500
INDIVIDUAL INCOME TAX RETURN
1999
Page 1
Fiscal Year
/
/
Beginning:
/
/
Ending:
Mo.
Day
Yr.
YOUR FIRST NAME
INITIAL
YOUR SOCIAL SECURITY NUMBER
-
-
L
L
DEPARTMENT USE ONLY
A
A
YOUR LAST NAME
SUFFIX
B
B
E
E
L
L
DEPARTMENT USE ONLY
SPOUSE’S SOCIAL SECURITY NUMBER
SPOUSE’S FIRST NAME
INITIAL
Del
Ext
-
-
SPOUSE’S LAST NAME
SUFFIX
USE BLACK INK ONLY
CHECK IF
FOREIGN ADDRESS
2. ADDRESS LINE 1
ADDRESS LINE 2 OR APARTMENT NUMBER
3. CITY
STATE
ZIP CODE
COUNTRY IF FOREIGN
-
ELECTRONIC FILING MAY SPEED YOUR REFUND BY 8 WEEKS
4. Use one number only and enter in the Residency Code box. PART YEAR RESIDENTS AND NONRESIDENTS MUST
RESIDENCY
CODE NUMBER
OMIT LINES 9 THROUGH 14 OF STEPS 3 AND 4 AND USE SCHEDULE 3 OF FORM 500, PAGE 4.
1. FULL-YEAR RESIDENT
2. PART-YEAR RESIDENT FROM
TO
3. NONRESIDENT
5. Fill in Filing Status Block with appropriate letter. (Must be same status as used on your Federal Return.)
FILING
STATUS
A. SINGLE
C. MARRIED FILING SEPARATE, SPOUSE’S SOCIAL SECURITY NO. MUST BE ENTERED ABOVE
B. MARRIED FILING JOINT
D. HEAD OF HOUSEHOLD OR QUALIFYING WIDOW(ER)
6..
Number of Exemptions from Federal Form 1040 or 1040A (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dependents:
Dependent’s
Dependent’s
First name
Last name
social security number
relationship to you
7.
If more than six
dependents,
attach schedule
If the amount on line 8 is $40,000 or more, or your adjusted gross income is less than your W-2s, you are
required to attach a copy of your Federal 1040 pages 1 and 2. Do not attach other Federal Schedules.
,
,
.
8. Federal adjusted gross income (From Federal Form 1040 or 1040A or 1040EZ) . . . . . . . . . . . . . . . . . . . . ➤
8
Do not use Federal Taxable Income.
,
,
.
9. Adjustments from Schedule 1. (See instructions on page 7, Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ➤
9
,
,
.
10. Georgia adjusted gross income (Net total of Line 8 and Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
,
Use EITHER
11. STANDARD Deduction (SEE INSTRUCTIONS-Line 11)
11a
Do not use Federal Standard Deduction.
Line 11c or Line 12
,
b. Are YOU 65 or over
blind
SPOUSE 65 or over
blind
x 1,300= . . .
(DO NOT WRITE ON BOTH)
11b
,
,
.
c. TOTAL STANDARD deduction (Line 11a + Line 11b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ➤
0 0
11c
12. TOTAL ITEMIZED deductions used in computing federal taxable income . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
➤
Schedule A-form 1040
Less: See Line 12 instructions Page 8
12=
,
,
.
13. Subtract either Line 11c or Line 12 from Line 10; enter balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
,
,
.
14. Number from block on Line 6_____multiplied by $2,700 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ➤
14
,
,
.
15. Georgia taxable income (Line 13 less Line 14 or Line 14, Schedule 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . ➤
15
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