Georgia Form 500 -Individual Income Tax Return

Georgia Form 500 -Individual Income Tax Return - 1999 Page 4

Page 4 Form 500 1999 Schedule

Social Security Number:

SCHEDULE 3 COMPUTATION OF GEORGIA TAXABLE INCOME FOR PART-YEAR RESIDENTS AND NONRESIDENTS

Income earned in another state as a Georgia resident is taxable. See other state credit, page 8, line 17, and page 11.

DO NOT USE LINES 9 THROUGH 14-PAGE 1, FORM 500

Federal Income

Income Not Taxable

Georgia Income

as shown on Return

to Georgia

COLUMN A

COLUMN B

COLUMN C

1. Wages, Salaries, Tips, Etc.. . . . . . . . . . . . . . . . . .

2. Interest and Dividends . . . . . . . . . . . . . . . . . . . . .

3. Business Income or (loss) . . . . . . . . . . . . . . . . . .

4. Other Income or (loss) . . . . . . . . . . . . . . . . . . . . .

5. Total Income: Total Lines 1 through 4 . . . . . . . . .

Adjustments to Income:

6. Total from Federal Form 1040 . . . . . . . . . . . . . . .

7. Total from Form 500 Schedule 1 page 3

(see instructions Line 9, page 7) . . . . . . . . . . . . .

8. Adjusted Gross Income:

Line 5 plus or minus Lines 6 and 7 . . . . . . . . . . .

9. RATIO: Divide Line 8, Column C by Line 8 Column A.

Not to exceed 100%

Enter percentage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10. Itemized or Standard Deduction

(see instructions for Line 10, page 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. Personal Exemption from form 500 page 1, line 6, multiplied by $2700 . . . .

12. Total Deductions and Exemptions: Add Lines 10 and 11 . . . . . . . . . . . . . . .

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

14. Georgia Taxable Income: Subtract Line 13 from Line 8, Column C

Enter here and on Line 15, Page 1 of Form 500 . . . . . . . . . . . . . . . .

Georgia Public Revenue Code Section 48-2-31 stipulates that taxes shall be paid in lawful money of the United States, free of any

expense to the State of Georgia.

Georgia Form 500 -Individual Income Tax Return - 1999 Page 4