Form 500 - Individual Income Tax Return - 2000
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4GEORGIA FORM 500
INDIVIDUAL INCOME TAX RETURN
2000
DEPARTMENT USE ONLY
Page 1
DEPARTMENT USE ONLY
Mo.
Day
Yr.
Fiscal Year
Mo.
Day
Yr.
Misc.
Del
Ext
Beginning:
Ending:
YOUR FIRST NAME
INITIAL
YOUR SOCIAL SECURITY NUMBER
L
Check box if you are using
A
YOUR LAST NAME
SUFFIX
a Software Program OR if
B
you do not want a booklet
E
SPOUSE’S SOCIAL SECURITY NUMBER
SPOUSE’S FIRST NAME
INITIAL
L
next year.
USE BLACK INK ONLY
SPOUSE’S LAST NAME
SUFFIX
CHECK IF
FOREIGN ADDRESS
ADDRESS LINE 2 OR APARTMENT NUMBER
ADDRESS LINE 1
Change of
Address
2.
ZIP CODE
CITY
STATE
COUNTRY IF FOREIGN
3.
Use one number only and enter in the Residency Code box. PART-YEAR RESIDENTS AND NONRESIDENTS MUST
RESIDENCY
4.
OMIT LINES 9 THROUGH 14 AND USE SCHEDULE 3 OF FORM 500, PAGE 4.
CODE NUMBER
2. PART-YEAR RESIDENT FROM
1. FULL-YEAR RESIDENT
TO
3. NONRESIDENT
FILING
5.
Fill in Filing Status Block with appropriate letter. (Must be same status as used on your Federal Return.)
STATUS
C. MARRIED FILING SEPARATE (Spouse’s social security no. must be entered above)
A. SINGLE
B. MARRIED FILING JOINT
D. HEAD OF HOUSEHOLD OR QUALIFYING WIDOW(ER)
Number of Exemptions from Federal Form 1040 or 1040A (see instructions)............................................................
6.
Dependents:
Dependent’s
Dependent’s
relationship to you
First Name
social security number
Last
If more than four
7.
dependents,
attach a list
IF AMOUNT ON LINE 8, 9, 10, 13, OR 15 IS NEGATIVE, FILL IN CIRCLE. EXAMPLE:
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.
9.
Adjustments from Schedule 1. (See instructions on Page 7, Line 9).....................
,
,
.
Georgia adjusted gross income (Net total of Line 8 and Line 9).............................
10.
10.
,
,
.
STANDARD Deduction (SEE INSTRUCTIONS - LINE 11)
11.
Use EITHER
Do not use Federal Standard Deduction.
,
11a
Line 11c or Line 12
b. Are YOU 65
SPOUSE 65
(DO NOT WRITE ON BOTH)
,
blind
blind
or over
x 1,300 = ...
11b
or over
11c
c. TOTAL STANDARD deduction (Line 11a + Line 11b)...........................................................
0
0
,
.
12.
TOTAL ITEMIZED deductions used in computing Federal taxable income
12=
,
,
.
Schedule A-Form 1040
Less: See Line 12 instructions
For Department Use Only
ELECTRONIC FILING MAY SPEED YOUR REFUND BY 8 WEEKS
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