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Georgia Form IT-QEE-TP1
(Last Rev. 6/12)
Please print your numbers like this in black or blue ink:
Qualified Education Expense Credit Preapproval Form
Georgia Department of Revenue
Version 2
This form is the first step in applying for the income tax credit for qualified education expenses. The
form is filed by the taxpayer and is used to request preapproval of an intended contribution
to a student scholarship organization.
Enter for Contributor:
SUBCHAPTER S CORPORATION FOR
INDIVIDUAL FILING SINGLE
INDIVIDUAL FILING A
C CORPORATION
INDIVIDUAL FILING MARRIED
GEORGIA PURPOSES, PARTNERSHIP,
OR HEAD OF HOUSEHOLD
MARRIED JOINT RETURN
OR FIDUCIARY
SEPARATE RETURN
O
R
I L
M
T I
E
D
L
A I
B
L I
T I
Y
C
O
M
P
A
N
Y
FIRST NAME OR NAME OF ENTITY
MI
TAXPAYER IDENTIFICATION NUMBER
DEPARTMENT USE ONLY
LAST NAME IF INDIVIDUAL
SUFFIX
IF INDIVIDUAL FILING JOINT, FIRST NAME OF JOINT FILER
MI
IF INDIVIDUAL FILING JOINT, I.D # OF JOINT FILER
LAST NAME OF JOINT FILER
SUFFIX
ADDRESS (NUMBER AND STREET or P.O. BOX)
CITY
STATE
ZIP CODE
CALENDAR YEAR IN WHICH
TAX YEAR END OF CONTRIBUTOR
CONTRIBUTION WILL BE MADE
TELEPHONE NUMBER
CONTACT PERSON (FOR CONTRIBUTIONS BY ENTITIES)
The contribution must be preapproved by the end of the calendar year. Also, the donation must be made within 60 days of the
date of the preapproval notice or by the end of the calendar year in which it was preapproved, whichever is earlier.
The taxpayer must add back to Georgia taxable income the amount of any federal charitable contribution deduction taken
on a federal return for which a Georgia qualified education expense credit is allowed.
The tax credit shall not be allowed if the taxpayer designates the taxpayer’s qualified education expense for a particular
individual.
The student scholarship organization must be on the Department of Education’s website before this form is filed.
A. CONTRIBUTION AMOUNT
.
,
,
00
1. The amount of the contribution the taxpayer intends to make.....
. 2
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corporation's or fiduciary's estimated income tax liability.....................
3. Name of student scholarship organization listed on the Department of Education’s website.
4. Taxpayer I.D.# of student scholarship organization.....................