STATE OF GEORGIA
Department of Revenue
Related Member Intangible Expenses and Costs and
Interest Expenses and Costs
IT-Addback (12/08)
A.
Taxpayer Information
____________________________________________________________________________________________
Taxpayer Name
Taxpayer Address
____________________________________________________________________________________________
Federal Identification Number
Taxable Year (Beginning & End)
Note: Regulation 560-7-3-.05(2) requires that the taxpayer add back related member costs to
income prior to claiming any exception to the addback.
B.
Addback
1.
Related member intangible expenses and costs, and interest expenses and
1.
costs required to be added back pursuant to Code § 48-7-28.3 and Regulation
560-7-3-.05. Enter amount here and on the applicable line of the tax return
in the Georgia “additions to federal taxable income” section.
C.
Exception for Income Allocated or Apportioned to and Taxed by Georgia or Another State.
(For additional information, please see subsection (d) of Code § 48-7-28.3 and paragraph (5) of
Regulation 560-7-3-.05).
Attach a separate schedule for each related member.
1.
Name of the related member.
1.
2.
Federal Identification Number of the related member.
2.
3.
Amount of the related member costs taxpayer paid directly or indirectly
3.
to such related member.
4.
Name of each state to whom net income tax was paid by the related member on a tax base which included
the related member costs. Do not include jurisdictions in which the related member costs are subject to
elimination.
a
b
c
d
(Attach a schedule if there are more than four states with respect to questions 4 through 9).
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