Clear
Print
MailingAddress:
Georgia Department of Revenue
600-T
Rev. 8/12)
Georgia Form
(
Processing Center
Exempt Organization
P.O. Box 740397
Unrelated Business Income Tax Return
Atlanta, Georgia 30374-0397
Page 1
Amended due to IRS changes
Address Change
Amended
UET Annualization Exception attached
Exempt Organization Unrelated Business Income Tax Return
2 0
(Under Georgia Code Section 48-7-25)
For the taxable year beginning ______________________, 20_______ and ending ______________________ , 20_______
Name of Organization
Name of Fiduciary
Federal Employer ID No. (in case of employees’
trust described in section 401 (a) and exempt under
section 501 (a), insert the trust’s identification number.)
Number and Street
Number and Street
City or Town
City or Town
Date of current
IRS code section
NAICS Code
exemption letter.
for which you are
exempt.
State
Zip Code
State
Zip Code
SCHEDULE 1
1.
1. Unrelated business taxable income from Federal Form 990-T (attach copy).........
2. Additions ...............................................................................................................
2.
3. Total (add line 1 and line 2) ................................................................................
3.
4. Subtractions ........................................................................................................
4.
5. Georgia unrelated business taxable income (line 3 less line 4) ............................
5.
COMPUTATION OF GEORGIA UNRELATED BUSINESS INCOME TAX
SCHEDULE 2
1.
1. Line 5, above, multiplied by 6% ...........................................................................
2.
2. Less: Credits and Payments .................................................................................
3.
3. Withholding Credits (G-2A, G-2LP and/or G-2RP) ...............................................
4.
4. Balance of tax due OR overpayment ....................................................................
5.
5. Interest due (see instructions) ..............................................................................
6.
6. Underestimated tax penalty ...................................................................................
7.
7. Other penalties due (see instructions) ..................................................................
8. Balance of tax, interest and penalties due with return ...........................................
8.
9. If line 4 is an overpayment, amount to be credited on 20
Estimated Ta
x
R
e
u f
n
d
e
d
DECLARATION:
A COPY OF THE FEDERAL 990 T AND SUPPORTING SCHEDULES (AND ANY EXTENSION) MUST BE ATTACHED TO THIS RETURN.
I/We declare, under penalty of perjury that I/we have examined this return (including accompanying schedules and statements) and to the best of
our knowledge and belief it is true, correct and complete. If prepared by a person other than a taxpayer,his/her declaration is basd on all informa-
tion of which s/he has any knowledge.
S
g i
n
a
u t
e r
f o
n I
d
v i
d i
u
l a
r o
F
r i
m
P
e r
p
r a
n i
g
R
e
u t
n r
S
g i
n
a
u t
e r
f o
O
f
c i f
r e
T
t i
e l
D
a
e t
E
m
p
o l
y
e
e
D I
r o
S
o
c
l a i
S
e
c
r u
y t i
N
u
m
b
r e