Form 500 - Georgia Individual Income Tax Return - 2014 Page 5
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500
Page
Georgia Form
Individual Income Tax Return
Georgia Department of Revenue
2014
YOUR SOCIAL SECURITY NUMBER
SCHEDULE 2 CREDITS for LINE 17, PAGE 2
(See Tax Booklet on Pages 13 and 16)
.
00
1.
1. Other State Credit(s) Tax Credit (See Tax Booklet on Page 15).........................
2.
Credits from Form IND-CR (Rural Physicians Credit, Disabled Person Home Purchase or Retrofit Credit, Driver Education Credit, Disaster Assist-
ance Credit, Qualified Caregiving Expense Credit, Georgia National Guard/Air National Guard Credit, Child and Dependent Care Expense Credit,
.
00
Form IND-CR
Adoption Credit, Eligible Single-Family Residence Credit).................................
2.
.
00
3.
3.
Low Emission Vehicle Credit
or Zero Emission Vehicle Credit
.........
(Requires DNR certification for either credit)
.
00
4.
Qualified Education Expense Credit (Individual/Non pass through).................
4.
.
00
5.
5.
Clean Energy Property Credit (Individual/Non pass through)...........................
Pass Through Credits from Ownership of Sole Proprietor, S Corp., LLC or Partnership Interest and Other Credits
You must list the appropriate Credit Type Code in the space provided. If you claim more than four credits, enclose a schedule.
Enter the schedule total on Line 10. See Tax Booklet on Page 16 for a list of available credits and their applicable codes.
6.
COMPANY NAME
CREDIT CODE TYPE
OWNERSHIP
FEIN
CREDIT CLAIMED ON THIS RETURN
.
00
CREDIT CODE TYPE
7.
COMPANY NAME
CREDIT CLAIMED ON THIS RETURN
OWNERSHIP
FEIN
.
00
8.
COMPANY NAME
CREDIT CODE TYPE
CREDIT CLAIMED ON THIS RETURN
OWNERSHIP
FEIN
.
00
9.
COMPANY NAME
CREDIT CODE TYPE
OWNERSHIP
FEIN
CREDIT CLAIMED ON THIS RETURN
.
00
.
00
Any additional pass-through credits claimed (Attach schedule)......................
10.
10.
.
00
Low Income Credit (See Tax Booklet).
11.
11a.
11b.
....................................................
11c.
.
00
Enter the total of Lines 1 through 11 here and on Line 17, Pg. 2 of 500 form...
12.
12.
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