Fillable Printable Withholding Income Statement Transmittal Form
Fillable Printable Withholding Income Statement Transmittal Form
Withholding Income Statement Transmittal Form
Instructions
1.Download (free) the latest version of Adobe Reader.
//www.adobe.com/products/acrobat/readstep2.html
2.Complete the worksheet below to automatically create your return.
4.Sign and date the return.
5.Cut the return along the dotted line.Mail only the return to the address on the return.Do not
send a payment with this return, submit an amended G-7 if additional tax is due.
DO NOT fold, staple or paper clip items being mailed.
DO NOT
mail in the worksheet, keep this for your records.
1.GA Withholding ID : 2. FEI Number :
5.Name :.............................
Street Address Line 1 :
Street Address Line 2 :
City :
State:Zip:
-
11.Telephone :..............................................................................
13.Calendar Year :.......................................................................
Number Of Forms :...............................................................
Georgia Taxable Wages :......................................................
Georgia Tax Withheld :.........................................................
6.
7.
8.9.10.
12.
14.
15.
16.
Domestic Employers :
Amended Return :
3.
4.
State of Georgia Department of Revenue
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KEEP THESE INSTRUCTIONS AND WORKSHEET WITH YOUR RECORDS
3.Click the “Print” button to print a completed G-1003return.
G-1003 Worksheet
W-2:
Form Type: G-2A:1099 :W2-C:
0000
Select
Print
Clear
IncomeStatementReturn
DO NOT SUBMITPAYMENT WITH THISFORM
GAWithholding IDFEINumber
TaxYear
Number ofForms
Georgia Taxable Wages
Signature
TelephoneDate
Georgia Tax Withheld
Vendor Code
EMPLOYER NAMEANDADDRESS
Check here if correction to
Social Security Numbers only.
Form Type
W-2G2-A1099W2-C
_________________
PO BOX 105685
GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
G-1003
ments electronically. Also employers who are federally required to file income statements electronically
Instructions for Preparing the G-1003
Income statements are due on or before February 28th of the following calendar year.Ifthisdate is a
weekend orholiday, theduedateisthe nextbusiness day.If abusinessclosesduringthetaxable year,
income statements areduewithin30daysafterpaymentoffinalwages. Please note for a flow-through
Submitnon-wagestatements (1099s )onlyifGeorgiatax iswithheld.Statementsthatdonotindicate
GeorgiataxwithheldmaybefiledundertheCombinedFederal/StateFilingProgram.
The“NumberofForms,”“Form Type”“GeorgiaTaxableWages”and“GeorgiaTax Withheld” blocks must
Copies of the corrected W2s/1099s/G2-As must accompany all amended returns.
SubmitFormG-1003 and paper copies of income statements to:
Ge
orgiaDepartmentof Revenue
PO Box 105685
Processing Center
Atlanta, GA30348-5685
If you file and pay electronically or are filing Form G2-FL, you must file the G-1003 and related state-
must file them electronically for Georgia purposes. Reg. 560-7-8-.33. Even if the employer is not required
to file electronically, they may choose to do so. To obtain a copy of our specifications, visit our website
//etax.dor.ga.gov or call 1-877-GADOR11 (1-877-423-6711).
entity, the G-1003 and the related G2-As for nonresident members are due by the earlier of the date
such entity’s income tax return is filed or the due date for filing such entity’s income tax return
(without
extension).
be completed
where applicable
.
(Rev. 7/13)
Title
Under penalty of perjury, I declare that this return has been examined by me and to the best of my knowledge and belief it is true,
correct and complete.
Cut ondotted line
PLEASE DONOT mail this entire page. Pleasecut alongdotted line and mail coupon only.
PLEASE DO NOT STAPLE OR PAPER CLIP.
Amended Return
Domestic employer
with no GA Tax Withheld
040
ATLANTA GA 30348-5685
Date Received
