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.
http://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
P
L
E
A
S
E
D
O
N
O
T
M
A
I
L
!
KEEP THESE INSTRUCTIONS AND WORKSHEET WITH YOUR RECORDS
3. Click the “Print” button to print a completed G-1003 return.
G-1003 Worksheet
W-2:
Form Type: G-2A: 1099 : W2-C:
0000
Select
Print
Clear
Income Statement Return
DO NOT SUBMIT PAYMENT WITH THIS FORM
GA Withholding ID FEI Number
Tax Year
Number of Forms
Georgia Taxable Wages
Signature
Telephone Date
Georgia Tax Withheld
Vendor Code
EMPLOYER NAME AND ADDRESS
Check here if correction to
Social Security Numbers only.
Form Type
W-2 G2-A 1099 W2-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. If this date is a
weekend or holiday, the due date is the next business day. If a business closes during the taxable year,
income statements are due within 30 days after payment of final wages. Please note for a flow-through
Submit non-wage statements (1099s ) only if Georgia tax is withheld. Statements that do not indicate
Georgia tax withheld may be filed under the Combined Federal/State Filing Program.
The “Number of Forms,” “Form Type” “Georgia Taxable Wages” and “Georgia Tax Withheld” blocks must
Copies of the corrected W2s/1099s/G2-As must accompany all amended returns.
Submit Form G-1003 and paper copies of income statements to:
Ge
orgia Department of Revenue
PO Box 105685
Processing Center
Atlanta, GA 30348-5685
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
https://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 on dotted line
PLEASE DO NOT mail this entire page. Please cut along dotted 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
