G-1003
(Rev. 1/11)
Income Statement Return
DO NOT SUBMIT PAYMENT WITH THIS FORM
GA Withholding ID FEI Number
Tax Year
Number of Forms
Vendor Code
EMPLOYER NAME AND ADDRESS
Check here if correction to
Social Security Numbers only.
Form Type
W-2 G-2-A 1099 W2-C
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I delcare under the penalty of perjury that this return has been examined by me and to the best of my knowledge is a true and complete
return.
Cut on dotted line
Instructions for Preparing the G-1003
Income statements are due on or before the end of February 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
Submit Form G-1003 and paper copies of income statements to:
Georgia Department of Revenue
Processing Center
P.O. Box 105685
Atlanta, GA 30348-5685
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
entity, the G-1003 and the related G-2-A’s for distributions to 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).
GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
P.O. BOX 105685
ATLANTA, GA 30348-5685
be completed.
Date Received
Copies of the corrected W2s/1099/G2As must accompany all amended returns.
Employers reporting 250 or more income statements must submit them electronically. Also if the employer
is required to electronically pay their Georgia Withholding, they must file the G-1003 and related income
statements electronically. Even if the employer is not required to file them electronically they may choose to
do so. To obtain a copy of our specifications, visit our website www.dor.ga.gov or call 1-877-GADOR11
(1-877-423-6711).
