Form IND-CR Fillable Individual Income Tax Credit Form
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Enclose with Form 500 (checkbox) Unchecked (Clear) Clear (Clear) Clear (Clear) Clear (Clear) Clear (Print) Print (Print) Print (Print) Print (Print) Print (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 1 2009 Acquisition indebtedness is debt incurred in acquiring constructing or substantially improving a qualified residence 1 5 0 00 1 Add Part 1 Line 3; Part 2 Line 4; Part 3 Line 3; Part 4 Line 6; Part 5 Line 4; Part 6 Line 6; 1 Amount of child & dependent care expense credit 1 Amount paid for the successfully completed course(s) 1 1 County of residence 1 County of residence 1 Credit remaining from previous years 1 Credit remaining from previous years 1 1 Credit remaining from previous years 1 1 Low Income Credit 1a 1 Other State(s) Tax Credit 1 Qualified caregiving expenses 1 The physician must have started working in a rural county after July 1 1995 If the physician worked in a rural county prior 1 Total credit (Enter amount from 2009 IND CR Part 9 Line 5 ) 1/3 of the credit or the taxpayer s income tax liability Any unused tax credit can be carried forward but cannot be carried back 1990 or any future such census For taxable years beginning on or after January 1 2012 the United States Decennial 1Page 2 County of practice 2 County of practice 2 Credit used in 2015 (enter here and include in Part 12) 2 Date assistance was received 2 2 Enter $2 000 per qualified foster child 2 2 Enter amount of qualified life insurance premiums 2 2 Georgia allowable rate 2 2 Maximum allowed per year 2 Maximum credit (cannot exceed $150 per child) 2 2 Percentage limitation 2 The physician must practice and reside in a rural county For taxable years beginning on or after January 1 2003 a 2Page 3 Allowable Child & Dependent Care Expense Credit (Line 1 x 30) 3 3 Amount of the disaster assistance received 3 3 Enter credit used in 2015 (enter here and include in Part 12) 3 Enter credit used in 2015 (enter here and include in Part 12) 3 3 Enter the lesser of Line 1 or Line 2 3 3 Line 1 multiplied by Line 2 3 Maximum credit allowed (multiply Line 1 by Line 2) 3 The physician must be licensed to practice medicine in Georgia primarily admit patients to a rural hospital and practice in 3 Type of practice 3 Type of practice 33 33% 3Page 4 Carryover to 2016 (Line 1 plus Line 2 les s Line 3) 4 4 Carryover to 2016 (Line 1 plus Line 2 less Line 3) 4 4 Date started working as a rural physician 4 Date started working as a rural physician 4 Enter credit used in 2015 (enter here and include in Part 12) 4 4 Enter unused credit (Total credit less amounts used in previous years) 4 Maximum credit 4 Maximum credit 4 4 Potential carryover to 2016 (Line 1 plus Line 2 less Line 3) 4Page 5 0 0 00 5 Credit allowed lesser of line 3 or line 4 5 Enter the lesser of Line 3 or Line 4 5 Enter the lesser of Line 3 or Line 4 5 5 Number of hospital beds in the rural hospital 5 Number of hospital beds in the rural hospital 6 Credit used in 2015 (enter here and include in Part 12) 6 Enter credit used in 2015 (enter here and include in Part 12) 6 Enter credit used in 2015 (enter here and include in Part 12) 6 6 Rural physicians credit enter $5 000 per rural physician 7 Carryover to 2016 (Line 1 plus Line 5 less Line 6) 7 7 Carryover to 2016 (Line 4 less Line 6) 7 Enter credit used in 2015 (enter here and include in Part 12) a credit equal to the lesser of the cost or $125 to retrofit an existing single family home with one or more of these features The a period of more than 90 consecutive days The credit shall be claimed and allowed in the year in which the majority of such A taxpayer is allowed the tax credit for a purchase of one eligible single family residence made between June 1 2009 and a) Any residence (including a new residence one occupied at the time of sale or a previously occupied residence) that was actual amount paid whichever is less A private driver training school is one that primarily engages in offering driving instruction Additional Qualifying Family Member Name if applicable: ADDRESS(NUMBER AND STREET or P O BOX) (Use 2nd address line for Apt Suite or Building Number) Age if 62 or over agent; or amounts were excluded from Georgia net taxable income Any unused tax credit cannot be carried forward to any succeeding amounts were excluded from Georgia net taxable income There is no carryover or carry back available The credit cannot and are on active duty full time in the United States Armed Forces or active duty training in the United States Armed Forces for and which is secured by such residence Refinanced debt is acquisition debt if at least a portion of such debt refinances the b) A residence with respect to which a foreclosure event has taken place and which is owned by the mortgagor or the mortgagor s Birth Date blackblack or blueblue ink: by the Department of Revenue or have been issued a special permanent parking permit by the Department of Revenue c) An owner occupied residence with respect to which the owner s acquisition indebtedness was in default on or before March care equipment and other supplies which have been determined by a physician to be medically necessary Services must be Census of 2010 is used (see regulation 560 7 8 20 for transition rules) A listing of rural counties for purposes of the CHECK IFADDRESS HAS CHANGED CITY (Please insert a space if city has multiple names) claimed and allowed in the year in which the ninetieth day occurs The credit shall apply with respect to each taxable year in claimed on Federal Form 1040 completed course of driver education to a private or public high school does not qualify for this credit A completed course of driver education includes additional courses offered by private driver training schools such as defensive driver education Date of Successful Completion days are served In the event an equal number of consecutive days are served in two calendar years then the exclusion shall be defined as an acute care hospital located in a rural county that contains 80 or fewer beds For taxable years beginning on DEPARTMENT USE ONLY disabled person must be the taxpayer or the taxpayer s spouse if a joint return is filed Qualified features are: Disaster assistance agency eligible single family residence is a single family structure (including a condominium unit as defined in O C G A 44 3 71) that Enter the total here and on Form 500 Page 6 Sch 2 Summary Section Line 1 exceed the taxpayer s income tax liability For more information see Regulation 560 7 8 43 expenses for a qualifying family member The credit cannot exceed $150 Qualified services include Home health agency features added to retrofit a home (up to $125 per feature) cannot exceed $500 final and ending in the year in which the adopted child attains the age of 18 This credit applies to adoptions occurring in First Child for sale prior to May 11 2009 and that remained for sale after May 11 2009; or Georgia Code Section 48 7 29 15 provides an income tax credit for the adoption of a qualified foster child The amount of Georgia Department of Revenue Georgia Department of Revenue Georgia Department of Revenue Georgia Department of Revenue (Approved web version) Georgia Emergency Management Agency or the Federal Emergency Management Agency The amount of the credit is equal Georgia Form IND CR Georgia Form IND CR Georgia Form IND CR Georgia Form IND CR (Rev 09/01/15) Grants from GEMA and/or FEMA Grants from the Department of Human Services Individual and Family Grant Program If disabled date of disability income tax return This credit cannot be carried forward The credit is computed as follows: inin black ink:ink: insurance coverage through the service member s Group Life Insurance Program administered by the United States Department insurance premiums nor the taxpayer s income tax liability Qualified life insurance premiums are the premiums paid for Interior passage doors providing at least a 32 inch wide opening is occupied for residential purposes by a single family that is: LASTNAME liability Any unused tax credit can be carried forward to the succeeding years tax liability but cannot be carried back to the liability for the purchase of a new single family home that contains all of the accessibility features listed below It also provides Light switches and outlets placed in accessible locations likelike this Loans from the Small Business Administration that are due to disasters declared by the President or Governor MI YOUR SOCIAL SECURITY NUMBER Name of dependent minor child Name of private driver training school Name: November 30 2009 The credit amount is the lesser of 1 2 percent of the purchase price of the eligible single family residence numbersnumbers like O C G A 48 7 29 1 provides a disabled person credit equal to the lesser of $500 per residence or the taxpayer s income tax O C G A 48 7 29 10 provides taxpayers with a credit for qualified child & dependent care expenses The credit is a percentage O C G A 48 7 29 17 provides taxpayers a credit for the purchase of an eligible single family residence located in Georgia An O C G A 48 7 29 2 provides a qualified caregiving expense credit equal to 10 percent of the cost of qualified caregiving O C G A 48 7 29 4 provides for a credit for a taxpayer who receives disaster assistance during a taxable year from the O C G A 48 7 29 5 provides for a driver education credit This is a credit for an amount paid for a dependent minor child for a O C G A 48 7 29 9 provides a tax credit for Georgia residents who are members of the National Guard or Air National Guard O C G A 48 7 29 provides for a $5 000 tax credit for rural physicians The tax credit may be claimed for not more than five obtained from an organization or individual not related to the taxpayer or the qualifying family member of the credit claimed and allowed under Internal Revenue Code 21 and claimed by the taxpayer on the taxpayer s Federal of Veterans Affairs Any unused tax credit is allowed to be carried forward to the taxpayer s succeeding year s tax liability One no step entrance allowing access into the residence Only enter the information for the taxpayer and/or the spouse if they are a rural physician or $1 800 00 The amount of the tax credit that may be claimed and allowed in a single tax year cannot exceed the lesser of or after January 1 2003 a rural hospital is defined as an acute care hospital located in a rural county that contains 100 or fewer beds For more information see Regulation 560 7 8 20 oror blue Page 5 Page 6 Page 7 Part 1 Disabled Person Home Purchase or Retrofit Credit Tax Credit Type 201 Part 10 Other State(s) Tax Credit (See Instructions in IT 511 Tax Booklet) Tax Credit Type 210 Part 11 Low Income Tax Credit (See the Low Income Tax Credit Worksheet) Tax Credit Type 211 Part 12 Total Section Part 2 Child and Dependent Care Expense Credit Tax Credit Type 202 Part 3 Georgia National Guard/Air National Guard Credit Tax Credit Type 203 Part 4 Qualified Caregiving Expense Credit Tax Credit Type 204 Part 4 Qualified Caregiving Expense Credit Tax Credit Type 204 (continued) Part 5 Driver Education Credit Tax Credit Type 205 Part 5 Driver Education Credit Tax Credit Type 205 (continued) Part 6 Disaster Assistance Credit Tax Credit Type 206 Part 7 Line 7; Part 8 Line 3; Part 9 Line 6; Part 10 Line 2 and Part 11 Line 2 Part 7 Rural Physicians Credit Tax Credit Type 207 Part 8 Adoption of a Foster Child Credit Tax Credit Type 208 Part 9 Eligible Single Family Residence Tax Credit Tax Credit Type 209 per residence physician qualifies for the credit if they practice in a rural county and reside in a county contiguous to a rural county A Please PleasePlease print principal amount of existing acquisition indebtedness printprint your prior years tax liability The approval letter from the disaster assistance agency must be enclosed with the return Purchase of a home that contains all four accessibility features OR total of accessibility Qualified caregiving expenses do not include expenses that were subtracted to arrive at Georgia net taxable income or for which qualify the physician must meet the following conditions: qualifying family member includes the taxpayer or an individual who is related to the taxpayer by blood marriage or adoption Qualifying Family Member Name: Reinforcements in bathroom walls allowing installation of grab bars around the toilet tub and shower where Relationship rural county is defined as one with 65 or fewer persons per square mile according to the United States Decennial Census of rural physicians credit may be obtained at the following web page: http://dor georgia gov Second Child if applicable services personal care services personal care attendant services homemaker services adult day care respite care or health Services under Chapter 13 of Title 43 The Driver Training School License Act The amount of the credit is equal to $150 or the State of Georgia Individual Credit Form State of Georgia Individual Credit Form State of Georgia Individual Credit Form State of Georgia Individual Credit Form STATE ZIP CODE subtracted by the taxpayer to arrive at Georgia taxable net income or with respect to any driver education expenses for which successfully completed course of driver education at a private driver training school licensed by the Department of Driver such facilities are provided SUFFIX SPOUSE S SOCIAL SECURITY NUMBER Taxpayer Spouse the credit is $2 000 per qualified foster child per taxable year commencing with the year in which the adoption becomes the fields of family practice obstetrics and gynecology pediatrics internal medicine or general surgery A rural hospital is The following types of assistance qualify: The qualifying family member must be at least age 62 or been determined disabled by the Social Security Administration A the taxable years beginning on or after January 1 2008 Any unused credit can be carried forward until used The taxpayer must have claimed the credit in 2009 in order to claim the unused credit below the taxpayer s income tax liability The credit is not allowed with respect to any driver education expenses either deducted or This credit can be carried forward 3 years For more information see Regulation 560 7 8 44 This credit cannot be carried forward This does not include schools owned or operated by local state or federal governments An amount paid for a This tax credit is only allowed once for each dependent minor child of a taxpayer The amount of the tax credit cannot exceed thisthis in to $500 or the actual amount of the disaster assistance whichever is less The credit cannot exceed the taxpayer s income tax To qualify for this credit the disabled person must be permanently disabled and have been issued a permanent parking permit to that date a period of at least three years must have elapsed before the physician returns to work in a rural county which such member serves for such qualifying period of time The credit cannot exceed the amount expended for qualified life years tax liability and cannot be carried back to any prior years tax liability Visit www dds ga gov/Training/index aspx years There is no carryover or carry back available The credit cannot exceed the taxpayer s income tax liability In order to YOUR FIRST NAME YOUR SOCIAL SECURITY NUMBER YOUR SOCIAL SECURITY NUMBER YOUR SOCIAL SECURITY NUMBER youryour numbers