Georgia Withholding on Distributions to Nonresident Members and Shareholders

Withholding on Distributions to Nonresident Members and Shareholders
TSD_Withholding_on_Distributions_to_NonResident_Members_Shareholders_G2A_5.31.16 v1.3
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Georgia Form
(Rev. 06/01/23)

CLEAR

G-2A

Page 1
2012 and Forward Form G2-A WITHHOLDING ON NONRESIDENT MEMBERS
SHARE OF TAXABLE INCOME SOURCED TO GEORGIA
YEAR

1. PAYER’S NONRESIDENT(NR) WH#

3. PAYER’S NAME AND ADDRESS

2. PAYER’S FEDERAL ID NUMBER
4. RECIPIENT’S FEIN/ID NUMBER

5. RECIPIENT’S NAME AND ADDRESS

6. AMOUNT OF NONRESIDENT MEMBER'S SHARE
OF TAXABLE INCOME SOURCED TO GEORGIA

7. GEORGIA TAX WITHHELD

GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
PO BOX 105685
ATLANTA GA 30348-5685

COPY 1- STATE COPY

INSTRUCTIONS FOR COMPLETING FORM G2-A

This form shall be used for taxable years beginning on or after January 1, 2012. Should be completed
by and filed by the entity who submitted the withholding payment directly to the Department of Revenue.

Enter Year in which the tax year of the distributing entity ends.
Box 1.

Enter Georgia Payer’s Nonresident Withholding Number.

Box 2.

Enter Federal Identification Number.

Box 3.

Enter name and address of payer.

Box 4.

Enter social security number if recipient is an individual or federal identification number if
recipient is a business.

Box 5.

Enter name and address of member/shareholder.

Box 6.

Enter the amount of nonresident member's share of taxable income sourced to Georgia.

Box 7.

Enter amount of Georgia income tax withheld.

For additional recipients of the withholding tax credits, complete Page 2 G-2A Allocation
Schedule.
On or before the earlier of the date the return is filed or the due date for filing the income tax
return of the flow through entity (without extension), all G2-As issued for the year should be
mailed along with Form G-1003 to:
Georgia Department of Revenue, Processing Center, PO Box 105685, Atlanta GA 30348-5685
Mail your payment with the GA-V Payment Voucher to:
Georgia Department of Revenue Processing Center, PO Box 740387, Atlanta, GA 30374-0387

Georgia Form
(Rev. 06/01/23)

G-2A

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CLEAR
TAXPAYER’S FEIN

Page 2
G-2A Allocation Schedule
Recipient’s Legal Name

1.

Recipient’s FEIN/SSN

Recipient’s Address
City
Recipient’s Legal Name

Payer’s GA Withholding ID
Allocation Total

State

ZIP

Recipient’s FEIN/SSN

Recipient’s Address

Country
Payer’s GA Withholding ID
Allocation Total

2.
City
Recipient’s Legal Name

3.

Recipient’s Legal Name

Recipient’s Legal Name

Recipient’s Legal Name

Recipient’s Legal Name

7.

ZIP

Recipient’s FEIN/SSN

Recipient’s Legal Name

State

ZIP

Recipient’s FEIN/SSN

Country
Payer’s GA Withholding ID

Country
Payer’s GA Withholding ID
Allocation Total

State

ZIP

Recipient’s FEIN/SSN

Country
Payer’s GA Withholding ID
Allocation Total

State

ZIP

Recipient’s FEIN/SSN

Country
Payer’s GA Withholding ID
Allocation Total

State

ZIP

Recipient’s FEIN/SSN

Recipient’s Address
City

Payer’s GA Withholding ID

Allocation Total

Recipient’s Address
City

8.

State

Recipient’s Address
City

Country

Allocation Total

Recipient’s Address
City

6.

Recipient’s FEIN/SSN

Recipient’s Address
City

5.

ZIP

Recipient’s Address
City

4.

State

Country
Payer’s GA Withholding ID
Allocation Total

State

ZIP

Country