NOTICE OF INTENTION TO CLAIM WITHHOLDING BENEFIT
NOTICE OF INTENTION TO CLAIM WITHHOLDING BENEFIT Name of Company Address City State ZIP Code Federal Employer I.D. Georgia Withholding I.D. (s) Tax Year of Income Tax Return on which credit claimed: Anticipated Date of Filing Qualifying Tax Credit: ( ) Headquarters Job Tax Credit ( ) Job Tax Credit* ( ) Film Tax Credit ................
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