Georgia QEE Tax Credit Application General InstructionsPlease complete this form to apply for Georgia QEE Tax Credits. Once the Submit button is clicked, AAA will be informed of your request and will work directly with the Georgia Department of Revenue to reserve your credits. Copy and paste this URL for more detailed instructions: https://www.aaascholarships.org/wp-content/uploads/2019/12/GA-Tax-Credit-Pre-Approval-Form-Instructions-rev2018.pdfContributor Type (select one):*Insurance CompanyNon-Insurance C-Corp or electing S-Corp or PartnershipNon-insurance LLC or non-electing S-Corp or Partnership MemberIndividual Filing Married Joint ReturnIndividual Filing Married Separate ReturnIndividual filing Single or Head of HouseholdEntity Name (see below fields if filing as individual) C-Corp, LLC, S-Corp or Partnership name onlyEntity EIN Individual/Member Name First Last Taxpayer ID # xxx-xx-xxxxJoint Filer Name, if applicable First Last Joint Filer Taxpayer ID #, if applicable xxx-xx-xxxxAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact Person* First Last Contact Email* Contribution InformationTax Year End of Contributor* MM/DD/YYYYCalendar Year in which Contribution will be made* 2025, for exampleAmount of Contribution the taxpayer intends to make*Limits: (1) Insurance companies, the lesser of the actual amount expended, 75 percent of the state insurance premium tax or $1 million, (2) C-Corps, S-Corps, & Partnerships (electing to pay tax at the entity level) the lesser of the actual amount expended or 75 percent of the entity’s state income tax liability for the tax year, (3) Each member of an LLC, S-Corp or Partnership, the lesser of the actual amount expended or $25,000 per tax year, (4) Single individual or a head of household, the actual amount expended or $2,500.00 per tax year, whichever is less, (5) Married couple filing a joint return, the actual amount expended or $5,000.00 per tax year, whichever is less, (6) Married couple filing a separate return, the actual amount expended or $2,500.00 per tax year, whichever is less. For an individual taxpayer the credit is further limited and may not exceed the taxpayer’s income tax liability. The amount of the credit that exceeds the taxpayer’s income tax liability can be used against the next succeeding five years’ tax liability.For C-Corps, and electing S-Corps & Partnerships, enter 75% of the entity's estimated GA income tax liabilityFor insurance companies, enter 75% of the entity's estimated GA insurance premium tax liabilityFor members of LLCs, and non-electing S-Corps & Partnerships, enter 5.75% of the entity's estimated GA net income.Certification by ApplicantApplicant certifies that all information above is true to the best of their knowledge and belief and is submitted for the purpose of obtaining preapproval of Georgia tax credits from the Commissioner.Name of Person Authorized to Apply for Credits* First Last Title, if Applying for Entity Phone*Date* MM slash DD slash YYYY Δ