Form Cd 14C – Fill Out and Use This PDF

The Georgia Department of Revenue Form CD-14C, known as the Collection Information Statement for Wage Earners and Self-Employed Individuals, is a detailed form designed for individuals who owe income tax, have a personal liability for excise, sales, withholding, partnership liabilities, or are self-employed. This form assists in providing the Georgia Department of Revenue (GA DOR) with comprehensive information about an individual's financial situation to evaluate their tax liability properly. It requires detailed insights into personal and household information, income, assets, and expenses to aid in this assessment. If you need to report or manage your tax responsibilities, ensure to fill out the Form CD-14C by clicking the button below.

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Form Cd 14C PDF Details

The Georgia Department of Revenue Form CD-14C, specifically designed for Collection Information, caters to wage earners and self-employed individuals grappling with personal income tax due on Form 500 and other specified tax liabilities. Created to streamline the process of gathering comprehensive financial data from individuals either employed or running their own business, this form serves as a critical instrument for those with personal responsibilities for excise, sales, withholding, or partnership liabilities, along with members of limited liability companies (LLCs) deemed disregarded entities. The structure of the form mandates complete sections based on employment status—wage earners filling out selected sections, while self-employed individuals are required to furnish details across all areas, underscoring the importance of thoroughness in providing personal, household, and business-related financial information. The introduction of sections dedicated to asset disclosures—spanning cash, investments, property, vehicles, and business assets—complements detailed income and expense records for both personal and business assessments. This comprehensive approach is designed to facilitate an accurate evaluation of an individual’s financial status, thereby aiding the Georgia Department of Revenue in making informed decisions regarding tax liabilities.

Question	Answer
Form Name	Form Cd 14C
Form Length	7 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 45 sec
Other names	ga earners self employed, cd 14c, cd 14b, georgia cd 14c

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Georgia Department of Revenue		Form CD-14C
Collection Information Statement for	Wage Earners and
		(June 2012)
Self-Employed Individuals

Use this form if you are

An individual who owes income tax on a Form 500, Georgia Individual Income Tax Return

An individual with a personal liability for an excise tax

An individual who is personally responsible for a sales tax or withholding tax liability

An individual who is personally responsible for a partnership liability

An individual member of a limited liability company (LLC) that is a disregarded entity

An individual who is self-employed or has self-employment income. You are considered to be self-employed if you are in business for yourself, or carry on a trade or business.

Wage earners Complete sections 1, 3, 6, and 7 including signature line on page 7.

Self-employed individuals Complete all sections and signature line on page 7

Note: Include attachments if additional space is needed to respond completely to any question.

Section 1

Last Name

Personal and Household Information

First Name	Date of Birth (mm/dd/yyyy)	Social Security Number

Marital status

Married Unmarried

Home Address (Street, City, State, ZIP Code)

Do you:

Own your home Rent

Other (specify e.g., share rent, live with relative, etc.)

County of Residence

Mailing Address (if different from above or Post Office Box number)

Primary Phone

Secondary Phone

(

)

(

)

Occupation

Employer's Address (Street, City, State, ZIP Code)

Employer's Name

Provide information about your spouse.

Spouse's Last Name

First Name

Date of Birth (mm/dd/yyyy)

Social Security Number

Occupation

Employer's Address (Street, City, State, ZIP Code)

Employer's Name

Provide information for all other persons in the household or claimed as a dependent.

Name	Age	Relationship	Claimed as a dependent		Contributes to
Name	Age	Relationship	on your Form 500?		household income?
			on your Form 500?		household income?

			Yes	No	Yes	No

			Yes	No	Yes	No

			Yes	No	Yes	No

			Yes	No	Yes	No

Section 2					Self-employed Information
If you or your spouse is self-employed, complete this section.

Is your business a sole proprietorship (filing Schedule C)?						Address of Business (If other than personal residence)
	Yes		No
	Yes		No

Name of Business

Business Telephone Number					Employer Identification Number	Business Website		Trade Name or dba
(		)		-
				-
Description of Business					Total Number of Employees	Frequency of Tax Deposits	Average Gross Monthly
							Payroll $

					www.dor.ga.gov		Form CD-14C (3-2012)

Page 2 of 7

Section 2

Self-employed Information - (Continued)

Do you or your spouse have any other business interests?

Business Address (Street, City, State, ZIP code)

Yes (Percentage of ownership:

)

Business Name

Business Telephone Number

Business Identification Number

(

)

Type of business (Select one)

Partnership

Single member LLC

Corporation

Other

LLC

Section 3

Personal Asset Information

If any total below results in a negative number, enter "0".

Cash and Investments (domestic and foreign)

Enter the total amount available for each of the following (if additional space is needed include attachments). Use the most current statement for each type of account, such as checking, savings, money market and online accounts, stored value cards (such as, a payroll card from an employer), investment and retirement accounts (IRAs, Keogh, 401(k) plans, stocks, bonds, mutual funds, certificates of deposit), life insurance policies that have a cash value, and safe deposit boxes.

Bank Account:

Checking

Savings

Money Market

Online Account

Stored Value Card

Bank Name

Account Number

(1a)

Bank Account:

Checking

Savings

Money Market

Online Account

Stored Value Card

Bank Name

Account Number

(1b)

Total value of bank accounts from attachment

(1c)

Add lines (1a) through (1c) =

(1)

Investment Account:

Stocks

Bonds

Other

Name of Financial Institution

Account Number

Current Market Value

Less Loan Balance

X .8 = $

– $

(2a)

Investment Account:

Stocks

Bonds

Other

Name of Financial Institution

Account Number

Current Market Value

Less Loan Balance

(2b)

X .8 = $

– $

Total of investment accounts from attachment. [current market value X.8 less loan balance(s)]

(2c)

Add lines (2a) through (2c) =

(2)

Retirement Account:

401k

IRA

Other

Name of Financial Institution

Account Number

Current Market Value

Less Loan Balance

X .7 = $

– $

(3a)

Retirement Account:

401k

IRA

Other

Name of Financial Institution

Account Number

Current Market Value

Less Loan Balance

X .7 = $

– $

(3b)

Total of investment accounts from attachment. [current market value X .7 less loan balance(s)]

(3c)

Add lines (3a) through (3c) =

(3)$

www.dor.ga.gov

Form CD-14C (3-2012)

How to Edit Form Cd 14C Online for Free

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Step 2: The tool will give you the capability to change your PDF document in many different ways. Transform it by including customized text, correct existing content, and place in a signature - all within a few mouse clicks!

With regards to the blank fields of this specific PDF, this is what you should consider:

1. Start completing your ga cd14c with a selection of essential blanks. Collect all the important information and make sure not a single thing forgotten!

2. Once your current task is complete, take the next step – fill out all of these fields - Name, Age, Relationship, Claimed as a dependent, Contributes to, on your Form, household income, Yes, Yes, Yes, Yes, Yes, Yes, Yes, and Yes with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Yes, on your Form, and Yes in cd 14b form

3. This third part is straightforward - fill in all the blanks in Section Do you or your spouse, Yes Percentage of ownership, Business Address Street City State, Business Name, Business Telephone Number Type of, Business Identification Number, Partnership, Single member LLC, LLC, Corporation, Other, Section, Personal Asset Information, If any total below results in a, and Cash and Investments domestic and in order to complete this part.

Section, If any total below results in a, and Personal Asset Information in cd 14b form

Be extremely careful while filling out Section and If any total below results in a, as this is where a lot of people make mistakes.

4. This specific section arrives with the next few blanks to complete: Account Number, Bank Account Bank Name, Total value of bank accounts from, Investment Account Name of, Stocks Bonds Other, Account Number, Current Market Value, Less Loan Balance, Add lines a through c, Investment Account Name of, Stocks, Bonds, Other, Account Number, and Current Market Value.

5. As a final point, the following last section is precisely what you'll have to finish prior to finalizing the document. The fields under consideration are the next: Retirement Account Name of, IRA, Other, Account Number, Current Market Value, Less Loan Balance, Total of investment accounts from, wwwdorgagov, Form CDC, and Add lines a through c.

cd 14b form writing process clarified (stage 5)

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Form Cd 14C – Fill Out and Use This PDF

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