Form C-15 is a return form used by Georgia taxpayers to report certain information about their income and expenses. The form is also used to claim certain tax credits and deductions. This article will provide a brief overview of the information required on Form C-15, as well as some of the tax credits and deductions that can be claimed on the form. IRS Tax Form 1040A 2016 Instructions - YouTube
| Question | Answer |
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| Form Name | Georgia Form C 15 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | C15 report list of unserviced preneed funeal contracts georgia form |
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STATE OF GEORGIA |
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Brian P. Kemp |
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SECURITIES AND BUSINESS REGULATION |
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Robert D. Terry |
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Secretary of State |
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2 Martin Luther King Jr. Drive, S.E. |
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Division Director |
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Suite 802 West Tower |
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Atlanta, Georgia 30334 |
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(404) |
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REPORT AND ITEMIZED LIST OF ALL UNSERVICED PRENEED FUNERAL CONTRACTS |
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AS OF 12/31/200__ |
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This report is mandated by O.C.G.A. |
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Please read instructions accompanying this form. |
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PART 1 - GENERAL |
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Registration Number |
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Total number of unserviced |
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Phone Number |
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contracts as of |
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Name of Registrant/Funeral Home |
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Mailing Address |
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City |
State |
Zip Code |
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Location of Records |
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City |
State |
Zip Code |
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Name and phone number of contact person regarding this report: |
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PART II - UNSERVICED PRENEED FUNERAL CONTRACTS |
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Contract Holder Name and |
Depository |
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Date of |
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Contract |
Total Amount |
Amount |
Total Amount |
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Bank Account Number |
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Contract |
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Number |
of Contract |
Paid to Date |
on Deposit |
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TOTAL (Page 1) |
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TOTAL (Page 2) |
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TOTAL OF ALL PAGES |
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Attach additional pages, as necessary, with complete information as above on every contract holder.
Form |
page 1 |
PART II - UNSERVICED PRENEED FUNERAL CONTRACTS
Contract Holder Name and |
Depository |
Date of |
Contract |
Total Amount |
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Amount |
Total Amount |
Bank Account Number |
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Contract |
Number |
of Contract |
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Paid to Date |
on Deposit |
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TOTAL (Page 2) |
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Attach additional pages, as necessary, with complete information as above on every contract holder. |
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PART III - CERTIFICATION |
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I hereby certify, under penalties of perjury, that the information contained in this Annual Report and the supporting documents attached hereto are true and correct to the best of my knowledge and belief. I further certify that all required deposits have been made
to the preneed escrow account. I am authorized to sign this document on behalf of the individual or corporate owner.
Signature: |
Print Name: |
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Title |
Date |
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Form |
page 2 |