Voluntary Film Tax Credit Audit Application

Name of Production: (required)

Production FEIN: (required)

Reporting Parent Name

Reporting Parent FEIN:

Production Mail Address:

Country (required)

Street address (required)

City (required)

State (required)

Zip code (required)

Production Contact Name: (required)

Production Contact Phone Number: (required)

Production Contact E-mail: (required)

Department of Economic Development Certification Number: (required)

Department of Economic Development Certification Date: (required)

Completion of Principal Photography in Georgia: (required)

Amount of Qualified Production Costs: (required)

Audit Fee - If qualified production costs are:

$500,000.00 to $5,000,000.00

$5,000,000.01 to $10,000,000

>$10,000,000.01

Audit Fees Due Upon Acceptance of Application:

$5,000

$12,500

$25,000