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Fill a Valid Replacement Check Request Georgia Template

The Replacement Check Request Georgia form is a crucial document for taxpayers who have not received their refund checks. This form allows individuals to request a replacement for checks that have been lost, stolen, or expired. By following the instructions carefully, taxpayers can ensure that their requests are processed efficiently.

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Fill a Valid Replacement Check Request Georgia Template

Contents

The Replacement Check Request Georgia form, known as Form IA-81, is an essential document for taxpayers who need to address issues with their refund checks. This form is designed for individuals or businesses seeking to replace a refund check that has been mailed but not received. It is also applicable for those who need to stop payment on checks that are lost, stolen, or destroyed. Additionally, if a refund check has expired—meaning it has not been cashed for more than 180 days after issuance—this form must be utilized. However, it is important to note that requests for replacement checks should not be made within 15 business days of the check's mailing date. Completing the form requires specific information, including the taxpayer's name, Social Security number, and the reason for the request. After submission, the processing time is typically between 10 to 15 business days. The form also includes a declaration section where the taxpayer affirms the accuracy of the information provided. If a third party is representing the taxpayer, a Power of Attorney must accompany the request. Submissions can be made via mail or fax to the Georgia Department of Revenue, ensuring that the process is straightforward and accessible for all taxpayers.

Replacement Check Request Georgia Example

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(R evised 4/29/15)

Form IA-81

Replacement Check Request Form

GENERAL INSTRUCTIONS

•DO Use this form to replace a refund check that has been mailed but never received.

•DO Use this form to request a stop payment on a check that has been lost, stolen or destroyed.

•DO Use this form if you have a refund check that has expired and has not been cashed for more than 180 days after issuance.

•DON’T Request a replacement check if it has been less than 15 business days since the check was mailed.

•PLEASE Allow 10-15 business days processing time for your completed form.

REFUND TAX YEAR: _____________

REFUND AMOUNT: $_______________

Check Tax Type:

Individual

Sales and use tax

Withholding

Motor Fuel

IFTA

Corporate

TAXPAYER INFORMATION (E-mail: ____________________________________________)

Primary Taxpayer Name or Name of Business:

Spouse Name (if applicable):

SSN

(spouse, if applicable)

State Tax Identification Number (STI)

Check Number (if known)

Mailing Address on Return:

City

State

Zip

Current Mailing Address: (if different from above)

City

State

Zip

Daytime Telephone Number

Fax Number

Name of Contact Person (if applicable)

Reasons for request (choose one):

Check Never Received

Lost

Stolen

Expired

Destroyed

Other (Please Explain :__________________________________)

Note: A “STOP PAYMENT” will be issued on the original refund check upon receipt of this form. If you receive/find your original check after submitting this form, please destroy the check.

DECLARATION:

I hereby declare, under penalties of perjury, that I have examined this request and, to the best of my knowledge and belief, it is true, correct and complete. If you are being represented by an attorney, accountant, or other third party, a properly executed Power of Attorney (Form RD-1061) authorizing the representative to act for the taxpayer must be included with this form.

Taxpayer’s Signature and Date

Spouse’s Signature and Date (if applicable)

Representative’s Name

Title (if applicable)

Representative’s Signature

Date

HOW TO SUBMIT YOUR FORM: You may submit your completed request to the Department as follows:

Mail to: Georgia Department of Revenue, PO Box 740389, Atlanta, GA 30374-0389

Download Replacement Check Request Georgia

Document Breakdown

Fact Name	Details
Purpose	This form is used to request a replacement for a refund check that was mailed but not received.
Stop Payment	The form can also be used to request a stop payment on a check that is lost, stolen, or destroyed.
Expiration	It is applicable if the refund check has expired and has not been cashed for over 180 days after issuance.
Waiting Period	A request for a replacement check should not be made until at least 15 business days have passed since the check was mailed.
Processing Time	Allow 10-15 business days for processing the completed form.
Governing Law	This form is governed by the Georgia Department of Revenue regulations regarding tax refunds.

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