IT-QRHOE-RHO1: Qualified Rural Hospital Organization Expense Tax Credit Letter of Confirmation (Revision)
Georgia · Georgia DOR · Used for tax years 2024, 2025, 2026
Georgia Form IT-QRHOE-RHO1 is a letter confirming a taxpayer’s contribution to a rural hospital organization for the qualified rural hospital organization expense tax credit. The hospital organization completes it and provides it to the taxpayer as the second step in applying for
Who files this form
The rural hospital organization completes Form IT-QRHOE-RHO1 and provides it to the contributing taxpayer. This is the second step in applying for the qualified rural hospital organization expense tax credit.
The form confirms that the taxpayer made a contribution to the rural hospital organization.
What you'll need
Have the following information ready to complete the form:
- Rural hospital organization: fiscal year ending, taxpayer identification number, name, street address, contact person and telephone number.
- Contributing taxpayer: name, taxpayer identification number, credit certificate number and address.
- Contribution: date, amount contributed and preapproved amount of credit.
- Certification: hospital organization name and the authorized officer’s signature, printed name, title, phone number and signing date.
How to file
The rural hospital organization should:
- Complete the hospital organization and contributing taxpayer fields. Print numbers in black or blue ink.
- Have an authorized officer sign the certification that the information on the form and any attachments is true to the organization’s best knowledge and belief.
- Provide the completed form to the taxpayer.
The form does not give a mailing address or e-file instructions.
Questions people ask
What does this form confirm?
It confirms that the taxpayer made a contribution to the rural hospital organization.
Is this the first step in applying for the credit?
No. The form states that it is the second step in the application process.
Who signs the form?
An authorized officer of the rural hospital organization signs the certification and supplies their name, title, phone number and the date.
Does the form ask for both the contribution amount and the credit amount?
Yes. It has separate fields for the amount of contribution and the preapproved amount of credit.