Help improve health care in our community through Georgia’s new tax credit opportunity!
St. Mary's Good Samaritan Hospital is excited to be partnering with the Georgia HEART Hospital Program to implement this exciting new rural hospital tax credit.
By law, in 2017, 2018 and 2019, Georgia taxpayers can receive a State income tax CREDIT for 90% of the amount they contribute to qualified rural hospitals, including Good Samaritan.
Simply tell the State that you want to direct a portion of your state tax dollars to ensure the future of quality local healthcare at Good Samaritan. See details on the back. Contributions made through this program also qualify as charitable deductions if you
itemize on your federal income tax return.
How much can I contribute for a tax credit?
Your contributions will help St. Mary's Good Samaritan Hospital continue to provide stateof-
the-art care locally. Here are details:
- Married Filing Jointly – 90% of the amount contributed or $10,000, whichever is less.
- To receive the full $10,000 tax credit, contribute $11,111.
- Individual Filer – 90% of the amount contributed or $5,000, whichever is less.
- To receive the full $5,000 tax credit, contribute $5,556.
- C-Corporation or Trust – 90% of the amount contributed or 90% of your Georgia income tax liability, whichever is less.
How do I sign up to contribute?
- Complete and submit your 2017 HEART Tax Credit Form in the Donate Section at www.georgiaheart.org, or mail a completed copy of the form to Georgia HEART at 3740 Davinci Court, Suite 375, Peachtree Corners, Georgia 30092.
- Georgia HEART will submit your tax credit pre-approval form on your behalf to the Georgia Department of Revenue (DOR).
- Within 60 days of receiving DOR tax credit pre-approval, send a check made payable to St. Mary's Good Samaritan Hospital to Georgia HEART for deposit to the hospital’s account.
- Georgia HEART will send you confirmation of your contribution and instruct you on how to submit a copy to the DOR.
- Georgia HEART will send you a tax receipt and filing instructions for 2017 tax filing purposes.
Your contribution will increase our hospital funding and our ability to provide for the health care of individuals in our community!
For information about the rural hospital organization expense tax credit, please visit the Georgia HEART website at www.georgiaheart.org or contact Georgia HEART staff at email@example.com.