CITY OF DEMOREST

BUSINESS LICENSE APPLICATION

INSTRUCTIONS

In addition to completion of the attached application and affidavit of citizenship, applicants for a business license must complete the following requirements:

Obtain all applicable permits for construction &/or renovation of the building. Pass building inspection, if applicable. Pass fire inspection. Obtain a certificate of occupancy. Show proof of professional license for business &/or individual, if a professional license is required. Show proof of registration with the Secretary of State’s Corporations Division, if business is incorporated or

operating as a Limited Liability Company. If selling alcohol, obtain appropriate licenses from the State of Georgia Department of Revenue and the City of

Demorest. Pay the Business License fee.

Applicant must contact Demorest City Hall when the business is ready for inspection. Upon completion of all listed requirements and passing inspection, the business license will be issued.

Business licenses are valid for the year in which they are issued and are renewable by December 31 of each year. Failure to renew the license will result in appropriate action by the City of Demorest to enforce the requirement of maintaining the business license.

In order to maintain a business license:

Licensee must renew the license by December 31 of each year by paying the license renewal fee. Licensee must pay the bill issued monthly by the City of Demorest for water, sewer, trash, and fire services. Licensee must be in compliance at all times with the ordinances of the City of Demorest. A copy of the

ordinances is available upon request at Demorest City Hall. Licensee must maintain all applicable federal, state, and professional licenses.

CITY OF DEMORESTBUSINESS LICENSE/OCCUPATIONAL TAX APPLICATION

Date____________________________

BUSINESS NAME: ________________________________________________________________________

Owner Type Individual

Partnership Corporation Limited Liability Company

SALES TAX ID#______________________________ Fed Work Auth User Id #_____________________________

NAIC # _______________________________________FEIN # ____________________________________

ADDRESS OF BUSINESS: __________________________________________

________________________________________________________________

PHONE NUMBER: __________________________

OWNER NAME:________________________________________________________________

MAILING ADDRESS: _____________________________________________

________________________________________________________________

PHONE NUMBER: __________________________

NUMBER OF EMPLOYEES: _________

________FULL TIME______PART TIME

TYPE OF BUSINESS: ______________________________________________________________________

____________________________________________ ______________________________ SIGNATURE & TITLE DATE

RETURN THE ENTIRE APPLICATION TO THE FOLLOWING ADDRESS:

BUSINESS LICENSE OFFICE COST OF LICENSE:CITY OF DEMORESTPO BOX 128 $100.00 PER YEARDEMOREST GA 30535 DUE January 10 of each year good through706-778-4202 December 31 of each year.

O.C.G.A. § 50-36-1 (e) (2) Affidavit

By signing this application, I hereby swear and affirm one of the following to be true and accurate pursuant to O.C.G.A. § 50-36-1:

1) _______ I am a United States citizen 18 years of age or older. Please submit a copy of your current Secure and Verifiable Document(s) such as driver’s license, passport, or other document.

2) _______ I am not a United States citizen, but I am a legal permanent resident of the United States 18 years of age or older, or I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act 18 years of age or older with an alien number issued by the Department of Homeland Security or other federal immigration agency. Please submit a copy of your current immigration document(s) which includes either your Alien number or your I-94 number and, if needed, SEVIS number.

STATE OF GEORGIA COUNTY OF ___________________________________

______________________________________________ SIGNATURE OF THE APPLICANT

SUBSCRIBED AND SWORN TO BEFORE ME THIS ______________________________________________ ________ DAY OF _____________________, ________

PRINT NAME

______________________________________________ ______________________________________________ NOTARY PUBLIC DATEMY COMMISSION EXPIRES: _____________________

Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d)

By executing this affidavit under oath, the undersigned private employer verifies one of the following with respect to its application for a business license, occupational tax certificate, or other document required to operate a business as referenced in O.C.G.A. § 36-60-6(d):

Section 1 Please check only one:

(A)

One January 1 of the below-signed year, the individual, firm, or corporation employed more than ten (10) employees. (For purposes of this affidavit, a business must count its total number of employees company-wide, regardless of the city, state, or country in which they are based, working at least 35 hours a week.)

*** If you select Section 1(A), please fill out Section 2 and then execute below.

(B) On January 1 of the below-signed year, the individual, firm, or corporation employed ten (10) or fewer employees.

*** If you select Section 1(B), please skip Section 2 and execute below.

Section 2

The employer has registered with and utilizes the federal work authorization program in accordance with the applicable provisions and deadlines established with O.C.G.A. § 36-60-6. The undersigned private employer also attests that its federal work authorization user identification number and date of authorization are as follows:

Name of Private Employer

Federal Work Authorization User Identification Number

Date of Authorization

_____________________________________________________________________________________________

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on _______________, ____, 20__ in ________________________(City), ______(State).

SUBSCRIBED AND SWORN BEFORE MEON THIS THE ___ DAY OF ______________, 20___

Signature of Authorized Officer or Agent

NOTARY PUBLICPrinted Name & Title of Authorized Officer or Agent

My Commissioner Expires ______________________