License Information

Occupation Tax/License # *
25-

Account # *

Classification/SIC Code *

Change of Company Information (if applicable)

Legal name change

DBA change (add $25)

Business address change (add $25)

Mailing address change

Fed Tax ID change

List names of new owners, members, or shareholders

Percentage of ownership

Gross Receipts and Employee Information

2025 Actual Gross Receipts *

2025 # of Employees *

2026 Estimated Gross Receipts *

2026 # of Employees *

Your Contact Information

Name *

Title *

Phone # *

Email Address *

I do hereby register and pay the occupation tax to operate said business with the activity according to the standard industry code indicated above. I declare that I am duly authorized by the business herein named to file this registration for occupation tax, including the accompanying schedules and statements, and that same are true, correct and complete. Providing false, fictitious, or fraudulent statements or representations may be guilty of a violation of O.C.G.A § 16-10-20.

Applicant Signature

Clear Signature

Submit Signature

Upload Supporting Documents

The following documents are required in image/pdf (jpg, jpeg, png, pdf) format. Please make sure to upload documents are set to PORTRAIT (VERTICAL) orientation (layout). Maximum of three files.
REQUIRED: NOTARIZED PRIVATE EMPLOYER AFFIDAVIT
REQUIRED: NOTARIZED AFFIDAVIT VERIFYING STATUS (Signee of the renewal registration must complete this affidavit if he/she is not a U.S. citizen or has not already provided proof of U.S. citizenship.)
REQUIRED: COPY OF LEGAL PHOTO ID (Copy of the signee's state- issued driver's license.)

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