Occupational Tax Certificate Guidelines

Transcription

1 Bulloch County Board of Commissioners Olympia Gaines Clerk of the Board/License Administrator Physical Address: 115 N. Main Street Statesboro, GA Mailing Address: P.O. Box 347, Statesboro, GA Phone # / Fax # Occupational Tax Certificate Guidelines The Bulloch County Board of Commissioners updated the fee structure for the annual Occupation Tax for businesses in the unincorporated area of Bulloch County recently. Individuals engaged in any business, trade, profession or occupation within the unincorporated area of Bulloch County, are now required to obtain an Occupational Tax Certificate by July 1 st. This is separate from other regulatory guidelines that may be required prior to opening a business within the County (e.g., alcohol license or other state issued licenses). The County will send the Occupational Tax Certificate by mail within one business week, once all the required information is submitted and approved. Required Information: 1. Submit application to the Clerk of the Board. Photo ID required for original application. 2. Submit Affidavit(s) - If your business employs less than eleven (11) employees, you should complete and execute the enclosed Private Employer Exemption Affidavit. If your business employs eleven (11) or more employees, you should complete and execute the enclosed Private Employer Affidavit of Compliance. You will note that this affidavit requires you to provide your Federal Work Authorization Use Identification Number for using the federal work authorization program commonly known as E-Verify. The Public Benefit Affidavit has to be completed for every business. 3. Submit the Sheriff Contact Information form. 4. Pay Occupational Tax - rate based on the number of employees (see below). Check and cash only. 1-3 employees - $ employees - $ employees - $ employees - $ employees - $ & above - $300 + $1 per employee over 26 Renewal: Certificates expire June 30 th of each year and must be renewed by July 31 st to remain current and avoid any penalties. Renewal notices will be sent out each June.

2 Bulloch County Board of Commissioners Clerk of the Board/License Administrator Physical Address: 115 N. Main Street, Statesboro, GA Mailing Address: P.O. Box 347, Statesboro, GA Phone # / Fax # Occupational Tax Certificate Application Business Name: Home Occupation? Yes / No Business Owner: Business Phone #: Business Fax #: Business Mailing Address: Business Physical Address: Property Owner s Name: Owner Phone #: Property Owner s Mailing Address: State Board Certificate #: Dominant Line of Business: Expiration Date: (Describe the nature of your business) Number of Employees: Is or will business sell alcohol? If yes, name on license? I certify that I have provided complete and accurate information. I understand that failure to comply with the occupation requirements may result in revocation of my Occupational Tax Certificate. Applicant Signature: Date: Office Use Only Zoning District: Map / Parcel: Use Permitted in Zoning District? Yes / No Property Taxes Paid? Yes / No Current Alcohol License? Yes / No / NA Health Dept. Approval? Yes / No / NA Public Benefit App.? Yes / No Sheriff Contact form? Yes / No Fire Dept. Approval? Yes / No / NA License Approved? Yes / No Approved by: Date: Comments:

3 17257 Hwy 301 North Statesboro, GA Phone (912) Lynn M Anderson Fax (912) Sheriff Dear Business Owner: Please take a moment to complete the following information regarding your business. This information will be forwarded to the Bulloch County Sheriff s Office in maintaining a database on businesses in case of emergency after hours contact. If any of the information should change, we would appreciate notification at the following address and telephone number. Again, thank you for your time and patience in completing this form. If you have any questions or concerns, please feel free to contact the Bulloch County Sheriff s Office. Business Name: Street Number: Street Address: Business Phone: Reference Person: Dispatch Alert: Please note any private security information regarding your business (such as vicious dog at gate, alarm company etc ) Contact Information: Please list three emergency contacts. Name Telephone Number(s) Cell Phone Number(s) General Information: Such as hours of operation, also please list any information that you feel would assist us in serving you and your business. SHERIFF S OFFICE USE ONLY

4 FILL OUT ONLY IF YOU HAVE LESS THAN 11 EMPLOYEES PRIVATE EMPLOYER EXEMPTION AFFIDAVIT PURSUANT TO O.C.G.A (d)-By executing this affidavit, the undersigned private employer verifies that it is exempt from compliance with O.C.G.A , stating affirmatively that the individual, firm, or corporation employs less than eleven (11) employees and is not required to register with and/or utilize the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A Signature of Exempt Private Employer Printed Name of Exempt Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on,, 20, in (city), (state). Signature of Authorized Officer or Agent Printed Name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF, 20 Notary Public My Commission Expires:

5 FILL OUT ONLY IF YOU HAVE 11 or MORE EMPLOYEES PRIVATE EMPLOYER AFFIDAVIT OF COMPLIANCE PURSUANT TO O.C.G.A (d) - By executing this affidavit, the undersigned private employer verifies it s compliance with O.C.G.A , stating affirmatively that the individual, firm, or corporation has registered with and utilizes the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A Furthermore, the undersigned private employer hereby attests that its federal work authorization user identification number and date of authorization are as follows: Federal Work Authorization Use Identification Number (E-Verify #) Date of Authorization Name of Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on,, 20, in (city), (state). Signature of Authorized Officer or Agent Printed Name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF, 20 Notary Public My Commission Expires:

6 Public Benefit Affidavit O.C.G.A (f) (2) Affidavit-By executing this affidavit under oath, as an applicant for a (n) [type of public benefit, OTC, Alcohol License] for,(name of Owner) as referenced in O.C.G.A , from Bulloch County, the undersigned applicant verifies one of the following with respect to my application for a public benefit: 1) I am a United States citizen. 2) I am a legal permanent resident of the United States. 3) I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency. My alien number issued by the Department of Homeland Security or other federal immigration agency is:. The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A (f)(l), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A , and face criminal penalties as allowed by such criminal statute. Executed in (city),,(state).. Signature of Applicant Subscribed and sworn before me on this the DAY OF, 20 Printed Name of Applicant NOTARY PUBLIC My Commission Expires: