The Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) is a sworn statement from Gwinnett County's Licensing & Revenue Division in which a private employer reports how many employees it had on January 1 and, if it had more than ten, its E-Verify registration details. The county's Business License page calls it the E-Verify Affidavit, and it is tied to an application for a Gwinnett County business license or occupational tax certificate. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the county publishes the original at gwinnettcounty.com.
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What is Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) – Gwinnett County, GA?
The Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) is a sworn statement, published by Gwinnett County's Licensing & Revenue Division, in which a private employer reports its employee count on January 1st and, above ten employees, its E-Verify registration.
The affidavit is made under oath with respect to the employer's application for a business license, occupational tax certificate, or other document required to operate a business. Section 1 offers two choices, and you check only one: (A) the employer had more than ten (10) employees on January 1st of the year in which it signs, or (B) it had ten (10) or fewer. Employers that select 1(A) complete Section 2, giving the employer name, the Federal Work Authorization User Identification Number and the Date of Authorization. Employers that select 1(B) skip Section 2.
The county's Business License page explains the background: the Illegal Immigration Reform and Enforcement Act of 2011 requires private employers with more than 10 employees as of July 1, 2013 to register with and use the federal work authorization program, known as E-Verify, and to submit an E-Verify Affidavit.
This is not the U.S. Citizen/Qualified Alien Affidavit. That separate affidavit, required under Official Code of Georgia § 50-36-1(1), certifies an applicant's legal presence in the United States. The private employer affidavit covers the employer's headcount and E-Verify status. It does not grant a license or register you with E-Verify.
Who needs to file Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) – Gwinnett County, GA?
Private employers that are applying to Gwinnett County for a business license, occupational tax certificate, or other document required to operate a business complete this affidavit. The form asks the employer to choose one of two statements about its size.
- More than ten employees (Section 1(A)): the employer must also complete Section 2 and attest that it has registered with and uses the federal work authorization program (E-Verify). The county's Business License page says private employers with more than 10 employees as of July 1, 2013 must register with E-Verify and submit an E-Verify Affidavit.
- Ten or fewer employees (Section 1(B)): the employer checks that box, skips Section 2 and executes the affidavit.
An authorized officer or agent of the employer signs, and prints their name and title. The form closes with a notary block, so the signature is sworn before a notary public.
To decide which box applies, count total employees company-wide, regardless of the city, state or country where they are based, who work at least 35 hours a week. Individual owners, firms and corporations are all covered by the wording of the form.
Applicants who need to certify their own legal presence use the separate U.S. Citizen/Qualified Alien Affidavit instead.
When to file Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) – Gwinnett County, GA
Complete the affidavit when you apply for a Gwinnett County business license, occupational tax certificate, or other document required to operate a business, because the form is made with respect to that application. No separate due date is printed on it.
The employee count is fixed by date: Section 1 asks how many employees the business had on January 1st of the year in which you sign.
Employers that check Section 1(A) attest in Section 2 that they registered with E-Verify in accordance with the provisions and deadlines in O.C.G.A. § 36-60-6; the form itself does not restate those deadlines. The county's Business License page adds that private employers with more than 10 employees as of July 1, 2013 must register with and use E-Verify. For registration steps, the county refers you to USCIS.gov, so register before you list a user identification number and authorization date on this form.
Documents you need
- Your Federal Work Authorization User Identification Number and Date of Authorization from E-Verify, needed only if you check Section 1(A), employed more than ten (10) employees on January 1st.
How to fill out Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) – Gwinnett County, GA
Count your company-wide employees
Before you start, count total employees company-wide on January 1st of the year you sign, in any city, state or country, who work at least 35 hours a week.
Check one box in Section 1
Check 1(A) if the business employed more than ten (10) employees on January 1st of the signed year, or 1(B) if it employed ten (10) or fewer. Check only one.
Enter the employer name in Section 2
If you checked 1(A), write the Name of Private Employer. If you checked 1(B), skip Section 2 and go to the execution lines.
Enter your E-Verify user ID
Under 1(A), write the Federal Work Authorization User Identification Number from your E-Verify registration.
Enter the date of authorization
Under 1(A), write the Date of Authorization for the federal work authorization program.
Enter the execution date and place
On the "Executed on" line, fill in the date, using the year of signing, and the city and state where you sign.
Sign as authorized officer or agent
Sign on the Signature of Authorized Officer or Agent line, then print the name and title of that officer or agent on the line below.
Have a notary complete the notary block
The notary public completes the "Subscribed and sworn before me" block with the day, month and year, signs, and enters the date the commission expires.
Review, download and print the PDF
Check that only one Section 1 box is marked and that Section 2 matches your choice, then download or print the completed PDF from FillingPDF and submit it with your application as described under How to submit.
How to submit Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d) – Gwinnett County, GA
Submit the affidavit to Gwinnett County together with your business license application. The form prints no separate mailing address, portal or appointment rule of its own.
- With the application: attach the completed, signed and notarized affidavit when you submit your application for a business license or occupational tax certificate.
- County information: the application requirements, the E-Verify note for private employers and the fee scale are described on the county's Business License page: https://www.gwinnettcounty.com/government/departments/planning-development/services/business-license.
- E-Verify registration: if you check Section 1(A), the county directs you to USCIS.gov for E-Verify registration instructions.
Before you hand it in, check that Section 1 has one box checked, Section 2 is filled out only for 1(A), the authorized officer or agent has signed and printed a name and title, and the notary has completed the notary block. Other documents the county lists for the application, such as a Certificate of Occupancy or a driver's license copy, belong to the application and not to this affidavit. FillingPDF lets you fill out and download the PDF; submission follows the county's channels above.
Common mistakes to avoid
- Checking both boxes in Section 1. The form says to check only one: 1(A) for more than ten employees or 1(B) for ten or fewer.
- Filling out Section 2 after choosing 1(B), or skipping Section 2 after choosing 1(A). Only 1(A) employers complete Section 2.
- Counting only the employees at the Gwinnett location. The form counts total employees company-wide, in any city, state or country, working at least 35 hours a week.
- Using a headcount from a date other than January 1st of the year in which the affidavit is signed.
- Leaving the Federal Work Authorization User Identification Number or the Date of Authorization blank after selecting 1(A).
- Signing without printing the name and title of the authorized officer or agent, which the form asks for under the signature line.
- Leaving the notary block (day, month, year, notary signature and commission expiration) empty. The affidavit is sworn before a notary public.
- Submitting this affidavit in place of the U.S. Citizen/Qualified Alien Affidavit. The county treats them as separate affidavits.
Frequently asked questions
What is the Gwinnett County E-Verify affidavit?
It is the Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d), a sworn statement of a private employer's headcount on January 1st and, above ten employees, its E-Verify registration. The county's Business License page calls it the E-Verify Affidavit.
Do I need the E-Verify affidavit for a Gwinnett County business license?
The form is made with respect to an application for a business license, occupational tax certificate or other document required to operate a business. The county says private employers with more than 10 employees as of July 1, 2013 must submit an E-Verify Affidavit.
Which box do I check if I have 10 or fewer employees?
Check Section 1(B), skip Section 2, and then sign and have the affidavit sworn before a notary public. The count is based on January 1st of the year in which you sign.
How do I count employees for the affidavit?
Count total employees company-wide, regardless of the city, state or country where they are based, who work at least 35 hours a week. Use the number of employees on January 1st of the year you sign.
Does the private employer affidavit have to be notarized?
The affidavit is executed under oath and ends with a "Subscribed and sworn before me" notary block. Sign it as the authorized officer or agent, and have the notary public complete the block.
What goes in Section 2 of the affidavit?
Only employers that check Section 1(A) fill it out: the Name of Private Employer, the Federal Work Authorization User Identification Number and the Date of Authorization. For E-Verify registration instructions, the county refers you to USCIS.gov.
What is the difference between this and the U.S. Citizen/Qualified Alien Affidavit?
The private employer affidavit reports an employer's size and E-Verify status. The U.S. Citizen/Qualified Alien Affidavit, required under Official Code of Georgia § 50-36-1(1), certifies the applicant's legal presence in the United States.
Can I fill out the Gwinnett County E-Verify affidavit online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service: it does not file the affidavit with Gwinnett County or notarize it, so you submit it through the county's channels.
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