The Legal Status & Private Employer Affidavit is a two-part sworn statement used by the Henry County Tax Commissioner - Business & Occupational Tax Division when someone applies for an Occupational Tax Certificate from Henry County, Georgia. The first part certifies the applicant's legal status; the second states how many people the private employer had on January 1 and, for larger employers, its federal work authorization number. 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 henrycountytax.com.
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What is Legal Status & Private Employer Affidavit – Henry County, GA?
The Legal Status & Private Employer Affidavit is the Henry County, Georgia affidavit that an applicant for an Occupational Tax Certificate signs under oath to certify legal status in the United States and to state the private employer's size and federal work authorization details.
The form has two sections, and the county states that both must be completed or the application will be rejected.
- Legal Status Affidavit. It rests on O.C.G.A. sec 50-36-1, which requires verification of legal status for public services and public benefits as defined in the Georgia Security and Immigration Compliance Act (GSICA). The applicant certifies being either a United States citizen 18 years of age or older, or a qualified alien or nonimmigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States.
- Private Employer Affidavit. It is made under O.C.G.A. § 36-60-6(d). The applicant, representing the named private employer, states whether the business employed more than ten or fewer than ten employees on January 1 of the year signed, and, for the larger group, gives its E-Verify number and federal work authorization user identification number and date of authorization.
The form ends with an execution line (date, city, state), the applicant's signature and printed name, and a notary public block with commission expiration. The Henry County Tax Commissioner's agency page lists this affidavit among the items of a complete occupational tax application. It is not a tax return and does not itself grant a license.
Who needs to file Legal Status & Private Employer Affidavit – Henry County, GA?
Anyone applying to Henry County, Georgia, for an Occupational Tax Certificate completes this affidavit as part of the application; the county's page lists it as "Legal Status/Private Employer Affidavit" in its list of what a complete application includes.
Within the form, groups choose their own entries:
- U.S. citizens who are 18 or older check the first legal status option.
- Qualified aliens or nonimmigrants who are 18 or older and lawfully present in the United States check the second option, attach a copy of the Alien Registration Card and give the Alien Registration Number.
- Employers with more than ten employees on January 1 of the year signed select 1(a), give an E-Verify number and also complete Section 2.
- Employers with fewer than ten employees on January 1 of the year signed select 1(b). The form states that the owner is considered an employee.
The person signing is the applicant, who signs on behalf of the private employer named on the form. The form does not describe any other person signing for the applicant.
When to file Legal Status & Private Employer Affidavit – Henry County, GA
Complete the affidavit when you apply for an Occupational Tax Certificate from Henry County, since it is one of the documents the county lists for a complete application. The form prints no separate due date.
Timing details printed on the form:
- Section 1 of the Private Employer Affidavit is to be filled out if the current date is after July 1, 2013.
- The employee count is measured on January 1 of the year in which you sign.
- The form is executed on a specific date, in a city and state, so sign it when you are ready to submit the application.
The affidavit also states that it is the company's responsibility to notify the occupational tax department of any changes or closure involving the business. The county takes applications by appointment, Monday through Friday, 8:30am to 11:00am and 2:30pm to 4:00pm.
Documents you need
- A copy of your Alien Registration Card, only if you are a qualified alien or nonimmigrant lawfully present in the United States and check option 2 of the Legal Status Affidavit.
How to fill out Legal Status & Private Employer Affidavit – Henry County, GA
Check your legal status option
In the Legal Status Affidavit, mark option 1 if you are a United States citizen 18 years of age or older, or option 2 if you are a qualified alien or nonimmigrant 18 or older and lawfully present in the United States.
Enter your Alien Registration Number
If you are not a citizen, write your number on the line labeled Alien Registration Number of Non-Citizens and prepare a copy of your Alien Registration Card to attach.
Name the private employer
In the Private Employer Affidavit, write the name of the private employer you represent on the line following "the private employer known as".
Select 1(a) or 1(b)
Mark 1(a) if the employer had more than ten employees on January 1 of the year you sign, or 1(b) if it had fewer than ten. The owner is considered an employee.
Add the E-Verify number
If you marked 1(a), enter the E-Verify# on the line provided.
Complete Section 2 if you chose 1(a)
Enter the Federal Work Authorization User Identification Number and the Date of Authorization for the employer's registration with the federal work authorization program.
Read the sworn statement
Read the paragraph about false statements under O.C.G.A. § 16-10-20 and the notice that you must report changes or closure of the business to the occupational tax department.
Fill in the execution line
Enter the day, month, year (202_), city and state where the affidavit is executed.
Sign and complete the notary block
Add the applicant's signature and printed name. The notary public signs and enters the commission expiration date in the notary block.
Review and download the completed PDF
Check that both sections are complete, then download or print the PDF from FillingPDF and take it, with the other application items, through the channels described under How to submit.
How to submit Legal Status & Private Employer Affidavit – Henry County, GA
The Henry County Tax Commissioner's agency page describes two ways to apply: by appointment at the Business & Occupational Tax Division, or online.
- By appointment: Applications are taken by appointment only, Monday through Friday, 8:30am to 11:00am and 2:30pm to 4:00pm. You can schedule an appointment through the county's occupational tax forms page, https://henrycountytax.com/176/Business-License-Forms.
- Online: The same page invites applicants to save time and apply online.
- By phone: For questions, call 770-288-8180, option 5.
The county lists what a complete application includes: a copy of your driver's license, page 2 of the application notarized, the gross receipts form, this Legal Status/Private Employer Affidavit, the ULDC requirements (home-based businesses only) and the application itself. The affidavit has its own notary block. The form names no mailing address. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Leaving either section incomplete: the form states that both sections must be completed or the application will be rejected.
- Not checking either legal status option, or checking the citizen option when you are a qualified alien or nonimmigrant.
- Checking option 2 without attaching a copy of your Alien Registration Card or without entering the Alien Registration Number.
- Selecting 1(a), more than ten employees, but skipping the E-Verify number or leaving Section 2 blank.
- Selecting 1(b) without remembering that the form counts the owner as an employee.
- Filling in the federal work authorization user identification number but omitting the date of authorization.
- Leaving the execution date, city and state, signature, printed name or notary block incomplete.
- Treating the affidavit as the whole application: the county also lists a driver's license copy, the notarized page 2, the gross receipts form and the application itself.
Frequently asked questions
What is the Legal Status & Private Employer Affidavit used for?
It is the sworn statement Henry County asks for with an Occupational Tax Certificate application. One section certifies your legal status in the United States; the other states the private employer's employee count and, if it applies, its federal work authorization details.
Is this a Henry County property tax form?
No. Searches for Henry County property tax often lead to the Tax Commissioner's site, but this affidavit belongs to the Business & Occupational Tax Division's Occupational Tax Certificate application. It does not deal with property tax bills.
Do I have to complete both sections of the affidavit?
Yes. The form states that both sections must be completed, or the application will be rejected. The Legal Status Affidavit and the Private Employer Affidavit each need your entries, and the form closes with a signature and notary block.
What do I attach if I am not a U.S. citizen?
If you are a qualified alien or nonimmigrant lawfully present in the United States, attach a copy of your Alien Registration Card, check option 2 and write your Alien Registration Number on the form. Citizens check option 1 and attach nothing for this section.
Which option do I pick, 1(a) or 1(b)?
Pick 1(a) if the business employed more than ten employees on January 1 of the year you sign, or 1(b) if it employed fewer than ten. The form says the owner is considered an employee. Only 1(a) filers complete Section 2 with their E-Verify number and work authorization details.
Does the affidavit need to be notarized?
The form includes a notary public signature line and a commission expiration line next to the applicant's signature and printed name, and it is executed under oath. The county's list also asks for page 2 of the application notarized.
How do I submit the Henry County occupational tax application?
The Tax Commissioner's page says applications are taken by appointment only, Monday through Friday, 8:30am to 11:00am and 2:30pm to 4:00pm, or you can apply online. For questions call 770-288-8180, option 5.
Can I fill out this affidavit online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not affiliated with Henry County, and does not submit the affidavit; you deliver it through the county's channels.
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