Affidavit Employer Form PDF Details

The Private Employer Affidavit of Compliance is a vital legal document for businesses operating in Georgia. Under O.C.G.A. § 36-60-6(d), private employers with more than ten employees must verify that each worker is lawfully authorized to work in the United States through the federal E-Verify program.

To complete this affidavit, employers must provide their federal work authorization user identification number and the date they enrolled in E-Verify. The form must be executed in the presence of a notary public, which reinforces its legal standing and confirms the accuracy of the information provided.

By signing the affidavit, an employer pledges under penalty of perjury that all information is accurate and true. Compliance demonstrates a commitment to maintaining a legal workforce and upholding the standards set by Georgia state law. Employers who fail to comply risk civil penalties and may lose eligibility for contracts with local government entities.

QuestionAnswer
Form NameAfidavit Employer Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesprivate affidavit pursuant, private employer affidavit, private employee affidavit form, private employer affidavit pursuant

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

By executing this affidavit, the undersigned private employer verifies its compliance with O.C.G.A. § 36-60-6, stating affirmatively that the individual, firm or corporation employs more than ten employees and 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. § 13-10-90. 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 User Identification Number

_________________________________

Date of Authorization

_________________________________

Name of Private Employer

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

Executed on ______, ___, 201__ 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 ______________,201__.

_________________________________

NOTARY PUBLIC

My Commission Expires:

_________________________________

How to Edit Afidavit Employer Form Online for Free

Filling out an Affidavit Employer Form requires accurate employer information, your E-Verify enrollment details, and a notary public's witness. Follow the steps below to complete the affidavit correctly and avoid common mistakes.

What You Need Before You Start

Gather the following information before you begin:

  • Your company's legal name and business address
  • Your federal work authorization user identification number (your E-Verify ID)
  • The date your company enrolled in E-Verify
  • A licensed notary public to witness and certify the completed form

How to Fill Out the Affidavit Employer Form

  1. Enter your employer details. Write your business name, address, and contact information in the designated fields at the top of the form.
  2. Provide your E-Verify information. Enter your federal work authorization user identification number and the exact date your company enrolled in E-Verify.
  3. Confirm the number of employees. Verify that your business employs more than ten workers, as the affidavit applies only to employers above this threshold.
  4. Review all entries for accuracy. Double-check every field before signing. Errors or omissions on this affidavit can result in legal penalties under Georgia law.
  5. Sign in front of a notary public. Do not sign the form before appearing before a notary. The notary must witness your signature and apply their seal to make the affidavit legally valid.
  6. File or retain the form. Submit the completed and notarized affidavit to the appropriate authority, or keep it on file as a compliance record for your business.

Frequently Asked Questions

Who is required to complete an Affidavit Employer Form?

Private employers in Georgia with more than ten employees must complete this affidavit to certify their compliance with E-Verify requirements under O.C.G.A. § 36-60-6.

What happens if an employer does not file the affidavit?

Failure to comply may result in civil penalties and jeopardize the employer's eligibility for contracts with local government entities in Georgia. Taking compliance seriously protects your business from these risks.

Does the Affidavit Employer Form need to be notarized?

Yes. The affidavit must be signed and notarized in the presence of a licensed notary public to be legally valid. For information on Georgia notary requirements, see the Georgia Notary Acknowledgement page.

Can employers outside of Georgia use this form?

This affidavit is specific to Georgia's employment verification law. Employers in other states should review their local regulations for E-Verify compliance documentation requirements.

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