Authorized Permit Agent Form PDF Details

In this blog post I will be going over the steps to get an authorized permit agent form from the Department of Alcoholic Beverage Control. The process is not very difficult, but there are a few steps involved so it's important to follow them in order. The first step is to fill out a request for application and submit it with your payment of $400. Make sure you include all pertinent information including your business name and address, as well as a home address where they can reach you at during regular business hours if necessary.

In the table, there's some information in regards to the authorized permit agent form. You might want to learn its size, the typical time needed to fill out the form, the blanks you'll have to fill in, and so on.

Form NameAuthorized Permit Agent Form
Form Length2 pages
Fillable fields17
Avg. time to fill out3 min 58 sec
Other namesauthorized permit agent form, permit agent georgia, georgia authorized, ga authorized

Form Preview Example

State Licensing Board for

Residential and General Contractors

The Authorized Permit Agent form may be used by a licensed contractor to designate an individual to obtain permit(s) on his/her behalf for a project(s). The contractor should submit an Authorized Permit Agent Form for each project that he/she designates an individual to pull permits for. The form is to be given to the permit office in the city or county in which the project is located. Do not send a copy of this form to the Board office unless you are requested to do so.

237 Coliseum Drive Macon, Georgia 31217 (478) 207-2440

State Licensing Board for

Residential and General Contractors

Authorized Permit Agent Form

License verification by permitting office should be completed by visiting

Licensed Contractor: _____Individual_____Qualifying Agent

Name of licensed person ________________________________________________________

*Please attach a copy of Individual license or Company License (Reflects company and qualifying agent license number)

License number of individual or qualifying agent: ______________________________

Name of licensed company(if applicable)__________________________

License number of company(if applicable):________________________________________

I, ______________________________________________, hereby designate

Licensed Individual or Qualifying Agent

________________________________________________ to apply for and obtain the permit(s) for the

*Please attach a copy of the authorized permit agent’s driver’s license.

project at:


Street address


Apartment or Suite Number



Zip Code

I, the undersigned, being the contractor as either an individual or a qualifying agent, do hereby affirm and swear, under oath, that all information on this form and on accompanying documents are true and correct.

Signature of individual or qualifying agent _________________________________________________

State of ______________________________ County of ____________________________________

Subscribed and sworn to before me this _______ day of ________________20__


Signature of Notary Public______________________________


237 Coliseum Drive Macon, Georgia 31217 (478) 207-2440


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georgia permit agent form empty fields to consider

Complete the Authorized Permit Agent Form, (Seal), 237 Coliseum Drive ● Macon, and www area with the details required by the application.

Entering details in georgia permit agent form part 2

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