i_9 2027.pdf

This is an E-Verify Affidavit Form B issued by the State of Georgia under O.C.G.A. 36-60-6(d), establishing compliance requirements for private employers. The form allows private employers with fewer than 100 employees to certify their exemption from mandatory E-Verify registration and utilization requirements under Georgia law. The affidavit requires execution by an authorized officer or agent of the exempt private employer and must be notarized, with the notary public providing certification of the execution date and commission expiration information.

The form serves as a compliance document for state and local contract opportunities in Georgia, enabling smaller employers to formally declare their exempt status from federal work authorization program requirements. Execution requires the signature and printed name of the exempt private employer, as well as the signature, printed name, and title of an authorized officer or agent. The affidavit must be executed under penalty of perjury and includes space for the date of execution, city, and state. No pricing terms, set-asides, incumbents, funding requirements, or contract renewal options are applicable to this compliance form.