SAVE Affidavit _ NEW.pdf
PDF 66 KB Posted
- Attached to
- 2026 - 28 Portable Message Signs on Trailers (4)
- Solicitation number
- PE-33306-NONST-2027-000000026
- Issued by
- Georgia
About this file
This is a SAVE Affidavit form required by the State of Georgia under O.C.G.A. 50-36-1(e)(2) for applicants seeking public benefits. The affidavit is associated with a Georgia state and local contract opportunity for the supply and delivery of 4 Portable Message Signs on trailers according to specified requirements. The form serves as a verification document whereby applicants must attest to their citizenship or immigration status under oath before a notary public.
The affidavit requires applicants to verify one of three immigration statuses: United States citizenship, legal permanent resident status, or qualified alien or non-immigrant status under the Federal Immigration and Nationality Act. Applicants must also confirm they are 18 years of age or older and have provided at least one secure and verifiable document as required by state law. The form includes standard notarization requirements and warns that false statements constitute a criminal violation under O.C.G.A. 16-10-20. Applicants must execute the affidavit in the presence of a notary public and provide specific personal information including their printed name, signature, and the location and date of execution.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2026 Invitation to Bid Portable message signs.docx | DOCX document | |
| E_Verify Affidavit _ NEW.pdf | ||
| 2026 Portable Message Sign 4 x 8 Specs.docx | DOCX document | |
| Bidding Check List.docx | DOCX document | |
| W_9 Form.pdf |
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Text version
O.C.G.A. § 50-36-1(e)(2) Affidavit
By executing this affidavit under oath, as an applicant for a(n) ____________________ [type of public benefit], as referenced in O.C.G.A. § 50-36-1, from _________________________ [name of government entity], the undersigned applicant verifies one of the following with respect to my application for a public benefit:
1) _________ I am a United States citizen.
2) _________ I am a legal permanent resident of the United States.
3) _________ I am a qualified alien or non-immigrant under the Federal Immigration and
Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency.
My alien number issued by the Department of Homeland Security or other federal immigration agency is:____________________.
The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A.
§ 50-36-1(e)(1), with this affidavit.
The secure and verifiable document provided with this affidavit can best be classified as:
In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as allowed by such criminal statute.
Executed in ___________________ (city), __________________(state).
Signature of Applicant
Printed Name of Applicant
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
___ DAY OF ___________, 20____
NOTARY PUBLIC
My Commission Expires:
File details come from the government source that posted it. Updated .