Tax Compliance Form.doc
DOC document 2 MB Posted
- Attached to
- 24-62 Two-Way Radios
- Solicitation number
- PE-55267-NONST-2024-000000003
- Issued by
- Jefferson County, Georgia
About this file
This document is a Tax Compliance Form for suppliers interested in state and local contract opportunities in the State of Georgia. It requires suppliers to provide information such as their name, physical location address, federal identification number, state taxpayer identification number, sales and use tax number, and withholding tax number. The form also asks the supplier to indicate the type of service they will perform and whether they will sell any tangible personal property or goods. Additionally, the supplier is required to provide information about any affiliates, including their name, federal identification number, state taxpayer identification number, sales and use tax number, and withholding tax number. The form states that the information provided will be submitted to the Georgia Department of Revenue for a determination of the supplier's eligibility for contract award, and that missing, incomplete, or erroneous data may delay or prohibit the verification of the supplier's eligibility.
The document emphasizes the importance of suppliers resolving any outstanding tax liabilities or missing tax returns, as no prohibited source may receive a contract award. The state entity is instructed to submit the completed form to the Georgia Department of Revenue for processing in accordance with the Georgia Procurement Manual.
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| 24_62 Two Way Radio Specs 2023.pdf | ||
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| JCSS STANDARD TERMS AND CONDITIONS.pdf | ||
| 24_62 GENERAL INFORMATION WORKSHEET.doc | DOC document | |
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| 24_62 Two_Way Radio NOITA Signed.pdf | ||
| 24_62 Two_Way Radio Questions and Answers.pdf | ||
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Text version
TAX COMPLIANCE
INSTRUCTIONS TO SUPPLIERS
Please complete the following information:
· Supplier’s Name:
· Physical Location Address:
· Federal Identification Number (FEI):
· Have you ever been registered in the State of Georgia?
· If so, please provide the following information, if applicable:
· State Taxpayer Identification Number (STI):
· Sales and Use Tax Number:
· Withholding Tax Number:
· What type of service will you perform?
· Will you sell any tangible personal property or goods?
· Supplier’s Affiliate’s Name:
· FEI:
· STI:
· Sales and Use Tax Number:
· Withholding Tax Number:
If there is more than one affiliate, please attach a separate sheet listing the information above.
· Person responsible for handling supplier’s tax issues (such as the CFO, the company tax officer, etc.):
· Name:
· Telephone Number:
· E-mail Address:
NOTICE TO SUPPLIER:
In the event the supplier is considered for contract award, the information provided in the form will be submitted by the State Entity to the Georgia Department of Revenue (“DOR”) for a determination as to whether the supplier is a “prohibited source” (as defined by O.C.G.A. §50-5-82) or whether there are any other outstanding tax issues. MISSING, INCOMPLETE, OR ERRONEOUS DATA MAY DELAY OR PROHIBIT VERIFICATION OF YOUR ELIGIBILITY FOR CONTRACT AWARD. NO PROHIBITED SOURCE MAY RECEIVE CONTRACT AWARD; THEREFORE, YOU ARE STRONGLY ENCOURAGED TO CHECK YOUR TAX STATUS NOW AND RESOLVE ANY OUTSTANDING TAX LIABILITIES AND/OR MISSING TAX RETURNS.
STATE ENTITY: Please submit this form via email to DOR at tsd-state-contractors@dor.ga.gov for processing in accordance with the Georgia Procurement Manual.
Revised: 12/22/2010
SPD-SP045
An Equal Opportunity Employer
File details come from the government source that posted it. Updated .