Tax Compliance Form.doc
DOC document 1 MB Posted
- Attached to
- Classroom Furniture
- Solicitation number
- PE-55267-NONST-2025-000000019
- Issued by
- Jefferson County, Georgia
About this file
This document is a Tax Compliance Form from the State of Georgia that suppliers must complete in order to be eligible for state and local contract awards. The form requires suppliers to provide their business information, including their name, physical location address, federal identification number, and any previous registration in the state. Suppliers must also disclose the type of service they will perform and whether they will sell any tangible personal property or goods. The form also requires information on any supplier affiliates. The person responsible for handling the supplier's tax issues must be identified, including their name, telephone number, and email address. The State Entity will submit the completed form to the Georgia Department of Revenue to determine if the supplier is a "prohibited source" or has any outstanding tax issues. Missing, incomplete, or erroneous data may delay or prohibit the verification of the supplier's eligibility for contract award.
The form emphasizes that no prohibited source may receive a contract award, and suppliers are strongly encouraged to check their tax status and resolve any outstanding tax liabilities or missing tax returns prior to submitting the form. The form also notes that the information provided will be used in accordance with the Georgia Procurement Manual.
View the file
Other files
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .