How do I complete and submit this affidavit?

Complete the section that applies to your application, sign the affidavit under oath before a commissioned online notary, and submit it with the required documents to the City of Dublin.

Do I need to complete both affidavit sections?

The form provides a SAVE affidavit for public benefit applicants and an E-Verify affidavit for private employers seeking an occupational tax certificate or alcohol license. Complete the section or sections that apply to you.

What documents accompany the SAVE affidavit?

The form says to submit front and back copies of a secure and verifiable document, unless the same individual submitted one previously and a copy is already on file.

Can I sign this affidavit with an online notary?

Georgia has no remote online notarization statute of its own. Georgia law recognizes acknowledgments taken by notaries of other states (O.C.G.A. §44-2-21); ask the city whether it accepts a remotely notarized oath—confirm with the city if unsure.

Dublin, GA · Laurens County

Citizenship and E-Verify Affidavits

This combined affidavit form is for Dublin applicants seeking listed public benefits and private employers applying for an occupational tax certificate or alcohol license.

Standard form~15 min to notarize

licensed online notary
~15 min average
Notarized PDF emailed

What you’ll need

Government-issued photo ID
Webcam-enabled device (laptop or phone)
This form, ready to upload as a PDF

Form previewView full PDF →

What this form is

The form includes a SAVE affidavit for an applicant to state their citizenship or immigration status and provide information about a secure and verifiable document. It also includes an E-Verify affidavit for a private employer to report its employee count and, when applicable, its federal work authorization enrollment details. Dublin requires the applicable affidavit with an occupational tax or alcohol license application, or another listed public benefit application.

Who needs it

Applicants for listed Dublin public benefits and private employers applying for an occupational tax certificate or alcohol license should complete the applicable affidavit section.

Why it needs a notary

The form has a subscribed-and-sworn jurat; the applicant or the private employer’s authorized officer or agent signs the applicable affidavit before the notary.

How to get this notarized

1
Download the Form
Get the Citizenship and E-Verify Affidavits form from the City of Dublin.
2
Fill the Applicable Section
Complete the SAVE section for a public benefit application, the E-Verify section for a business application, or both if applicable.
3
Book an Online Notary
Arrange an appointment with a commissioned online notary and have the completed affidavit ready.
4
Sign Under Oath on Video
Sign the applicable affidavit before the notary during your online session.
5
Submit to the City
Send the notarized affidavit and any required supporting documents to the City of Dublin.

Preview the form

The blank PDF straight from Dublin. Look it over, then upload your filled copy to start the notary session.

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You’ll need ID and a webcam.

A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.

Frequently asked questions

How do I complete and submit this affidavit?: Complete the section that applies to your application, sign the affidavit under oath before a commissioned online notary, and submit it with the required documents to the City of Dublin.
Do I need to complete both affidavit sections?: The form provides a SAVE affidavit for public benefit applicants and an E-Verify affidavit for private employers seeking an occupational tax certificate or alcohol license. Complete the section or sections that apply to you.
What documents accompany the SAVE affidavit?: The form says to submit front and back copies of a secure and verifiable document, unless the same individual submitted one previously and a copy is already on file.
Can I sign this affidavit with an online notary?: Georgia has no remote online notarization statute of its own. Georgia law recognizes acknowledgments taken by notaries of other states (O.C.G.A. §44-2-21); ask the city whether it accepts a remotely notarized oath—confirm with the city if unsure.

Other forms in Dublin

Alcohol License Application

Dublin