Dallas, GA · Paulding County
Private Employer Affidavit
This affidavit lets a private employer report its January 1 employee count and, when applicable, federal work authorization information for a business license, occupational tax certificate, or other business operating document.
- 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
What this form is
The private employer selects whether it had more than ten employees or ten or fewer employees on January 1 of the stated year. Employers selecting more than ten employees also complete the section attesting to federal work authorization registration and providing the user identification number and authorization date. The form accompanies an application for a business license, occupational tax certificate, or other document required to operate a business.
Who needs it
A private employer applying for a business license, occupational tax certificate, or other document required to operate a business uses this affidavit to report its employee count.
How to get this notarized
- 1
Download The Affidavit
Get the Private Employer Affidavit from the City of Dallas document center.
- 2
Fill In The Employer Details
Select one employee-count option and, if required, complete Section 2 with the employer and federal work authorization information.
- 3
Book An Online Notary
Arrange a session with a commissioned online notary and have the completed affidavit ready.
- 4
Sign On Video
The authorized officer or agent signs and swears to the affidavit before the notary during the video session.
- 5
Submit To The City
Submit the notarized affidavit with the business license, occupational tax certificate, or other business operating document application.
Preview the form
The blank PDF straight from Dallas. Look it over, then upload your filled copy to start the notary session.
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 the Private Employer Affidavit?
- Select one employee-count option for January 1. If the employer had more than ten employees, complete Section 2 with the work authorization details. An authorized officer or agent signs and swears to the affidavit before a notary.
- Do I need to complete Section 2?
- Complete Section 2 only if you select Section 1(A), indicating the employer had more than ten employees on January 1. If you select Section 1(B), the form says to skip Section 2.
- Can I use a commissioned online notary for this affidavit?
- Georgia has no remote online notarization statute of its own. Georgia law recognizes acknowledgments taken by notaries of other states under O.C.G.A. §44-2-21, but this form calls for a sworn statement; confirm with the city if unsure.
- Who signs the affidavit?
- The form provides a signature line for an authorized officer or agent of the private employer, along with a printed name and title field. The signer must take the oath before the notary.
Private Employer Affidavit in other Georgia cities
Each city publishes its own version of this form. Pick the city where you’re filing.