Fillable Printable Tsd Form St-C 214-6 Certification Of Subcontractor Residency

Tsd Form St-C 214-6 Certification Of Subcontractor Residency

ST-C 214-6 (Rev. 3/13)

Georgia Department of Revenue

Certification of Subcontractor Residency

is a subcontractor contracting with

(Subcontractor’s Legal Name)(GA DOR Sales & Use Tax No.)

(Contractor’s Legal Name)

to perform all or any of the construction, alteration, repair, or improvement of the real property located at

(Date)

commencing on

Under penalties of perjury I declare that this certificate has been examined by me and to the

best of my knowledge and belief is true and correct, made in good faith, pursuant to the sales

and use tax laws of the State of Georgia.

I certify that

(Subcontractor’s Legal Name)

, is

a nonresident subcontractor, as provided by O.C.G.A. § 48-8-63, who does not

have a bona fide place of business in Georgia through the maintaining of a permanent

domicile or business facility engaged in constructing, altering, repairing, or improving real

property;

a resident subcontractor who does have a bona fide place of business in Georgia

through the maintaining of a permanent domicile or business facility engaged in

contracting real property work. The street address (P.O. Box not accepted) of the bona

fide place of business is:

Subcontractor’s Authorized Representative

Date

Print NameTitle

CLEAR