Cobb County Business License Division P.O. Box 649 Marietta ...

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Cobb CountyBusiness License DivisionTaxicab Company ApplicationRevised 10/1026Updated 10/6/10Metro AtlantaDept. of Motor VehiclesMariettaCarrollton1605 County Services Pkwy 512 Old Newnan RoadMarietta, GA 30008 Carrollton, GA 30117770-528-3250 770-836-4603Canton1085 Marietta HighwayCanton, GA 30114770-720-3693Forest Park5036 Georgia Highway 85Forest Park, GA 30297404-669-3961Lawrenceville310 Hurricane Shoals RoadLawrenceville, GA 30045770-995-6890Cartersville1300 Joe Frank Harris ParkwayCartersville, GA 30120770-387-3700U:\ComDev\GIS_Section\JosephPowell\contribute\downloads\Taxicabapp10NEWADDFeeIncreaseDRAFT.DOC
Cobb CountyBusiness License DivisionTaxicab Company ApplicationRevised 10/1027Affidavit Verifying StatusOf Cobb County Business License ApplicationBy executing this affidavit under oath, as an applicant for a Cobb County Business License, I am stating the following withrespect to my application for a Cobb County Business License for _________________________________[INSERT BUSINESSNAME]:_______I am a United States citizen or legal permanent resident 18 years of age or older;OR_______I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act 18 years of age or olderand lawfully present in the United States.In making the above representation under oath, I understand that any person who knowingly and willfully makes a false,fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of theOfficial Code of Georgia._____________________________Signature of Applicant_________________________________Date_____________________________Printed NameSUBSCRIBED AND SWORNBEFORE ME ON THIS THE____ DAY OF ____________, 20_______________________________Notary PublicMy Commission Expires:__________________________________Alien Registration number for non-citizens_____________________________U:\ComDev\GIS_Section\JosephPowell\contribute\downloads\Taxicabapp10NEWADDFeeIncreaseDRAFT.DOC
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Cobb County Business License Division P.O. Box 649 Marietta ...

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