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ROCKDALE COUNTY PLANNING AND DEVELOPMENT
BUSINESS LICENSE CHECKLIST
Commercial or Home Occupation
SUBMIT:
☐ Completed application form (enclosed)
☐ Georgia’s driver’s license or Georgia ID
☐ Fee (check or money order made payable to Rockdale County, credit card, or exact cash)
☐ Affidavit Verifying Citizenship Status form (enclosed)
☐ Proof of occupancy: Signed lease agreement with applicant's name, signed and notarized
letter from property owner, or Tax Records
☐ E-Verify Compliance form (enclosed)
☐ Commercial licenses only: Compliance Inspection application package (separate file)
IMPORTANT CONTACT INFORMATION:
☐ To register a corporation (including LLC): Secretary of State (404-656-2817)
(www.sos.state.us/corporations)
☐ To register as a child care provider: Bright from the Start (www.decal.ga.gov, 404-656-5957)
☐ To register as a personal care home: Department of Human Resources
(http://aging.dhs.georgia.gov/adult-day-care, 404-657-4076)
☐ For commercial fleet: Georgia Department of Driver Services (www.dds.ga.gov, 678-413-
8400),
US Department of Transportation (DOT) www.dot.state.us)
☐ For cottage food: Georgia Department of Agriculture (www.agr.state.ga.us) (404-656-3627)
☐ For food services: Food Inspection Report or Permit from Rockdale County Board of
Environmental Health (www.rockdalehealth.com, 770-278-7342). Rockdale County Water
Resources Fat, Oil & Grease (FOG) program (grease traps and interceptors): 770-278-7450.
☐ To obtain a federal employer identification number (EIN): Internal Revenue Service (Form
SS-4: http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Apply-for-an-
Employer-Identification-Number-(EIN)-Online)
☐ To obtain a state tax ID number: Department of Revenue (877-423-6711, Form CRF-002:
http://dor.georgia.gov/documents/crf-002)
Department of Planning and Development contact information:
In person: 958 Milstead Avenue, Conyers, GA 30012 ◦ Monday through Friday, 8:00am to 5:00pm
Mail: P.O. Box 289, Conyers, GA 30012
Phone: 770 278-7100
Email: businesslicense@rockdalecountyga.gov
Fax: 770 278-8940
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ROCKDALE COUNTY PLANNING AND DEVELOPMENT
P.O. Box 289/958 Milstead Avenue, Conyers, GA 30012
Phone: 770-278-7100
Email: businesslicense@rockdalecountyga.gov
BUSINESS LICENSE AND OCCUPATIONAL TAX APPLICATION
Business Information
Name of Business /DBA
Business Type (check one)
☐ Commercial
Ownership Type (check one)
☐ Single Proprietor (Owner)
☐ Partnership
☐ LLC
Business Physical Address
Business Telephone Number
Number of Employees
E-Verify Number
NAICS Code
Business Mailing Address
Detailed Business Description
Business Owner Information
Name of Owner (First)
(Middle )
( Last)
Address
E-Mail Address
Work Telephone Number
Cell Telephone Number
Corporate Information (if applicable)
Name of Corporation
Corporate Address
Federal Employer ID Number (EIN)
GA State Tax ID Number
Corporate Officer Name/Title
Officer’s Telephone Number
Officer’s Email Address
Local Contact Name
Contact’s Telephone Number
Contact’s Email Address
State License (if applicable)
License Type
License Number
This application is to be executed under the following oath: “I solemnly swear, subject to criminal penalties for false
swearing that the information in this application is true and correct and that the application is herein made to procure the
granting of this license.”
Signature: Print Name:
Date:
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AFFIDAVIT VERIFYING CITIZENSHIP STATUS
O.C.G.A. 50-36-1(e)(2)
By executing this affidavit under oath, as an applicant for a Permit or License, as referenced in O.C.G.A.
50-36-1, from Rockdale County, the undersigned applicant verifies one of the following with respect to
my application for a public benefit:
I am a United States citizen.
I am a legal permanent resident of the United States.
I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act
with an alien number issued by the Department of Homeland Security or other federal
immigration agency.
My alien number issued by the Department of Homeland Security or other federal
immigration agency is: ____________________________________
_____________________________, the undersigned applicant also hereby verifies that he or she is 18
years of age or older and has provided at least one secure and verifiable document, as required by
O.C.G.A. 50-36-1(e)(1), with this affidavit.
Wait to be in front of notary to sign
Applicant signature
The secure and verifiable document provided with this affidavit can best be classified as:
(type of document)
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 O.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute.
Executed in , , this day of , 20
(city) (state) (day) (month) (year)
For notary use only
SEAL
Notary Public signature
GA Registration No. and expiration date
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E-VERIFY COMPLIANCE FORM
O.C.G.A. §36-60-6(d).
By executing this affidavit under oath, the undersigned private employer verifies one of the following with respect
to its application for a business license, occupational tax certificate, or other document required to operate a
business as referenced in O.C.G.A. §36-60-6(d).
SECTION I
Check only one:
On January 1
st
of the current year, the individual, firm or corporation employed ten (10) or fewer employees.
Skip to Section II
On January 1
st
of the current year, the individual, firm or corporation employed more than ten (10)
employees.
The employer has registered with and utilizes the federal work authorization program in accordance with the
applicable provisions and deadlines established in O.C.G.A. §36-60-6. The undersigned private employer also
attests that its federal work authorization user identification number and date of authorization are as follows:
Name of exempt private employer (company name):
Federal Work Authorization User Identification Number:
Date of authorization:
Complete Section II
SECTION II - Wait to be in front of notary to fill out
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed in , , this day of , 20
(city) (state) (day) (month) (year)
Applicant signature
Applicant name and title
For notary use only
SEAL
Notary Public signature
GA Registration No. and expiration
date
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CUSTOMARY HOME OCCUPATION AGREEMENT
Rockdale County Unified Development Ordinance Section 218-13 (dd)
PLEASE READ CAREFULLY
1. Only residents of the dwelling containing the home occupation may be engaged in the home occupation.
The home occupation shall not involve group assembly or group instruction on the premises.
2. The home occupation shall be clearly incidental to the residential use of the dwelling and shall not change
the residential character of the building.
3. No products may be produced, stored or sold on the premises; except that bona fide agricultural products
grown on the premises may be displayed in A-R district and the W-P district.
4. Use of the building for the purpose of a home occupation shall not exceed 25 percent of the square
footage of one floor of the principal building.
5. No internal or external alterations inconsistent with the residential use of the building shall be permitted.
No exterior evidence of the conduct of a home occupational shall be allowed. No signage of any kind for
the home occupation is allowed.
6. The home occupation shall not constitute a nuisance to the neighborhood. Furthermore, except as would
be caused by a typical residential use, no noise, vibration, dust, odor, smoke, glare or electric disturbance
that is perceptible beyond any property line will be permitted to occur as a result of the home occupation.
7. No accessory buildings or outside storage shall be used in connection with the home occupation.
8. Only one vehicle shall be permitted in connection with the home occupation. That vehicle must be one
that is designed and used primarily as a passenger vehicle with a carrying capacity of less than ¾ ton.
9. No earth-moving equipment or heavy construction or hauling equipment shall be allowed on the
premises.
10. Pursuant to the above requirements, a home occupation includes, but is not limited to, activities such as
the following:
a. Art studio
b. Dressmaking
c. Teaching of any kind, provided instruction is limited to not more than two pupils at a time.
d. However, a home occupation shall not be interpreted to include any occupation or profession
providing medical or mental health services including, but not limited to, physician,
veterinarian, dentist, psychiatrist or psychologist and it shall not be interpreted to allow the
preparation of food for sale on the premises.
11. No more than one vehicle used in the home occupation may be parked on the premises overnight, and no
more than one additional vehicle connected with the home occupation may be parked on the premises
during the day, provided the gross vehicle weight of each such vehicle shall not exceed two tons.
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QUESTIONNAIRE:
Besides a computer and telephone, what other kinds of equipment do you have associated with your
home business?
Do all parties listed on the license currently live in the home where the business is being licensed?
☐ Yes ☐ No
Do you live in the home that is listed on the application?
☐ Yes ☐ No
Will there be vehicles such as trucks coming to and from your property?
☐ Yes ☐ No
If yes, explain:
How will you deliver your products or services to your customer?
Describe in detail how your business will be conducted.
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HOME OCCUPATION AFFIDAVIT
O.C.G.A
I, (name) , applying for a business license for
(Name of business) located at
(Address) have been given Code Section 218-
13 (dd), The Customary Home Occupation Agreement. By my signature below, I attest that I have read
and understood the agreement. I have an “office only” preparing paperwork for my business in my
home. I will not have any person connected to the business at my home except those living in the
dwelling. As part of the Home Occupation I understand I must live in the above dwelling.
I understand that this license is not to be construed as permission to use a facility, public or private. Any
activity conducted at such a location will abide by the rules and regulations of usage of said facility.
By signing this affidavit I am accepting responsibility that all local, state and federal regulations have
been met.
Wait to be in front of notary to sign
Applicant signature
Executed in , , this day of , 20
(city) (state) (day) (month) (year)
For notary use only
SEAL
Notary Public signature
GA Registration No. and expiration date