Form Att-14 - Certificate Of Residence For Retail License Applicants Only - 2013
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ATT-14 (Rev.1/13)
Georgia Department of Revenue
Alcohol and Tobacco Division
Telephone: (404) 417-4900
E-mail:
ATDIV@dor.ga.gov
CERTIFICATE OF RESIDENCE FOR RETAIL LICENSE APPLICANTS ONLY
Submit online at
https://gtc.dor.ga.gov
STATE OF GEORGIA, _________________________________ COUNTY:
I, _____________________________________________, Judge of the Probate Court for
________________________________________ County, Georgia, hereby certify that
________________________________________ is now, and has been a bona fide resident of the
State of Georgia for one year and the County of ________________________________________
for one year immediately preceding the date of this affidavit, based upon the affidavit of applicant,
and the evidence submitted therewith.
I further certify that _____________________________________________ is a resident of
a municipality or a county wherein the sale of distilled spirits is authorized.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Probate
Court, this ____ day of _____________________________, 20 ________ .
_____________________________________________
JUDGE OF THE PROBATE COURT
_____________________________________________
(AFFIX SEAL)
COUNTY, GEORGIA
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