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House Bill 225 - Company Registration |
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Please click here to review
the Online Registration Instructions, before filling out the online application below.
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Applicant's Legal Name |
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(If DBA as carrier listed below)
Enter Legal Name
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Account Type |
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Business Address |
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Street |
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Enter street address
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City |
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Enter city
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State |
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Enter state
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Zip Code |
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Enter zip
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County |
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Select County
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Mailing Address |
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Check this box if Business Address and Mailing Address are the same.
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Street |
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City |
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State |
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Zip Code |
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County |
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Telephone Number |
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Cell Phone Number |
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Fax Number |
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Email Address |
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Enter Email
Invalid Email Format
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(Retype Email Address) |
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Retype Email
Invalid Email Format
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The undersigned understands that the electronic signing and sealing of documents is governed by
Georgia law specifically, but not limited to, Chapter 12 of Title 10 of the Official Code of
Georgia. By executing this affidavit, the undersigned verifies its compliance with the requirements
of Article 3 of Chapter 1 of Title 40 of the Official Code of Georgia and states affirmatively that
the individual or company is engaged in passenger carrier services. I declare, to the best of my
knowledge, the information herein is true, accurate, and complete. By electronically signing this
document, you are not only agreeing to the foregoing but certifying that any willful falsification of
any information contained herein is grounds for suspension, revocation, or cancellation of license(s)
and/or criminal prosecution.
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By clicking Submit you are acknowledging that your operation qualifies for one or more services under this registration and that the registration fee is nonrefundable.
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