Form S & Ut - 214-7 - Notice Of Prime Or General Contractor Of Funds Withheld Pending Request Of A Release Notice

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S & UT – 214-7 (Rev. 08/03)
SALES & USE TAX DIVISION
1800 Century Center Blvd. NE, Suite 8204
Atlanta, GA 30345-3205
(404) 417-6646
NOTICE OF PRIME OR GENERAL CONTRACTOR
Clear Form
OF FUNDS WITHHELD PENDING REQUEST OF A RELEASE NOTICE
Print Form
This form is ONLY to be submitted 60 days following the subcontractor’s sales and use tax reporting
period upon completion of each phase of the work:
This is to certify that the undersigned is holding in escrow funds on work performed by the named Sub-
Contractor under the requirements of Section §48-8-63 of the Official Code of Georgia Annotated:
Sub-Contractor’s Name
______________________________________________________
Address
______________________________________________________
Job Location
______________________________________________________
Period Work was in Progress ______________________________________________________
Nature of Work Performed
______________________________________________________
Amount of Contract
______________________________________________________
Amount of Retainage
______________________________________________________
___________________________________________
(Prime or General Contractor)
___________________________________________
Date _______________________
(Signature)
___________________________________________
(Address)
___________________________________________

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