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Form S&ut 214-1 - Notice Of General Or Prime Contractor Of Contract Let To A Subcontractor

S & UT – 214-1 (Rev. 12/00)

Georgia Department of Revenue

Sales and Use Tax Division

Contract Section

P.O. Box 38040

Atlanta, GA 30334

Notice of General or Prime Contractor

of Contract Let to a Subcontractor

Each general or prime contractor shall file this from with the State Revenue Commissioner

within ten (10) days after the execution of any contract or contracts with a subcontractor that are

for $250,000 or more on a single project.

1.____________________________________________________________________________

(Name)

(If a partnership, also name the partners;)

______________________________________________________________________________

(If a corporation, also name its Executive Officers.)

2.____________________________________________________________________________

(Address)

(Area Code and Telephone Number)

3.____________________________________________________________________________

(Kind of business engaged in)

4.____________________________________________________________________________

(Name of Subcontractor)

5.____________________________________________________________________________

(Address of Subcontractor)

6.____________________________________________________________________________

(Nature of work to be performed)

(Indicates if labor contract only)

7.____________________________________________________________________________

(Where work is to be performed)

(State, County, City, Street Number)

8.____________________________________________________________________________

(When work is to be performed)

9.____________________________________________________________________________

(Total gross amount of the contract)

EXECUTED THIS _____ DAY OF __________, 20__.

______________________________

(General or Prime Contractor)

Form S&ut 214-1 - Notice Of General Or Prime Contractor Of Contract Let To A Subcontractor