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Form GIMC Rev. 4/2013 State of Georgia Department of Revenue Print Clear Georgia Intrastate Motor Carrier Registration GIMC Application SECTION 1 GENERAL INFORMATION Please indicate Registration Year 20 MC Number Telephone Number Fax Number ZIP Code State FEIN Email Address State Tax ID Number SSN US DOT Number Legal Name Doing Business Under the Following Name DBA Principal Place of Business Street Address City Mailing Address For Corporations L...

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