The Uniform Certificate of Authority Statement of Withdrawal Application should be used to file a complete Surrender of the. Certificate of Authority. The.Hey Buddy Buck here! 020) since January 1, 1995. 4. The entity selected in item 1 and named in item 2 no longer transacts business in Georgia and surrenders its certificate of authority. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Purpose: A Statement of Withdrawal can be used to voluntarily withdrawal the business entity from transacting business in. SF 1103 becomes SF1103. It has one of the highest rates of voter registration in the country. Form Number, Form Name, Category.