This form is to authorize CICM.INC to submit your application for participation in the Qualified Education Expense Credit for the Georgia Department of Revenue. Please complete and submit this form. All applications will be submitted to the GA Dept. of Revenue by CICM on Jan 1st of the next calendar year. Click here to download a printable version of this form. Please submit the printed version to CICM SSO by email, fax, or mail.