Fill and Sign the Form 4669 Missouri

MAG 4 0 - 05 ABANDONED MOTOR VEHICLE NOTICE (REPAIR FACILITY) Owner Name : __________________________________ Owner Address : ___________________________________ ___________________________________ Vehicle Make: ____________________ Year: ______ Model: _______________________________ Vehicle ID (VIN)#: _______________________________ Vehicle License #: __________ State ________ Dear Owner: You have been identified as an owner of the above - referenced vehicle, which is currently being held at the business listed below, and are being notified in accordance with OCGA 40 - 11 - 19(b)(1) . The following fees are currently due: $ Fees owed for repair of vehicle $ Daily fee for storage of vehicle after co mpletion of repairs Daily fees will accrue until full payment has been made at the rate of $________ per day . Additional fees that are recoverable b y a repair facility include fee s for obtaining the owner’s information, notifying the owner (including adv ertising, if necessary), court filing costs, attorney’s fees, and interest. The repair facility has the right to petition a court to foreclose a lien for all amounts owed after 10 calendar days from the date this notice was sent. If the lien is foreclosed , a court shall order the sale of the vehicle to satisfy the debt. If you wish to disclaim ownership in this vehicle, complete and return the form found on the next page /back of this letter. Disclaiming ownership and judgment of foreclosure being entered shall result in the holding of an auction. The excess proceeds (if any), that may exist shall be deposited with the Department of Revenue and be treated as unclaimed property. Disposition of such property shall be govern ed pursuant to O.C.G.A. § 44 - 12 - 211.1. Please contact us immediately, or we will avail ourselves of all remedies allowed by law. The vehicle is currently located at _________________________________________________________________. Anyone with an ownership interest in this vehicle should contact the following business immediately . Business Name: ___________________________________________ Address: ___________________________________________ ___________________________________________ Telephone #: _________________________________ __________ MAG 40-05 DISCLAIMER OF MOTOR VEHICLE OWNERSHIP INTEREST Georgia, _________ County I, ___________________ (name of motor vehicle owner) do hereby swear that I disclaim any and all ownership interest in: Vehicle Make: ____________________ Year: ______ Model: _______________________________ Vehicle ID #: _______________________________ Vehicle License #: __________ State ________ I understand that by signing this form I will no longer hold any rights to the above l isted vehicle and such vehicle may be sold at auction to satisfy a debt related to a lien filed against the vehicle. I further understand that disclaiming an ownership interest in this vehicle does not relieve me of any other debts related to such vehicle, such as a debt entered into for the purchase of such vehicle. By signing this form, I understand that I waive all future notices to which I am entitled under Article 1A of Chapter 11 of Title 40, “The Abandoned Motor Vehicle Act.” Sworn to and Subscribed before me This ____ day of_____________20___ ________________________________ ________________________________________ Notary Public or Clerk Owner of Vehicle My Commission Expires: If you wish to disclaim ownership, return this complete d and notarized form to __________________ ___________ ______________________________________________________________ (name and address of party owed fees)