Fill and Sign the Ga Abandoned Form

PRINT CLEAR MV-603 (Rev. 04-2017) NOTICE OF AN ABANDONED VEHICLE AND REQUEST FOR INFORMATION Research fee: $2.00 for printout of tag, title & lien information per abandoned vehicle I do solemnly swear or affirm that the vehicle described herein is or will become abandoned or a derelict motor vehicle as described in §40-11-1 of the OCGA. As provided in Code Sections §40-11-2 and §40-11-9 of the OCGA, this is to request the names and addresses of all owners, lessors, lessees, security interest holders and lien holders of such vehicle. I understand that I shall not be entitled to any storage fees if I do not provide the notice and information required by §40-11-2 and §40-11-9 of the OCGA. I also understand that any person who knowingly provides false and misleading information when providing any notice of information as required by §40-11-2 and §40-11-9 of the OCGA shall be guilty of a misdemeanor punishable by fine up to $1000 or by imprisonment of up to one (1) year. Name of Person Removing or Storing Vehicle Vehicle Identification Number Street Year City State Zip Tag No. Make Model State of Issue Date Vehicle Removed Present Location of Vehicle (Street Address) Date Vehicle Becomes Abandoned City Location Vehicle Removed From State Zip Telephone Number (including area code) City State ZIP Sworn to and subscribed before me this __________day of _______________________, ____________ (Day) (Month) (Year) X__________________________________________________________________________________ (Authorized signature of person removing/storing vehicle) X_________________________________________ (Notary Public’s Signature and Seal or Stamp) ______________________________________ (Date My Notary Public Commission Expires) __________________________________________ (Notary Public’s Georgia Driver’s License Number) Mail the Notice and Request for Motor Vehicle Information (Form MV-603) and fee to the County Tag Agent in the county where the vehicle is stored or to: ATTN: Research/Abandoned Vehicles Department of Revenue/Motor Vehicle Division PO Box 740381 ATLANTA, GA 30374-0381 Except for signatures, this form must be typed, electronically completed & printed or legibly hand printed in black or blue ink. ORIGINAL FORM MUST BE SUBMITTED. ANY ALTERATION OR CORRECTION VOIDS THIS FORM.