Georgia Code Title 40. Motor Vehicles and Traffic § 40-11-19.5

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:

______________________(motor vehicle year, model, and make)

______________________(vehicle identification number (VIN))

______________________(vehicle registration number, if available)

I understand that by signing this form I will no longer hold any rights to the above listed 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 of the Official Code of Georgia Annotated, “The Abandoned Motor Vehicle Act.”

Sworn to and subscribed in _______________ County, Georgia,

This _____ (date)

Before me:

___________________________

(Notary public signature, seal, and commission expiration date).

If you wish to disclaim ownership, return this completed and notarized form to __________________ (name and address of party owed fees).