Form Pt 472Ns – Fill Out and Use This PDF

After I, enter the Servicemember Full Legal Name and the Servicemember's Number.

Enter the Location of Georgia permanent duty station.

Swear or affirm that you are temporarily residing in the State of Georgia solely because your military orders require you to be stationed in Georgia.

At this time, enter your home of record: the City, the County and the State.

Enter the dependent: servicemember's spouse who is not a Georgia resident; or servicemember's child who is not a Georgia resident; or individual who is not a Georgia resident for whom servicemember provided more than one-half support for 180 days preceding request for relief under the Servicemembers Civil Relief Act.

Enter the City, the County and the State where the dependent is a resident.

Check Servicemember or Dependent: the Servicemember or the Dependent is obtaining a Georgia title for the following motor vehicle.

You are qualified to receive the protections of the Servicemembers Civil Relief Act of 2009, as amended.

Enter the Vehicle Identification Number (VIN), Year, Make and Model/Body Style.

Mark this line if you are voluntarily paying the title ad valorem tax on this motor vehicle and therefore will not be subject to sales and use tax rules.

Or mark this line if you will NOT pay title ad valorem tax on this motor vehicle and therefore will be subject to sales and use tax rules.

Sign in the Servicemember's Signature box and enter the Georgia Residence Address.

Any person making a false affidavit or affirmation as to any matter contained in this affidavit, or forging or causing this affidavit to be forged, shall be guilty of a felony and subject to a fine not to exceed ONE THOUSAND DOLLARS ($1,000), or imprisonment for not less than one (1) year and not more than five (5) years, or both (checked November 1, 2026).