How to Fill Out Form T-17

Form T-17 at a glance

What it is: T-17 (Rev. 7-2017) is the Statement of Title Held By Lienholder, Security Interest Holder or Leasing Company.

Who signs: The Owner(s) or Lessee(s) sign under Applicant(s)' or Lessee(s)' Signature(s) & Account Number.

What to bring and attach to Form T-17

An original valid out-of-state registration certificate or a non-negotiable certificate of title and a properly completed and signed MV-1 Title Application must accompany this properly completed and signed form.

A filled-in Form T-17 example: a financed car with the title held by the lender

Form T-17 example filled out, example: a financed car with the title held by the lender
Dana Sample completes Form T-17 for a financed car. Sample Auto Finance holds the title, T000123456 issued by Florida, for payment of a lien on Dana Sample's 2019 Example Sedan. The picture shows page 1 only, and every value in it is made up.

How to fill out Form T-17, box by box

Vehicle description, title number and owners

Form T-17 example filled out, vehicle description, title number and owners

Under Vehicle Description, enter the Year Model, the Make of Vehicle and the Vehicle Identification Number (VIN).

Enter the Title Number and the Name of State Issuing Title.

Enter the Owner(s)' Full Legal Names as Shown on Title.

Title holder name and address

Form T-17 example filled out, title holder name and address

Under Name & Address of Title Holder, enter the Title Holder's Name (Lien or Security Holder or Leasing Company), the Title Holder's Street Address or PO Box Number and the Title Holder's City, State & Zip.

Account Number and acknowledgement

Form T-17 example filled out, account Number and acknowledgement

Enter the Account Number.

The Acknowledgement is by the County Tax Commissioner or His or Her Designated Employee.

If your situation is different

A lessee signs the title application for the leasing company

Enter the correct and complete name and address of your leasing company or lending institution on the title application. Also, if the lessee signs the title application for the leasing company, a power of attorney must be submitted authorizing the lessee to sign for the leasing company.

Common questions about Form T-17

What is a T17 form?

T-17 (Rev. 7-2017) is the Statement of Title Held By Lienholder, Security Interest Holder or Leasing Company. This is to certify that the titleholder, whose name and address is shown under Name & Address of Title Holder, is holding the title for the vehicle described under Vehicle Description for payment of a lien, security interest or as required by a lease agreement.

Sources

[1] Form T-17 (Rev. 7-2017), Georgia Department of Revenue (the Official source link on this page).

Form T-17 PDF Details

An original valid out-of-state registration certificate or a non-negotiable certificate of title and a properly completed and signed MV-1 Title Application must accompany this form.

Title application: enter the correct and complete name and address of your leasing company or lending institution on the title application.

Lessee: if the lessee signs the title application for the leasing company, a power of attorney must be submitted authorizing the lessee to sign for the leasing company.

Acknowledgement: the form has an Acknowledgement by County Tax Commissioner or His or Her Designated Employee.

QuestionAnswer
Form NameForm T-17
Form Length1 page
Fillable?Yes
Fillable fields12
Avg. time to fill out2 min
EditionRev. 7-2017
Matches the agency's fileYes, checked October 2, 2026
Other namesT-17, T17, Form T-17, Form T17, Statement of Title Held By Lienholder, Security Interest Holder or Leasing Company
Official sourceForm T-17 (Rev 7-2017), Georgia Department of Revenue