Form T 216 – Fill Out and Use This PDF

T-216 (Rev 12-04)

WEB and MVS Manual

Affidavit of a Georgia Certificate of Title

Lost in the Mail

Section 40-3-31, paragraph (5), of the O.C.G.A. allows for a replacement title to be issued without the $8.00 processing fee when the original certificate of title was lost in the mail prior to its receipt by the vehicle owner. This provision only applies to those replacement applications received within sixty- (60) days of the title’s issue date. The application for a replacement title must be submitted to your County Tag Agent or to State Motor Vehicle Services at the following address: DMVS/Motor Vehicle Services, P O. Box 740381, Atlanta, GA 30374-0381, together with this completed affidavit.

This is to certify that an inquiry was made with State Motor Vehicle Services or the County Tag Office and their records reflect that Georgia certificate of title number________________________________________ was issued for the following described

(Title Number)

vehicle in the name of:

_____________________________________________________________________________

(Owner(s)’ Name(s) As Shown on the Records of Motor Vehicle Services)

_____________________________________________________________________________

(Owner(s)’ Address As Shown on the Records of Motor Vehicle Services)

and was mailed on the following date: _______________________________________________

	(Month, Day and Year)
__________________________________	_______________________________________
(Year, Make & Model of Vehicle)	(Vehicle Identification Number)

I/we, _________________________, am/are requesting that a replacement certificate of title be

(Owner(s)’ Printed Name(s)

issued for the vehicle described above since this certificate of title has not been received.

Under the provisions of §40-3-31, paragraph (5), of the O.C.G.A., I/we do solemnly swear under penalty of a felony for making a material false statement punishable by a fine up to $5,000.00 or by imprisonment of up to five- (5) years or both that the statements contained herein are true and accurate:

____________________________			________________________________
	(Date)		(Owner(s)’ Signature(s)
Sworn to and Subscribed Before Me			________________________________________
			(Owner(s)’ Printed Name(s)
This _________Day of______________________, __________			________________________________________
(Day)	(Month)	(Year)	(Owner(s)’ Current Street Address)
____________________________________________________			________________________________________
(Notary Public’s Signature & Seal or Stamp)			(Owner(s)’ Current City, State and Zip)

____________________________________________________

(Date My Notary Commission Expires)

Except for the signatures, this form must be typed, electronically completed and printed or printed legibly by-hand in blue or black ink and signed. All applicable spaces on this form must be completed. Any alterations or corrections void this form. The vehicle owner(s) must complete this form. An attorney-in-fact cannot complete this form. A completed and signed application for a replacement title, Form MV-1, must accompany this form. Applications for replacement title not received more than sixty- (60) days from the title’s issue date cannot be processed without the $8.00 processing fee. A $10.00 special handling fee is due for those applications processed through Motor Vehicle Services’ walk-in or mail-in expedited service.