GA Senior Exemption Application Form PDF Details

Applying for a Senior Exemption in Georgia offers eligible seniors a valuable opportunity to receive an exemption from the state’s emissions inspection requirements, a process that can be cumbersome and time-consuming. To qualify, seniors must meet specific criteria, including being 65 years or older, owning a vehicle that is at least 10 model years old, driving fewer than 5,000 miles per year, and being the primary registered owner of the vehicle. The application process requires submitting proof of age, ownership, and a completed Senior Exemption Application form. Additionally, a proxy may assist with the application process, provided they submit their driver's license along with the required documentation. Communication with Georgia's Clean Air Force (GCAF), whether for renewing an exemption or applying for the first time, is streamlined through various channels, including email, fax, mail, or in-person submissions. Processing times may vary based on the submission method. Understanding the eligibility requirements, gathering the necessary documentation, and following the submission instructions carefully ensures a smooth application process for securing a Senior Exemption.

QuestionAnswer
Form Name GA Senior Exemption Application Form
Form Length 2 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 30 sec
Other names cleanairforce com senior exemption, dmv georgia senior exemption forms, senior exemption emission waiver, emissions exemption form ga

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Senior Exemption

Application Instructions

Please read the below instructions for information on applying for a Senior Exemption. Please note additional information may be required in order to process the Senior Exemption.

To qualify for a Senior Exemption, you must meet all of the following criteria:

You are 65 years old or older.

Your vehicle is 10 model years old or older.

You do not drive over 5,000 miles per year. Note: the odometer must be in working condition.

You are the primary registered vehicle owner (your name is the first listed on the Georgia title/ registration).

When applying for a Senior Exemption, please provide the following documents:

Proof of age. Examples include a copy of your driver's license or birth certificate.

Proof of ownership, which can be one of the following: last year's tag receipt, this year's registration renewal notice, or Georgia title.

Completed Senior Exemption Application (attached).

Note: A proxy may submit the completed Senior Exemption Application and necessary documentation for eligible seniors. If submitting by proxy, the application must be completed and signed by the proxy. The proxy must also submit a copy of their driver's license. The documentation mentioned above must also be submitted with the completed application (attached).

SUBMITTAL INSTRUCTIONS

When communicating with Georgia's Clean Air Force (GCAF), please reference your vehicle identification number (VIN) and/or license plate number.

If you have applied for a Senior Exemption in the past, you will be able to renew your Senior Exemption by the GCAF Call Center at 800.449.2471 and supplying GCAF with the current owner and vehicle information. Documentation will be required if there is a discrepancy between the information on file and what is being updated for the current year.

If this is your first time applying for a Senior Exemption, you may submit the application and supporting documentation via e-mail, fax, mail, or in-person.

E-mail: waivers@cleanairforce.com

Fax: 404.479.4384

Phone: 800.449.2471

Mail: Include a self addressed, stamped envelope when submitting your application and supporting

documentation via mail to: 3800 Camp Creek Parkway, Building 2400, Suite 110, Atlanta, GA 30331. In-person at any GCAF Service Center or select metro Atlanta tag offices. For a complete listing of phone numbers and addresses for GCAF Service Centers and metro Atlanta tag offices, visit www.cleanairforce.com or call 800.449.2471.

Please allow three (3) business days for processing faxed or e-mailed applications. For mailed applications please note, the US Postal Service may extend the time of delivery. Once received, mailed applications with supporting documentation will be processed in three (3) business days. Motorists will be contacted once the waiver has been processed.

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Senior Exemption

Application

In accordance with the provision of Georgia law, the requirements for emission inspection may be extended to senior citizens per O.C.G.A 391-3-20-.03.

As the owner of this vehicle, I certify and represent, under penalty of law, that the information provided is true and correct. I understand and acknowledge that submitting false or fraudulent statements or writings in a matter under the jurisdiction of the state agency is a crime and can result in fines, imprisonment, or both (O.C. G.A 16-10-20).

As the associate, I have verified that the vehicle has met all waiver requirements (O.C.G.A 16-10-20).

To apply for a Senior Exemption, gather the required documents as listed on the instruction sheet and complete the below application. When submitting by proxy, the proxy must complete the section below, sign the application and provide a copy of their driver's license. Please note additional information may be required in order to process the Senior Exemption.

REGISTERED OWNER INFORMATION

Name:

Address:

Date of Birth:

Phone Number:

City:

 

 

 

State:

 

Zip Code:

 

 

County:

 

E-mail Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Year:

 

 

Make:

 

 

 

 

VIN:

 

 

 

 

 

 

 

 

List your actual mileage (do not include decimals):

PROXY INFORMATION (IF APPLICABLE)

Model:

Tag Number:

Is your odometer

Yes

No

functional?

 

 

_____________________________________

Proxy's Signature (person applying for senior)

Proxy's Drivers License Number

 

 

 

 

 

 

 

 

Proxy's Printed Name

Proxy's Phone Number

By signing this application, you are attesting you did not exceed the 5,000 miles per year limit during the past year and all the information contained herein is accurate and correct.

_________________________________________

______________________

Applicant Signature (registered owner)

Date

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