Form Mv-46a - Certificate Of Title Bond Affidavit
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1Form MV-46A (Rev. 06-2005)
Certificate of Title Bond Affidavit*
(Submit with Form MV-46 – Certificate of Title Bond)
The undersigned does hereby swear and affirm under oath that of his or her own personal knowledge, the following
information is true and correct:
On or about the
day of
, ________,
(Day)
(Month)
(Year)
(Full Legal Name of Applicant(s) for Georgia Title)
(Street Address Including City, State & Zip)
acquired a
______________________________
_______________________
(Year Model & Make of Vehicle)
(Vehicle Identification Number)
(Length & Width, if Mobile Home)
From
(Seller or Transferor’s Full Legal Name)
(Seller or Transferor’s Street Address Including City, State & Zip)
Moreover, satisfactory and required title documents cannot be produced because of the following reason(s):
Was this vehicle acquired through the abandoned vehicle process?
Yes
No
Has an insurance company ever made a “total loss” settlement or has this vehicle ever been wrecked to such an extent that
its restoration required the replacement of two or more major component parts?
Yes
No
Sworn to and subscribed before me
This
day of
,
________________________________________
(Day)
(Month)
(Year)
(Printed Name of Applicant for Georgia Title)
_____________________________________________________
_______________________________________________________
(Printed/Typed Name of Notary Public)
(Signature of Applicant for Georgia Title)
________________________________________________________
(Notary Public’s Signature & Notary Seal or Stamp)
(Applicant’s Drivers License Number & State/Country of Issue)
________________________________________________________
(Date My Notary Commission Expires)
(Date)
*This form is available from the Department of Revenue’s website, Except for the signatures, this form
must be typed, legibly hand printed or electronically completed and printed in blue or black ink. The applicant(s) must
sign this completed form.
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Any alteration or correction voids this form.
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