Form T-226d - Application To Extend Initial Registration Period For A Motor Vehicle Purchased From A Georgia Motor Vehicle Dealer
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Form T-226D (Rev. 10-12)
Web and MV Manual
Application to Extend Initial Registration Period for a Motor Vehicle
Purchased from a Georgia Motor Vehicle Dealer
_ _ __ __ ___________________________________________________________________________
Purpose of this Form: This form is to be used by a vehicle owner to request an extension on the initial registration period
for a motor vehicle that has been purchased from a licensed dealer but has not yet been issued plates and has not yet
been titled as required by law.
How to submit this Form: This fully completed form must be submitted along with the required items below to your local
County tag office. Please refer to our website at
etax.dor.ga.gov to locate the address(es) for your specific
County.
Additional requirement(s) in order for this form to be processed:
Motor Vehicle Dealer’s Invoice of Sale/Bill of Sale
Owners’ Full Legal Name
Mailing Address
(
)
State
Zip
Telephone #
City
Owner(s)’ Full Legal Name(s)
(If Secondary Owner(s) are listed)
Mailing Address
Zip
(
)
City
State
Telephone #
VEHICLE INFORMATION:
Year
Make
Model
Purchase
_____/_____/_____
VIN
Date
Insurance Company
Name
_____/_____/_____
Insurance Expiration Date
Policy #
DEALER INFORMATION:
Dealer Name
Dealer’s City
Dealer’s State
I/We purchased the motor vehicle described above from a Georgia motor vehicle dealer. It has been at least twenty-five days (25) since the
date of this purchase. I/we do not have a license plate for this motor vehicle and the title has not been issued in my/our name for this 1986
or newer motor vehicle that is required to be titled.
Attached to this form is a copy of the motor vehicle dealer’s Invoice of Sale that I/we received when the vehicle was purchased and the
temporary license plate that was issued when the vehicle was purchased.
I/We request that ______________________________, County Tag Agent extend the initial registration period for this vehicle and issue a
County Tag Agent Temporary Operating Permit to expire thirty (30) days from the expiration date of the temporary license plate issued by
the dealer.
“I __________________________________, hereby affirm, under penalty of law, that I have examined and reviewed the information in
the submitted form(s) or application(s), including any supplemental form(s) and/ or document(s) and that these document(s) and or
statement(s) do not contain any untrue statement(s) nor are they missing any material information and/ or fact(s). I also acknowledge and
understand that any false statement(s) submitted is punishable under the law and may result in a denial of my application.”
Signature: ___________________________________Date: _____/_____/_______
STATE OF GEORGIA
COUNTY OF ________________
Sworn to (or affirmed) and subscribed before me this _____ day of __________, 20___, by
(__________________________)
(NOTARY STAMP OR SEAL)
Notary Signature
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