Form T-228 - Affidavit Of Fact For A Motorcycle Or Motor Scooter printable pdf download

Form T-228 (Rev. 02-2005)

Affidavit of Fact for a Motorcycle or Motor Scooter

To obtain a Georgia certificate of title for the motorcycle or motor scooter described below,

certain conditions must apply. All sections of this affidavit must be completed. Except for

the signatures, this affidavit must be typed, electronically completed and printed or printed

legibly by-hand in blue or black ink. Only the vehicle owner(s) or the selling dealer can

complete this form.

Important Information: You are also required to have a Georgia law enforcement officer

complete a Certification of Inspection, Form T-22B, for verification that the motorcycle or

motor scooter meets all Federal motor vehicle safety standards by having a NHTSA (National

Highway Traffic Safety Administration) label affixed. The completed Certification of

Inspection, Form T-22B, must be submitted with this completed affidavit.

Part 1

(Vehicle VIN, Make and Year Model)

Vehicle Identification Number_________________________________________________

Vehicle Make________________________________ Vehicle Year Model______________

Part 2

(Vehicle Description – Please Answer All Questions)*

•

Was the motorcycle or scooter manufactured for lawful highway use?

Yes

•

Was the motorcycle or scooter manufactured to “exceed” 30 miles per hour?

Yes

•

Does the motorcycle’s or scooter’s “engine” exceed 50 (cc) cubic centimeters? Yes

•

Does the motorcycle or scooter have more than two (2) horsepower?

Yes

All questions must be answered “Yes” in order to make application for a Georgia certificate of title

and/or license plate. A title/license plate will not be issued if it is determined that the vehicle is not in

total compliance.

Part 3

(Signature & Address of Person Completing This Affidavit)

________________________________

_____________________________________

Signature

Driver’s License # & State of Issue

________________________________________

______________________________________________

Street Address

Printed Name of Company (if applicable)

________________________________________

______________________________________________

City, State, & Zip

Position with Company (if applicable)

_______________________________

____________________________________

______

Telephone Number Including Area Code

Company’s Address (if applicable)

Part 4

(Acknowledgement by Notary Public)

Sworn to and subscribed before me this _______day of__________________, _________

(Day)

(Month)

(Year)

________________________________

____________________________________

Notary’s Signature & Notary Seal or Stamp

Notary’s Printed Name

________________________________

____________________________________

Notary’s Drivers License # & State of Issue

Notary’s Street Address

________________________________

____________________________________

Date My Notary Commission Expires

Notary’s City, State, & Zip

Note: Only the vehicle owner(s) or the selling dealer can complete this affidavit. If the

manufacturer’s certificate of origin does not indicate the motorcycle or motor scooter was

manufactured for highway use in the United States, it may not be acceptable.

Form T-228 - Affidavit Of Fact For A Motorcycle Or Motor Scooter

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