Form T-56 - Notice To Vehicle Owner - Payment Of A 'Total Loss' Claim printable pdf download

State of Georgia

T-56 (Rev. 06-2007)

Department of Revenue

Motor Vehicle Division

Notice to Vehicle Owner – Payment of a ‘Total Loss’ Claim

The vehicle described below is now classified as a salvage vehicle. Since you are retaining the salvage vehicle, you must

comply with the following: Please place your initials to the left of each requirement listed and sign in the designated space

below.

Owner’s Initials

Requirements

You must immediately remove the license plate from the vehicle;

_____________

The vehicle:

▪

Must be rebuilt or restored;

▪

Must pass a State Motor Vehicle Division Inspection; and,

▪

Must have a new Georgia license plate issued and affixed to it before it can be driven.

You must provide your insurance company with the following before receiving payment in settlement of a ‘total loss’

_____________

claim;

▪

The vehicle’s original valid title, when available*

▪

The vehicle’s license plate and registration certificate for submission by your insurance company to the State Motor

Vehicle Division with an application for a Salvage title in your name. You cannot sell this vehicle until you have

obtained a salvage title in your name.

▪

A properly completed and signed

Application for a Salvage Title, Form

MV-1S. Except for your signature and your

initials, this application must be typed, electronically completed and printed, or printed legibly by hand in blue or

black ink in your full legal name and signed. If jointly owned, each owner’s full legal name, driver’s license

number and signature is required. For reference purposes only, the name of the state or country that issued the

driver’s license should be recorded in the space provided.

*Please refer to the instructions on the reverse side of this form for information pertaining to vehicles ten (10) model years old and older.

After you obtain a Salvage title and decide to rebuild or restore this vehicle or have someone rebuild or restore it for you, you must also

comply with the following: Note: Anyone purchasing a salvage vehicle with the intent on rebuilding or restoring it, must be licensed with

sed Motor Vehicle Dealers and Used Motor Vehicle Parts Dealers.

this state’s State Board of Registration of U

Owner’s Initials

Requirements

You must obtain photographs of the vehicle in its wrecked or damaged condition. These photographs must accompany

___________

your application for a Rebuilt title.

You must retain and submit parts bills of sale for all parts used to restore the vehicle showing the re-builder or you, the

___________

vehicle owner, as the purchaser

You must apply for a Rebuilt title and an inspection by the State Motor Vehicle Division’s Inspection Section once the

___________

vehicle has been restored or rebuilt but before the vehicle is painted. You must submit a check or money order for the

total fees due payable to the Department of Revenue. The title fee is $18 and the inspection fee is $100. For detailed

instructions for applying for a Rebuilt title and an inspection, please refer to the reverse side of this form.

inspection fee ($100) is required each ti

me this vehicle is insp

ected.

Vehicle Information

Year Model & Make of Vehicle:

Vehicle Identification Number:

Title Number & State of Issue:

Tag Number & State of Issue:

Estimated Cost of Repairs:

D ate of Settlement:

Owner’s Certification – Please Read Before Signing

This is to certify that the insurance agent named below has advised me of my responsibilities regarding the salvage vehicle described above.

I understand that this vehicle cannot be driven until it has been restored or rebuilt, passed a State Motor Vehicle Division Inspection, and has

a new Georgia license plate issued and affixed to it. I also understand that the vehicle’s title when issued will be branded as follows: If the

vehicle’s restoration to a safe operable condition required the replacement of one (1) or more major component parts, the new title when

issued will be branded ‘Rebuilt’.

Owners’ Printed Names:

Owners’ Signatures:

Date:

O wners’ Street Address including city, state & zip:

Insurance Company’s Certification

This is to certify that to the best of my ability, the requirements outlined

above have been explained

to the vehicle owners:

Insurance Company’s & their Authorized Agent’s Printed Name:

Insurance Agent’s Signature:

Insurance Company’s Street Address including city, state & zip:

cc: Owner, Insurance Company & ATTN: Salvage Section, DOR/Motor Vehicle Division, Post Office Box 740384, Atlanta, GA 30374-0384

Importan

t: Please make sure this form reflects the correct vehicle data, i.e. VIN, year model and make, and all applicable

spaces have been

completed. The vehicle owner must initial, date and sign this completed form in the spaces provided.

ANY CORRECTION OR ALTERATION WILL VOID THIS FORM.

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Form T-56 - Notice To Vehicle Owner - Payment Of A 'Total Loss' Claim

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