Ga. Code § 40-11-19.5
DISCLAIMER OF MOTOR VEHICLE OWNERSHIP INTEREST
Georgia, __________________ County
I, __________________ (name of motor vehicle owner) do hereby swear that I disclaim any and all ownership interest in:
__________________ (motor vehicle year, model, and make)
__________________ (vehicle identification number (VIN))
__________________ (vehicle registration number, if available)
I understand that by signing this form I will no longer hold any rights to the above listed vehicle and such vehicle may be sold at auction to satisfy a debt related to a lien filed against the vehicle. I further understand that disclaiming an ownership interest in this vehicle does not relieve me of any other debts related to such vehicle, such as a debt entered into for the purchase of such vehicle. By signing this form, I understand that I waive all future notices to which I am entitled under Article 1A of Chapter 11 of Title 40 of the Official Code of Georgia Annotated, "The Abandoned Motor Vehicle Act."
__________________
Owner signature
Sworn to and subscribed in __________________ County, Georgia,
This __________________ (date)
Before me:
__________________
(Notary public signature, seal, and commission expiration date).
If you wish to disclaim ownership, return this completed and notarized form to __________________ (name and address of party owed fees).
OCGA § 40-11-19.5