MAG 40-07
Owner Name: __________________________________
Owner Address: ___________________________________
Vehicle Make: ____________________ Year: ______ Model: _______________________________
Vehicle ID (VIN) #:_______________________________ Vehicle License #: __________ State ________
Dear Owner:
You have been identified as an owner of the above-referenced vehicle, which is currently being held at the business
listed below, and are being notified in accordance with OCGA 40-11-19(c)(1). The following fees are currently
$ Fee for storage of the vehicle. ($_________ per day for ________ days.)
Daily fees will accrue until full payment has been made at the rate of $________ per day from the date of this
notice. Additional fees that are recoverable by a salvage dealer include fees for obtaining the owner’s information,
notifying the owner (including advertising, if necessary), court filing costs, attorney’s fees, and interest.
The salvage dealer has the right to petition a court to foreclose a lien for all amounts owed after 10 calendar days
from the date this notice was sent. If the lien is foreclosed, a court shall order the sale of the vehicle to satisfy the
If you wish to disclaim ownership in this vehicle, complete and return the form found on the next page/back of this
letter. Disclaiming ownership and judgment of foreclosure being entered shall result in the holding of an auction.
The excess proceeds (if any), that may exist shall be deposited with the Department of Revenue and be treated as
unclaimed property. Disposition of such property shall be governed pursuant to O.C.G.A. § 44-12-211.1.
Please contact us immediately, or we will avail ourselves of all remedies allowed by law.
The vehicle is currently located at _________________________________________________________________.
Anyone with an ownership interest in this vehicle should contact the following business immediately.
Business Name: ___________________________________________
Address: ___________________________________________
Telephone #: ___________________________________________
MAG 40-07
Georgia, _________ County
I, ___________________ (name of motor vehicle owner) do hereby swear that I disclaim any and all ownership
interest in:
Vehicle Make: ____________________ Year: ______ Model: _______________________________
Vehicle ID #: _______________________________ Vehicle License #: __________ State ________
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, “The Abandoned Motor Vehicle Act.”
Sworn to and Subscribed before me
This ____ day of_____________20___
________________________________ ________________________________________
Notary Public or Clerk Owner of Vehicle
My Commission Expires:
If you wish to disclaim ownership, return this completed and notarized form to _____________________________
______________________________________________________________(name and address of party owed fees)