Your Resource
for Georgias Vehicle Emissions Inspection & Maintenance (I/M) Program.
Out-of-Area Vehicle Verification
This document is to verify the vehicle identified below is physically stationed well-outside the Georgia vehicle emissions
testing area (13 counties in metro Atlanta). This verification will be used by the motorist as a supporting document to apply for
an Out-of-Area-extension from emissions testing, which is required by Georgia Law, O.C.G.A. § 12-9-45(a) for vehicle
registration. The vehicle must receive an emissions inspection once it returns to the metro Atlanta area.
THIS FORM MUST BE COMPLETED BY A DULY CONSTITUTED FEDERAL, STATE, COUNTY
OR CITY LAW ENFORCEMENT OFFICER OR AUTHORIZED CAMPUS POLICE/SECURITY OR
MILITARY OFFICER
This statement is to certify that on this (day) of (month), 20 (year), I have
made a physical/visual inspection of the vehicle identified below.
Vehicle Identification
VIN Year
Make Model
License Plate Year/State Issued
Location of Inspection
Address
City State Zip Code Zip Code Plus
Inspecting Officer
Name Title
Badge Number Signature Telephone Number (include area code)
Agency Name
Agency Address
City State Zip Code Zip Code Plus
All spaces on this form must be completed or this application will not be accepted. Additional information may be required. Any alterations
will automatically void this form. Additional copies of this form may be obtained at www.CleanAirForce.com. Allow three (3) business
days for processing. For assistance, call 1.800.449.2471.
CleanAirForce.com | 1.800.449.2471
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