MAGISTRATE COURT OF ______________COUNTY, GEORGIA
Date Filed ________________ Case No: _______________
Vehicle Owner Name, Address
Plaintiff(s) Name, Address
Motor Vehicle Description and VIN Lien Holders Notified
PETITION FOR ABANDONED MOTOR VEHICLE LIEN FORECLOSURE
NOW COMES PETITIONER, a [ ] towing or storage facility [ ] repair facility [ ] salvage dealer, and files this petition to foreclose on
the above-referenced abandoned motor vehicle.
Date vehicle was [ ] towed [ ] left at repair facility [ ] left with salvage dealer (authority to tow attached)
Date information was requested from Department of Revenue or authorized entity (copy of owner information attached)
Date and method of first notice [ ] mailed [ ] hand delivery [ ] advertised [ ] disclaimer (proof of compliance attached for
The accrued fees allowed under OCGA § 40-11-19, as set forth below, have not been paid.
PETITIONER PRAYS that the lien be foreclosed and an order be issued to allow for public sale of the vehicle to satisfy a lien for the
Removal (Towing) Fee: $
Storage: (At $ __ __ _ per day for __ days) $
Future Storage Fee $ per day from date of filing this action through 25
days after judgment is rendered
Repair Fees (if applicable, with invoice attached): $
Cost of Obtaining Owner Information: $
Notification/Advertising Fees: $
PETITIONER ALSO PRAYS for prejudgment interest at the rate of 4% per annum from which the OCGA § 40-11-19 notification
was received, 15% attorney’s fees (if applicable), and all costs of court.
Sworn to and Subscribed before me
This ____ day of_____________20_____
Notary Public or Clerk Plaintiff/Attorney for Plaintiff
My Commission Expires:
YOU MUST FILE AN ANSWER TO THIS CLAIM NO LATER THAN TEN (10) DAYS FROM RECEIPT
OF THIS NOTICE USING THE STANDARDIZED ANSWER FORM PROVIDED. FAILURE TO FILE A
TIMELY ANSWER WILL RESULT IN FORECLOSURE OF THE LIEN AND A COURT ORDER
AUTHORIZING DISPOSITION OF THE VEHICLE PURSUANT TO OCGA 40-11-19.2.