Georgia Department of Revenue - Motor Vehicle Division - Affidavit of Repossession - T-16 Revised 10-2017

Sep 16, 2026

Uploaded by Melati

Georgia Department of Revenue, Motor Vehicle Division Form T-16 is an affidavit used by a repossessor to certify that a motor vehicle was repossessed due to the vehicle owner(s)’ failure to satisfy a lien or security interest. The form provides sections for owner information, lienholder/security interest holder details, vehicle identifying data, and an authorization certification requiring an agent’s signature and date. Submission requires completion without corrections, along with the current Georgia title and applicable fees, then notarization before a notary public.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Purpose of this Affidavit

How to Submit this Affidavit

Required Document(s) and Fee

Owner Information (Section A)

Lienholder or Security Interest Holder Information (Section B)

Vehicle Information (Section C)

Certification (Section D)

Notary Public Acknowledgment (Section E)

Instructions to Complete the T-16 Form

Completing this Affidavit

Georgia Department of Revenue-Motor Vehicle Division Affidavit of Repossession ANY CORRECTION OR ALTERATION WILL VOID THIS AFFIDAVIT T-16 (Revised 10-2017) Web and MV Manual Purpose of this Affidavit: This affidavit is to be used by a repossessor to certify that a motor vehicle has been repossessed because of the vehicle owner(s)’failure to meet his/her obligation for settlement of a lien or security interest on said vehicle. How to submit this Affidavit: This affidavit must be completed in its entirety, legibly printed or typed, and submitted along with all required document(s) to the county tag office in the county where you reside. Please refer to [http://dor.georgia.gov](http://dor.georgia.gov to)[ to](http://dor.georgia.gov to) locate the county tag office in your county of residence. Required document(s) : Current Georgia title Fee: $18.00 Title Fee, any penalty fee and Title Ad Valorem Tax (TAVT) , if applicable. | A | OWNER INFORMATION | | | | | | | | | | | | | | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Primary Owner’s Full Legal Name:
Mailing Address: | | | | | First Name Middle Initial Last Name Suffix
Street No. Street Name Apt./Suite No. | | | | | | | | | | | | | | | | | | | City: | | | | | | | | State: | | | ZIP Code: | | | | | | | | Telephone No.: | | | | | Secondary Owner’s Full Legal Name:
First Name Middle Initial Last Name Suffix
Mailing Address:
Street No. Street Name Apt./Suite No. | | | | | | | | | | | | | | | | | | | | | | | | City: | | | | | | | | State: | | | ZIP Code: | | | | | | | | Telephone No.: | | | | | B | LIENHOLDER OR SECURITY INTEREST HOLDER INFORMATION | | | | | | | | | | | | | | | | | | | | | | | Lienholder’s or Security Interest Holder’s Name: | | | | | | | | | | | | | | | | | | | | Date of Repossession: | | / / | | Mailing Address:
Street No. Street Name Apt./Suite No. | | | | | | | | | | | | | | | | | | | | | | | | City: | | | | | | | | State: | | | ZIP Code: | | | | | | | | Telephone No.: | | | | | C | VEHICLE INFORMATION | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Vehicle Identification No. (VIN): | | | | | | | | | | | | | | | | | | | | | | | | Year: | | | | | | Make: | | | | | | | | | | | | | | | | | | Current Title No.: | | | | | | | | | | | | | | | | | | | | | | | | D | CERTIFICATION | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | I hereby certify that the information shown on this affidavit is complete and correct. I also certify that all holders of unsatisfied liens and/or security interests recorded against this vehicle on the records of the Georgia Department of Revenue, Motor Vehicle Division, have been duly notified to protect any interests they have in the vehicle.
Authorized Agent’s Name:

Position/Job Title:

Authorized
Agent’s Signature:

Date:
/ / | | | | | | | | | | | | | | | | | | | | | | | | E | NOTARY PUBLIC ACKNOWLEDGMENT | | | | | | | | | | | | | | | | | | | | | | | Sworn to and subscribed before me this day of
| | | | | | | | | | Month | | | | | | , | Year | | | | Notary Seal or Stamp | | | Notary Public’s Full Legal Name:
Physical Address: | | | | | | | | | | | | | | | | | | | | | | | | Email Address: | | | | | | | | | | | | Telephone No.:
| | | | | | | | | | | | Signature of Notary Public: | | | | | | | | | | | | | Commission Expires: | | | | | / / | |

FAQs

What is the purpose of Form T-16 Affidavit of Repossession?

It is used by a repossessor to certify that a motor vehicle was repossessed because the owner failed to meet obligations related to a lien or security interest.

Where and how must the completed T-16 affidavit be submitted?

Complete the form in its entirety, legibly printed or typed, and submit it with all required documents to the county tag office in the county where you reside.

What happens if any correction or alteration is made to the T-16 affidavit?

Any correction or alteration will void the affidavit.

Sep 16, 2026

Uploaded by Melati