Use this template/form as an Affidavit of Repossession form in the State of Georgia
Text version of this Form
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T-16 (Rev 08-2005)
Affidavit of Repossession
State of Georgia Page 1 of 2
County of _________________
This is to certify that the undersigned has repossessed the motor vehicle described below
because of the vehicle owner(s)’ failure to meet his or her obligation for settlement of a lien or
security interest on said vehicle.
Important: Please read all of the instructions on page 2 of this form before completing.
Vehicle Owner(s)’ Full Legal Name(s)
Vehicle Owner(s)’ Address including city, state & zip code
Vehicle Year Model & Make Vehicle Identification Number (VIN) Current Title #
Lien or Security Interest Holder’s Name Date of Repossession
City, State & zip code
I, the undersigned, hereby certify that the information shown on this form 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.
Typed or Printed Name of Lien or Security Interest Holder
Authorized Signature Date
Position or Job Title
Sworn to and subscribed before me this
Notary’s Telephone # including area code ________ of _________________, ________
(Day) (Month) (Year)
Date My Notary Commission Expires Notary Public’s Signature & Notary Seal or Stamp
Notary’s Printed Name
Note: If the title is not available, the repossessor must obtain a title in the state where the
vehicle is currently titled before transferring ownership of the vehicle
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T-16 Instructions (Rev. 08-2005) Page 2 of 2
Instructions for Completing an Affidavit of Repossession (Form T-16)
The following documents and fee(s) must be submitted together to either the Department of
Revenue/Motor Vehicle Division, PO Box 740381, ATLANTA, GA 30374-0381, or to the
applicable County Tag Office.
1. Title Application – Except for the signature(s), this form must be typed, electronically
completed and printed or legibly hand-printed in blue or black ink in the current owner(s)’
full legal name(s) reflecting their current address. The vehicle owner(s) must sign this
completed and signed Limited Power of Attorney (Form T-8) must be submitted.
2. Title Document – The current Georgia title must be submitted, if available. If the Georgia
title is not available, the repossessor must obtain a Georgia title in their name first, unless
the vehicle is exempt from the odometer disclosure requirements of the Federal Truth in
If the Georgia title is not issued in the person’s name from which the vehicle
was repossessed, the title must be submitted properly assigned to that person.
If the current title is an out-of-state title, it must be submitted or the
repossessor must secure a title in their name first from the state where the
vehicle is currently titled.
If the repossessor is not recorded on the face of the title or in the title
assignment as the lien or security interest holder, a copy of the contract
between the repossessor and the party from whom the vehicle was
repossessed must be submitted.
If the repossessor has sold the vehicle, the repossessor should complete the
first title assignment transferring the ownership of the vehicle to the purchasing
name is his or her complete name as it appears on his or her valid Georgia
driver’s license or Georgia identification card. If the title is lost, the
repossessor must obtain a title in their name from the state where the vehicle
is currently titled before transferring ownership.
3. Supporting Document(s) – An Affidavit of Repossession (Form T-16) must be completed
and signed by the repossessor. An affidavit of repossession from another state is
acceptable if it contains all of the required information and is signed by the repossessor
with his or her signature notarized.
4. Processing Fees – Pay all fees due ($18.00 title fee plus any title penalty fee for late
application) with cash or a certified check or money order payable to the office
Please do not remit cash through the mail! If a title is not applied for within ninety-days
(90) of the purchase date, a $10 title penalty fee must be included in your payment.
Important: If the vehicle is “exempt” from the odometer disclosure requirements but is still
required to be titled in Georgia but the Georgia title is unavailable, the repossessor is not
required to obtain a title in their name. In this situation, the repossessor may give the
purchaser(s) a bill of sale and a completed and signed Affidavit for a Repossessed Motor
Vehicle (Form T-16). This exception only applies when there is a Georgia title on record.