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MV-603I (Rev. 06-2005) Abandoned Vehicle Affidavit From Insurance Company or Company Storing Vehicle For Insurance Company State of Georgia, County of I, a duly authorized agent of Owner/Agent of Company Storing Vehicle do hereby solemnly swear or affirm that the vehicle described as: Company Storing Vehicle Year Model & Make of Vehicle Vehicle Identification Number was removed to and/or has been stored Location Where Stored Said vehicle is now an abandoned vehicle as defined in OCGA §40-11-1 and has not been claimed by the owner, lessor, lessee or any holder of a lien or security interest. I further solemnly swear or affirm that in following the procedure to foreclose on an abandoned vehicle lien on said vehicle, I have complied with the requirements of OCGA §40-11-2 as evidenced by the following: 1. This vehicle was being stored by an insurance company providing insurance to cover damages to the vehicle as provided in OCGA §40-11-2 but has become abandoned. The name and address of said insurer is: (Name & Address of Insurer) Said insurer did/ did not acquire said vehicle after paying a total loss claim. Please check one box. 2. Within seven calendar days of the day such vehicle became an abandoned motor vehicle, I/we gave notice in writing to the Department of Revenue pursuant to the procedure set forth in OCGA §40-11-2 and requested the name and address of all owners of such vehicle as evidenced by the document(s) attached hereto and incorporated herein as “Exhibit 3. Within five calendar days of having received the information requested, I/we either: a. Notified the owner, or lessee, or any holder of a lien or security interest by certified mail and first class mail; and, b. Placed an advertisement in a newspaper of general circulation in the county where such vehicle was obtained once a week for two consecutive weeks because the owner could not be ascertained or the certified mail was returned undeliverable; or, c. Placed an advertisement at the county courthouse in such place where other public notices are posted for two consecutive weeks because there is no newspaper in such county. Pursuant to OCGA §40-11-2 said notice advised the owner(s) of their obligations and rights to redeem such vehicle and such owner, lessee or holder of a lien or security interest has either disclaimed their ownership or interest in such vehicle, as evidenced by the document(s) attached hereto and incorporated herein by reference or has failed to redeem such vehicle. 4. I/We have made demand for payment of which demand has not been satisfied. More than ten-days (10) have elapsed since notification and no petition for a judicial hearing has been made. Therefore, I/we ask the court to authorize the foreclosure of my/our lien and the sale of this motor vehicle. Signature of Owner or Agent of Company Storing Vehicle Date Sworn and subscribed before me this Street Address for Company Storing Vehicle Day Month Year City, State & Zip Notary Public’s Signature & Notary Seal or Stamp Telephone Number Including Area Code Date My Notary Commission Expires Print this form! Clear form