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Warning odometer discrepancy!

Vehicle Section:Except for the signature, this application must be typed, electronically completed & printed or legibly hand printedin black or blue Identification NumberYearMakeBody StyleModelColorCylindersNew or UsedDate PurchasedEmission Certificate #Current Title #Current Title s State of IssueGA County of ResidenceDistrict # odometer Reading Warning odometer discrepancy! Complete For All Commercial VehiclesGross Vehicle Weight & Load Straight Truck? Used For Hire? Type of Trailer Pulled?Product Hauled? Is This A Farm Vehicle? _____ Yes No Yes No _____ Yes NoNumber of Owners_____ Owner Section Leased Vehicle? No YesOwner # 1MV-1 (Revised 11-2013)Full Legal Name of Owner #1 Date of BirthIf you purchased this vehicle from an out-of-state dealer/business, did you pick-upthe vehicle out-of-state? Yes NoOwner # 2 Full Legal Name of Owner #2 Date of BirthAddress (Street address including city, state & zip)Mailing Address (If different from street address including city, state & zip)Seller SectionLessee SectionFull Legal Name or Business Name & Address:Le ssee s Full Legal Name & Address or Business Lessee s Full Name & Address:If Georgia Seller, GA County Name Le ssee s GA County LocationSecurity Interests or Liens SectionName & Address of 1stSecurity

Vehicle Section: Except for the signature, this application must be typed, electronically completed & printed or legibly hand printed in black or blue ink. Vehicle Identification Number Year Make Body Style Model Color Cylinders New or Used Date Purchased Emission Certificate # Current Title # Current Title’s State of Issue GA County of Residence District #

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