Web and MV Manual Georgia Department of …

1 Have a question? Visit our website at or scan the QR code above for more information. T-11 (Revised 10-2017) Web and MV Manual Georgia Department of Revenue - Motor Vehicle Division Affidavit of Correction ANY CORRECTION OR ALTERATION WILL VOID THIS AFFIDAVIT Purpose of this Affidavit: This affidavit is to be completed by the seller/transferor of a motor vehicle when there is a correction made in the assignment of title or Manufacturer s Certificate of Origin. This affidavit cannot be used when information has been blocked out by erasure or the use of correction fluid, or to correct an odometer reading, a purchase date or an incorrectly recorded lienholder or security interest holder. 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 the seller/transferor resides.

2 Please refer to to locate the county tag office in your county of residence. Required document(s): You must provide the Manufacturer s Certification of Origin or Certificate of Title showing the assignment correction. A REASON FOR TITLE ASSIGNMENT CORRECTION Check applicable box below: [ ] Typographical error [ ] Customer changed mind [ ] Seller signed their name incorrectly [ ] Seller assigned title to himself [ ] Seller assigned title to wrong party [ ] Seller made strikeover in purchaser s name [ ] Assignment placed in Dealer Assignment in error [ ] Notary Public placed signature in wrong space [ ] Purchaser s name misspelled [ ] Other _____ _____ _____ B VEHICLE INFORMATION Vehicle Identification No. (VIN): Year: Make: Model: C CERTIFICATION I hereby certify that the strikeover on the assignment of the attached Manufacturer s Certificate of Origin or Certificate of Title for the above described vehicle was made due to the reason provided in Section A.

3 I also affirm that I am the seller/transferor in the assignment where the correction has been made. Seller/Transferor s Full Legal Name: First Name Middle Initial Last Name Suffix Signature: Date: / / D 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: / / Have a question? Visit our website at or scan the QR code above for more information. INSTRUCTIONS How to complete the T-11 Form COMPLETING THIS AFFIDAVIT This affidavit must be completed in its entirety, legibly printed in blue or black ink or typed. Any correction or alteration will void this affidavit. Section A: Provide the reason for correcting the title assignment.

4 Section B: Record the vehicle information for which the title assignment has been corrected. Section C: Certify before a Notary Public that all statements are true and accurate. Section D: Affidavit must be notarized by a commissioned Notary Public. REQUIRED DOCUMENT(S) The following document is required: Manufacturer s Certificate of Origin or Certificate of Title SUBMITTING THIS AFFIDAVIT This affidavit must be submitted along with all required document(s) to the county tag office in the county where the seller/transferor resides. Please refer to to locate the county tag office in your county of residence. IMPORTANT INFORMATION This affidavit cannot be used to correct an incorrectly entered odometer reading, a vehicle s purchase/transfer date or an incorrectly recorded lien or security interest holder.

5 WHAT DOCUMENT(S) and/or FEE(S) should be SUBMITTED for a(n).. Incorrectly entered odometer reading: Form T-107 Odometer Discrepancy Affidavit(s) Correction in vehicle's purchase or transfer date: Payment of a $ title penalty. A copy of the front and back of the check between the seller and the buyer supporting the purchase or transfer date change. A replacement title or statement of origin from the issuing agency for proper assignment with the correct date. Incorrectly recorded lien or security interest holder: Form T-4 Release of Lien or Security Interest This form must be completed by the incorrectly recorded lien or security interest holder.