IN THE MAGISTRATE COURT OF GWINNETT COUNTY STATE OF GEORGIA __________________________________________________ Plaintiff vs. Civil Action File No: ________________________________ (Motor Vehicle) __________________________________________________ (Vehicle Identification Number) (Tag Number) AFFIDAVIT OF DISPOSITION OF ABANDONED MOTOR VEHICLE INFO & FORMS ON INTERNET www.gwinnettcourts.com Last known registered owner(s) & lienholder(s): _______________________________________________________ ______________________________________________________________________________ Comes now ___________________________________________________, [ ] the Plaintiff [ ] agent for the Plaintiff herein, who after having been duly sworn or affirmed states that the following facts are true and correct to the best of his/her knowledge: [] The vehicle was redeemed by owner/lienholder prior to public auction. No sums are due and payable. Or [] The vehicle was sold at public auction on , at , said address being within: [ ] the city limits of _____________________________________________________; [ ] unincorporated Gwinnett County. The sale was conducted in compliance with the provisions of O.C.G.A. ' 40-11-6. 1. The vehicle was impounded at the request of a: [ ] private individual [ ] city officer/official of _________________________________ [ ] county officer/official [ ] Georgia State Patrol. The amount received for the vehicle at public sale The amount of the lien on the vehicle The amount due to Clerk of Court and submitted herewith (Name of Municipality) 2. 3. 4. 5. $ __________________ $ __________________ $ __________________ A true and correct copy of the bill of sale of the vehicle is attached hereto as AExhibit A@. _____________________________________ [ ] Plaintiff [ ] Agent for Plaintiff Sworn to and subscribed before me this _________ day of _____________________, 20_____. Notary Public/Clerk of Court My Commission Expires: Q:\Magforms\MAG 40-04 Affidavit of Disposition of AMV (AUG 2001) American LegalNet, Inc. www.FormsWorkFlow.com