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Affidavit Form. This is a Georgia form and can be use in Pierce Local County.
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Tags: Affidavit, Georgia Local County, Pierce
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
IN THE MAGIS TRATE COURT OF PIERCE COUTY
S TATE OF GEORGIA
:
_____________________________
Plaintiff
Vs.
-against-
Calendar No.
:
JUDICIAL SUBPOENA
Plaintiff(s)
Civil Action File No. _________
:
______________________________
(Motor Vehicle)
:
:
______________________________
(Vehicle Identification Number)
Defendant(s)
:
......................................................
______________________________
(T ag Number)
THE PEOPLE OF THE of the OF NEW YORK
The name(s) and address(es)STATElast known registered owner(s) and/or all lienholder(s) of the vehicle is/are:
TO
[ ] Unknown;_____________________________________________________________________________
________________________________________________________________________________________
GREETINGS:
Personally appeared before the undersigned officer, duly authorized to administer oaths, _________________
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
___________________, who being duly sworn, deposes and states as follows:
the Honorable
at the
Court
,
1.
located at
County of
T he Plaintiff is inon the
possession of the above described motor vehicle. T he vehicle wasnoon, and at at the request of
impounded any recessed
in room
,
day of
, 20
, at
o'clock in the
a: [ ] private individual [ ] city officer/official [ ] county officer/official [ of Georgia State Patrol.
] the
or adjourned date, to testify and give evidence as a witness in this action on the part
2.
T he Plaintiff has taken the following described actions to perfect the lien on the vehicle as set forth below:
Your have to n provide d to subpoena is punishable and lie nholde r as follows: (See O.C.G.A. liable to
[ ] Notice s failurebe ecomply with thisthe last known owne ras a contempt of court and will make you 40-11-2)
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure toEVENT
comply.
DEADLINE
DATE
CO MPLETED
Vehicle towed
N/A
Witness, Honorable
, one of the Justices of the
Court in
County,
day of
, 20 Within 72 hours of towing
Owner & Lien info requested from law enforcement 40-11-2(a)(b)
First Notice to Owner & Lienholder by Certified or Registered Mail 4011-2(e)
DMV Statement Filed Within 7 Days Vehicle Became Abandoned
40-11-2(e)
Information Received from DMV
Within 7 days (or forfeit storage
fees)
th
[ (Attorney must sign above and or name below)
] 7 day ended Sat., Sun., type
legal holiday and notice was given
next day.
Within 7 days of the 30 day
Attorney(s) for
deadline from date vehicle
removed
N/A
This notice applies ONLY when owner/leinholder ascertained solely
Within 5 days of receipt of DMV
Office and Sat., Sun., &
thru DMV: Notice(s) to Owner & Lienholder By Certified or Registered info, excludingP.O. Address legal
Mail of vehicle location, is deemed abandoned if not redeemed. 40-11holidays.
2(f)
Additional Notice(s) to Owner Lienholder By Certified or Registered
Mail of itemized statement of removal, storage and advertising fees, if
applicable. (May be combined with preceding notice if owner info
ascertained only from DMV.) 40-11-5(2)
After the 30 days from the date
Telephone No.:
vehicle removed and before one
Facsimile No.:
year from removal date or date lien
E-Mail
recorded. Address:
Mobile Tel. No.:
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
[ ]
Plaintiff(s)
[ ]
Index No.
The above notices were not sent because the identity of the owner and/or lienholder cannot
:
Calendar No.
ascertained. Proper notice has been given by running an advertisement as required by
O.C.G.A. § 40-11-2(g).
:
JUDICIAL SUBPOENA
M ore than ten (10) days prior to filing this Affidavit, demand was made by certified or registered
-against:
mail upon the last known registered owner of the vehicle for the payment of the reasonable fees for
removal and storage plus the costs of any applicable advertisement, including an itemized
:
statement of all charges.
:
3.
The Plaintiff has complied with the notice requirements of the O.C.G.A. §40-11-12 by one or more of
Defendant(s)
:
the following methods:
......................................................
[ ]
seeking the identity of the last known registered owner from a local law enforcement agency and
the identity of the last known registered owners, lessors, security interest holders and lienholders
THE PEOPLE OF THE STATE OF NEW YORK
from the Department of Revenue.
TO ]
[
[ ]
checking the motor vehicle records of another state if the Plaintiff has knowledge of facts which
reasonably indicate that the vehicle is registered in another state.
placing an advertisement in a newspaper of general circulation in ______________ County once
a week for two consecutive weeks for vehicles of which the identity of the owner cannot be
ascertained.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
GREETINGS:
,
the Honorable
at the
Court
[ ] of
located at
County notifying the owner by registered or certified mail of the owner’s right to redeem the vehicle.
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
4. This adjourned is made testify and give evidence asyear from: this action on the part of the
or affidavit date, to within the period of one a witness in
[ ]
the recording of a lien on the vehicle with the Department of M otor Vehicles, as set forth in
paragraph 2 above.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
[ ] the assertion of a lien by retention of the motor vehicle removed/retained as set forth in paragraph
result of your failure to comply.
2 above.
Witness, Honorable
, one of the Justices of the
WHEREFORE, Plaintiff makes this affidavit for the purpose of foreclosing the lien upon the above described
Court in
County,
day
, 20
vehicle and prays that execution issue for: of
Removal Fee
Accrued Storage Fee
Future Storage Fee
Administration Fee
Court Costs
$________________
(Attorney must sign above and type name below)
$________________
$________________ per day from date of filing this action.
$________________
$________________
Attorney(s) for
Sworn to and subscribed before me this _____
________________________________
[ ] Plaintiff [ ] Agent of Plaintiff
day of _________________, 20____.
Office and P.O. Address
__________________________________
Clerk of Court/Notary Public
________________________________
Address
________________________________
Telephone No.:
Telephone
Facsimile No.: No.: ___________________
E-Mail Address:
Mobile Tel. No.:
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