A certification by whoever is physically holding the certificate that they are holding it for payment of a lien, a security interest, or as required by a lease agreement. It is the document that lets a title application go forward when the certificate itself is sitting in a lender's or a leasing company's vault rather than in your glovebox.
Written against T-17 (Rev 7-2017), issued under the Motor Vehicle Division, and acknowledged by a county tax commissioner or their designated employee.
This is a short form that gets used for a long list of situations, and the acknowledgement block at the foot means it is normally completed at a county tag office rather than posted in. Ring ahead and ask what that office wants to see with it.
Two documents, and they are not the same thing. Take the blank T-17 from the dor.georgia.gov copy so you get the revision that is current today.
This is the actual T-17, rendered from the PDF the Georgia Department of Revenue, Motor Vehicle Division publishes and completed end to end: letterhead, every field, and the blocks at the foot.
Amber — you write it
Grey — not yours to fill
Numbered — explained below
The actual T-17 at revision 7-2017. The signature rule and the county acknowledgement block carry no fillable fields in the Department's PDF, so they are blank here - the owner signs in ink and the tax commissioner's office completes the block at the counter.
Field by field
Every line, in the order you meet it
1
You fill this in
Vehicle description
Year model, make of vehicle and the vehicle identification number.
Watch out: Take these from your registration if you cannot get to the certificate - which, given that somebody else is holding it, is the situation this form exists for.
2
You fill this in
Title number and issuing state
The number printed on the certificate and the state that issued it.
Watch out: The lender or leasing company can read both off the document they are holding. Asking them for the title number in the same call as asking for this form saves a second one.
3
You fill this in
Owners' full legal names as shown on title
Every name printed on the certificate.
Watch out: As shown on title, which on a leased vehicle may be the leasing company rather than the driver. Copy, do not paraphrase.
4
The lienholder fills this in
Name and address of the title holder
The lien or security interest holder or leasing company, with its street address or post office box and city, state and zip.
Watch out: The same name and address has to go onto the MV-1 title application. A mismatch between the two documents is what sends the package back.
5
You fill this in
Signatures and account number
The owner or lessee signs, and the account number goes underneath.
Watch out: This is the one block on the form that is yours rather than the title holder's. The account number is on your statement.
At a glance
What goes where
On the form
What to put in it
Vehicle description
Year model, make of vehicle and the vehicle identification number across one row, then the title number and the name of the state issuing the title.
Owners' full legal names as shown on title
One wide rule. Names as the certificate has them, not as they are written elsewhere.
Name and address of the title holder
The lien or security holder or leasing company's name, street address or post office box number, and city, state and zip on three separate rules.
Applicants' or lessees' signatures and account number
Signed by the owner or lessee rather than by the title holder, with the account number underneath.
Acknowledgement
A block for the county tax commissioner or their designated employee to acknowledge the statement at the counter.
What has to travel with it
Printed at the foot: an original valid out-of-state registration certificate or a non-negotiable certificate of title, and a properly completed and signed MV-1 title application.
What gets this one rejected
•Sending it in alone. The form states plainly what has to accompany it - the original out-of-state registration certificate or a non-negotiable certificate of title, and a completed, signed title application.
•A leasing company name that is not the one on the title application. The form asks for the correct and complete name and address of the leasing company or lending institution to be entered on the title application as well.
•A lessee signing for the leasing company without authority. Where the lessee signs the title application for the leasing company, a power of attorney authorising them to do so has to be submitted.
•An owner name that differs from the certificate. The block asks for owners' full legal names as shown on title.
•Leaving the account number blank. It is what ties the statement to the lender's file.
Rules that decide whether it is accepted
•It certifies possession, not release. This form says the title is being held. It does not say the debt is paid and it does not release anything - the paid-off case is a Form T-4 or a release signed on the certificate itself.
•A leased vehicle is the everyday case. The heading names leasing companies alongside lien holders, and a lease is the situation where the person driving the car has never held the certificate at all.
