How to fill out Georgia T-4

The lender's sworn statement that the loan is paid and the security interest gone. Georgia's ordinary route is a release signed on the face of the certificate itself; this affidavit is what happens when that has not been done and the certificate has to be accompanied by a separate, notarised document instead.

Written against T-4 (Rev 2-2015), issued under Article 3 of Chapter 3 in Title 40, as the form itself cites it. Start this before you list the car, not after a buyer asks. A loan settled years ago can still be showing on the Department's record, and chasing a lender's title department for a notarised affidavit is measured in weeks, not days.

Two documents, and they are not the same thing. Take the blank T-4 from the dor.georgia.gov copy so you get the revision that is current today.

Step 1 · the form itself Blank T-4 — Notice of Satisfaction of Security Interest or Lien Holder's Affidavit PDF at dor.georgia.gov · new tab

Filled in

What a completed one looks like

This is the actual T-4, 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

A Georgia Form T-4 filled in: Reginald T. Amos, Vice President of Lending, appearing for Cannonball Credit Union of 755 Riverside Dr, Macon, Georgia; owner Alvin R. Pettigrew of 1240 Hazel St, Macon; a 2015 Honda, VIN 5FNYF4H54FB024871, model Pilot Sport Utility; state of title records Georgia, title number 40318726, account number 4471-908326; and the Yes acknowledgement box ticked. — The actual T-4 at revision 2-2015, completed by a fictional lender releasing a fictional loan. The notary block at the foot carries no fillable field in the Department's PDF - it is completed in ink, in front of the notary, which is the point of it.

Field by field

Every line, in the order you meet it

1
The lienholder fills this in
The person appearing
Printed full legal name of the executive officer, or the full legal name and driver's licence number of a sole proprietor or partner.
Watch out: A title clerk at a bank is usually not an executive officer. Ask who at the lender is authorised to swear this before the appointment is made, or the notary visit is wasted.
2
The lienholder fills this in
Legal business name of the lien holder
The lender's legal business name as listed on the certificate of title.
Watch out: As listed on the certificate. Lenders merge and rebrand constantly, and a release in the new name against a certificate in the old one is the commonest reason this affidavit is refused.
3
The lienholder fills this in
Owner names as they appear on the certificate
Your name, spelled the way the certificate spells it, and your residence address below it.
Watch out: If the certificate has your name wrong, fixing that is a separate errand and it comes first. A one-and-the-same affidavit exists precisely for this.
4
The lienholder fills this in
The vehicle row
Vehicle year and make, vehicle identification number, model and body style.
Watch out: Check the VIN character by character against the certificate before it is notarised. Nothing on this form can be corrected afterwards.
5
The lienholder fills this in
Title number and account number
State of title records, the title number and the lender's account number for the loan.
Watch out: The account number is the lender's own reference and is what lets them find the file if the Department queries it. It is not on your certificate; it comes off your loan statement.
6
The lienholder fills this in
The Yes acknowledgement
A single tick beside the paragraph about the State Revenue Commissioner's power to investigate and to reject an application.
Watch out: Small box, long paragraph, easy to miss. It sits on the right-hand edge of the block and an untick led form is incomplete.

At a glance

What goes where

On the form	What to put in it
Who is appearing	The printed full legal name of the executive officer, or the full legal name and driver's licence number of a sole proprietor or partner, on the first rule.
The lien holder	The legal business name of the security interest or lien holder exactly as it is listed on the certificate of title, then the business address including city, state and zip code. Where the lien holder is an individual, a copy of the driver's licence has to accompany the form.
The owner	Owner or owners' names as they appear on the certificate of title, then the residence address including city, state and zip code.
The vehicle	Vehicle year and make, vehicle identification number, and model and body style in three boxes across one row.
The record	State of title records, title number and account number - the lender's own reference for the loan being released.
The acknowledgement tick	A single Yes box beside a long paragraph acknowledging that the State Revenue Commissioner may investigate the titling and registration of the vehicle, may refuse to issue a certificate where there are reasonable grounds to believe an application contains a false statement, and has the discretion to reject the application for title.
Notary public acknowledgement	The officer, partner or sole proprietor signs and dates on the basis of personal knowledge of the facts and circumstances surrounding the security interest, sworn to and subscribed before a notary who adds a signature, seal, printed name, residence address, business phone number and commission expiry.

What gets this one rejected

•Anyone but the lien holder executing it. The instruction is that this affidavit should be executed by the person who holds a security interest or lien on the motor vehicle described.
•Using it for an electronic lien. The note is unambiguous: this form is not permitted for use by any participant in the Electronic Lien on Title programme for any security interest or lien which has been recorded electronically.
•A business name that does not match the certificate. The form asks for the legal business name as listed on the certificate of title, not the lender's current trading name.
•Any alteration. The footer says any alteration or correction voids this form, and that all previous revisions of it are obsolete.
•Sending it in on its own. It has to be legibly completed and attached to the application for certificate of title.
•An individual lien holder with no identification. Where the lien holder is a person rather than a business, a copy of their driver's licence has to accompany the form.

Rules that decide whether it is accepted

•Black or blue ink, except for the signatures. The instruction line allows typing or legible printing in black or blue ink, or completing it electronically and printing it - and then names the signatures as the exception, because those go on afterwards in front of a notary.
•It is a paid-off lien, not a released one. This document says the debt is satisfied. If the lender still holds the certificate because the loan is live, that is a different form and a different conversation - Form T-17 is the one that covers a title being held.

Every line here was read off T-4 (Rev 2-2015) itself — the PDF is here — and off the Georgia Department of Revenue, Motor Vehicle Division pages. This is plain-language help with a form, not legal advice, and where our wording and the agency's differ, theirs governs.

Back to all Georgia seller paperwork, or what selling a car in Georgia involves.

How to fill out Georgia T-4

What a completed one looks like

Every line, in the order you meet it

The person appearing

Legal business name of the lien holder

Owner names as they appear on the certificate

The vehicle row

Title number and account number

The Yes acknowledgement

What goes where

What gets this one rejected

Rules that decide whether it is accepted

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