MV-603D Rev 2-2009
Disposition Notice
Derelict Vehicle Sale Only
Under provisions of Code Section O.C.G.A. § 40-11-9, I declare the following vehicle a derelict motor
vehicle:
_______________________________________________________________________________
Vehicle Year
Make
Model
Vehicle Identification Number (VIN)
________________________________________________________
Business Name, if incorporated or DBA
_______________________
Phone Number
_________________________________________________________
City, State
_______________________
Zip code
_________________________________________________________
Business Name and Location where vehicle was delivered for dismantling or scrapped
_______________________
City, State & Zip Code
Any vehicle without a manufacturer’s Vehicle Identification Number (VIN) shall not be declared a derelict
This disposition notice must have the following supporting documentation upon filing with Department
of Revenue – Motor Vehicle Division:
•
Notice of Abandoned Vehicle (Form MV-603) that was filed no less than 30 days prior to this notice.
•
Bill of Sale (Form T-7).
•
Written appraisal attached because a similar vehicle is not listed in the Black Book and certifying the extent of
damage.
□ The value of the vehicle is less than $300 as determined by half the wholesale value of a similar vehicle in the rough
section in the NATIONAL AUTO RESEARCH BLACK BOOK, GEORGIA EDITION.
OR
This is to further certify that the aforementioned vehicle meets four (4) of the following conditions
required by law for a derelict vehicle. (Check at least 4 conditions):
□ Unattended vehicle left on private or public property without a note from the driver. The vehicle was left unattended on
private property for two (2) days without a note or three (3) days on public property without a note.
□ A note was left, but the vehicle remained unattended for five (5) days on either public or private property.
□ Vehicle is damaged to such an extent that the restoration of the vehicle to an operable condition would require the
replacement of one or more major component parts.
□ Vehicle is inoperable due to major mechanical breakdown - engine, transmission, or wheels missing, no coolant, no engine
oil, or burned transmission fluid.
□ Vehicle is seven (7) or more model years old.
□ Vehicle has no current tag or there is no tag or title information in the Motor Vehicle Division files.
□ An insurance company or owner to a wrecker service abandoned the vehicle after a total loss claim was paid.
□ The vehicle is completely destroyed by fire, flood or vandalism or is otherwise damaged to the extent that restoration of
the vehicle to a safe and operable condition would require replacement of more than 50 percent of its major component parts.
_________________________________________________________
Signature
_______________________
Date
________________________________________________________
Full Legal Name
_______________________
Title
By signing this form, I understand that according to O.C.G.A. 40-3-90 “A person who, with fraudulent intent . . . (4)
uses a false or fictitious name or address or makes a material false statement, or fails to disclose a security interest, or
conceals any other material fact in a application for a certificate of title . . . shall be guilty of a felony. Further,
according to O.C.G.A. 40-3-94 “A person who . . . (4) willfully violates any other provision of this chapter shall be
guilty of a misdemeanor.”
Original form delivered by person declaring vehicle derelict to ATTN: Salvage Section
DOR/Motor Vehicle Division
P.O. 740381
Atlanta, GA 30374-0381.
Copy to person that dismantled or scrapped vehicle
Copy retained by person declaring motor vehicle a derelict vehicle
2/4/2009