Fill a Valid Mv6 Georgia Template

Dealer, Distributor, Manufacturer & Transporter Tag Application

Please read the instructions that apply to requested tag category before completing and submitting documents and fees.

In accordance with Georgia Law §40-2-38, I am applying for distinguishing tags for motor vehicles manufactured, distributed, exchanged, sold, transported or leased by the company, business, firm, corporation or LLC referenced in this application.

TAG CATEGORY

Check box to indicate the tag category you are requesting. Submit a separate MV-6 application for each category or business location.

By placement of my signature hereon, I do solemnly swear, affirm or certify under criminal penalty of a felony for fraudulent use of a false or fictitious name or address or making a material false statement punishable by a fine of up to $5,000 or by imprisonment of up to five (5) years, or both, that statements contained on documents submitted by me are true and accurate. I also swear, affirm or certify that I am the authorized agent to sign for the company listed above, and shall comply with all state laws, rules and regulations pertaining to these tags.

The person authorized to complete this application must print their name, sign their name and enter their position or job title with the company and the date signed. Attach a copy of the authorized person’s valid Georgia driver’s license or Georgia ID card.

Form MV-6A (Rev. 12-2013)

Georgia Department of Revenue – Motor Vehicle Division

Authorize/Add/Delete Agents

Dealer, Distributor, Manufacturer & Transporter Tags

Please read the instructions that apply to requested tag category before completing and submitting documents and fees.

In accordance with Georgia law §40-2-38, I am authorizing, adding or deleting agents/representatives for the distinguishing tags issued for motor vehicles the company, business, firm, corporation or LLC referenced in this application manufactures, distributes, exchanges, sells, transports or leases.

AUTHORIZE/ADD Agents (Complete additional MV-6A forms as necessary.)

Record authorized agents’ full, legal names as shown on their valid Georgia driver’s licenses or Georgia ID cards & their positions or job titles with the company, business, firm, corporation or LLC.

Attach a copy of each agent’s Georgia driver’s license or Georgia ID card. Each authorized agent must sign & date this form.

DELETE Agents (Complete additional MV-6A forms as necessary.)

Record the name of agents/representatives no longer authorized to act as agents or representatives of the company, business, firm or LLC.

By signing this form to authorize, add or delete agents of the company, business, firm or LLC recorded above, I swear, affirm or certify under criminal penalty of a felony for fraudulent use of a false or fictitious name or address or for making a material false statement punishable by a fine of up to $5,000 or by imprisonment of up to five (5) years, or both, that statements contained on documents submitted by me or authorized agents/representatives are true and accurate. I also swear, affirm or certify that I am the authorized agent of the business listed above and shall comply with all state laws, rules and regulations pertaining to these tags.

Form MV-6B (Revised 12-2013)

Georgia Department of Revenue - Motor Vehicle Division

Dealer, Distributor, Manufacturer or Transporter Application for Additional Tags

Please read the instructions that apply to requested tag category before completing and submitting documents and fees.

Tag Category

Affidavit

I, ___________________________________________________________________, am applying for __________________________________

additional tags. To be eligible to receive more than two (2) additional tags, I am completing the following affidavit certifying the number of vehicles the business named in this application sold (retail or wholesale), distributed, manufactured or transported during the previous calendar year based on its business records. If the business named in this application is a new business or has been in business less than a year, I am certifying the number of vehicles the business is projected to sell (retail or wholesale), distribute, manufacture or transport during the coming calendar year. I understand that the Department has the right to limit the number of additional tags issued when the numbers certified in this affidavit differs from the department’s records, business records or investigative findings. I also understand that the Department may request additional documents to validate the need for additional tags.

I hereby swear, affirm or certify under criminal penalty of a felony for fraudulent use of a false or fictitious name or address or making a material false statement punishable by a fine of up to $5,000 or by imprisonment of up to five (5) years, or both, that statements contained on documents submitted by me are true and accurate and I understand the authorized uses of these tags as required by this state’s laws, rules and regulations. I understand that I must promptly file a police report when a tag is lost or stolen and submit a copy of such police report to the Motor Vehicle Division. I further swear, affirm or certify that in accordance with §40-3-33 (b) of Georgia Law, my records shall be available for inspection by any representative or officer of the Department of Revenue upon request during normal business hours.

Signature & Position/Job Title of Person Authorized to Complete MV-6, MV-6A, MV-6B & MV-6C Forms:

Sworn to and subscribed before me this _________ of ____________________, 2________.

If you need additional information, please call 1-855-406-5221. You can electronically complete & print these forms for signing & submission from our website, etax.dor.ga.gov.

E-mail: dealer.tags@dor.ga.gov

Customer ID Number _______________

Registration Year _______________

O.C.G.A. § 50-36-1(E) (2) AFFIDAVIT

By executing this affidavit under oath, as an applicant for:

(Check all that apply.)

Motor Vehicle Dealer, Distributor, Manufacturer, or Transporter Tag

as referenced in O.C.G.A § 50-36-1, from the Georgia Department of Revenue, the undersigned applicant verifies one of the following with respect to my application for a public benefit:

1)_________ I am a United States citizen.

2)_________ I am a legal permanent resident of the United States.

3)_________ I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency.

My alien number issued by the Department of Homeland Security or other federal immigration agency is:

____________________.

The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A. § 50-36-1(e) (1), with this affidavit.

The secure and verifiable document provided with this affidavit can best be classified as:

____________________________________________________________________________________.

In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as allowed by such criminal statute.

Executed in__________________ (city), ___________________ (state)

SUBSCRIBED AND SWORN

BEFORE ME ON THIS THE

___ DAY OF _______, 20___

________________

NOTARY PUBLIC

My Commission Expires: