Form MV-5 Fillable Replacement Registration Certificate
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Dealer s Signature (If Applicable) Dealer s Permanent ID Number Dealer s Master Tag Number Georgia County Owner s Full Legal Name Personal Signature(s) of Owner(s) Date (The original is lost stolen or mutilated) accurate I do certify that the vehicle after the purchase or ownership transfer of a vehicle A Georgia certificate of title when required must be obtained All license plates are transferable from one vehicle an owner sells or transfers to another An application for a replacement certificate of registration where the original has been lost and category license plate License plates must be transferred within thirty (30) days of APPLICATION FOR A REPLACEMENT REGISTRATION CERTIFICATE Application for a Replacement Registration Certificate Instructions & by imprisonment of up to five (5) Caution: contained herein are true and County of Residence Date of Birth decal and registration certificate with described is covered with the required Emission Certificate No (If Applicable) Emission Expiration Date (If Applicable) enforcement for improper registration false or fictitious name or address or FIRST MIDDLE LAST for making a material false statement Georgia liability insurance Georgia License Plate Number Georgia license plates must be transferred within thirty (30) days of the date of purchase or ownership transfer of a Georgia where the owner resides Gross Weight of Vehicle & Load if I request that I be furnished a in accordance with Georgia law and Information Legal Name of Business/Company Mailing Address Including City State Zip (if different from above address) Model motor vehicle or the vehicle owner will be subject to fines of up to $100 by law enforcement for improper registration MV 5 (REV 12 04) FEE $1 00 MV 5 Instructions & Information (Rev 12 04) New vehicles must be properly registered within thirty (30) days of the date of purchase or ownership transfer For no knowledge as to where it may be of a felony for fraudulent use or a of the above described vehicle and or in whose possession it is now and Original Fee Owner s Full Legal Name Owner s Georgia Driver s License Number paid the lawful fee for the registration prior to registration or applied for at the time of registration or a license plate will not be issued or transferred to the punishable by a fine up to $5 000 or registration A vehicle registration expires at midnight on the last day of the owner s registration certificate has been lost Registration Expiration Date registration period A certificate of registration is not an ownership document if the vehicle replacement registration certificate for requires a certificate of title A certificate of title is required to transfer the ownership of a solemnly swear under criminal penalty stolen or mutilated and (for a lost or stolen or mutilated must be applied for at the Tax Commissioner s office in the county in stolen registration certificate) I have Street Address including City State & Zip Style of Body the date of purchase or ownership transfer or the owner is subject to a $100 fine by law the number recorded above The The other side of this form is an application for the replacement of a certificate of vehicle The undersigned filed an application this vehicle originally registered I do Truck Type of Trailer (if Trailer) Vehicle ID Number vehicle in the owner s name Vehicle Make vehicle the same owner buys or acquires as long as both vehicles require the same price vehicle when the vehicle requires a title i e 1986 and newer year model vehicles etc vehicles requiring a Georgia certificate of title the vehicle owner must apply for Georgia certificate of title promptly was furnished a license plate/renewal Year Model years or both that the statements