2018 Surety Bond Girls Title Bond Application
The data submitted in this form is safe with SSL Secure Encryption. Depending on the value of the car, we may request your Social Security Number separately.
(To view this application in Spanish, please click on this link: https://docs.google.com/a/suretybondgirls.com/forms/d/1ooNwwIPfR-PWN5s-lhYnPU7WEBfvFt7-WQ1u9-UejF0/viewform.)
You will need to have a form T-22B completed by a GA law enforcement officer. You can access this form by clicking on this link:
http://dor.georgia.gov/sites/dor.georgia.gov/files/related_files/document/MVD/Form/MV_Serial_Plate_Verification_Form_T22B_0.pdf
Email address *
Date
MM
/
DD
/
YYYY
Applicant Information
New Owner of the vehicle to be titled
Name *
Exactly as it appears on drivers license
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
County *
Your answer
Phone Number *
Home, Mobile
Your answer
Date of Birth *
mm/dd/yyyy
Your answer
Drivers License # (if not GA issue, which state) *
Your answer
E-mail Address *
Your answer
Vehicle Information
Describing the vehicle to be titled
Make *
Your answer
Model *
Your answer
Year *
Your answer
VIN Number *
Please double check for accuracy
Your answer
Has the vehicle been salvaged?
Is this an abandoned vehicle?
Is there a Lien on the Vehicle
Which documents do you have in your possession? *
Required
Length and Width if a Mobile Home
Your answer
Why is the title bond needed? *
Your answer
Bonded Title Amount
Min. $5,000.00 (leave blank if you're not sure)
Your answer
Seller's Information
Previous Owner's information
Seller's Name *
Your answer
Seller's Street Address
Your answer
Seller's City
Your answer
Seller's State
Your answer
Seller's Zip
Your answer
Sellers Driver's License Number/State of Issue
Your answer
Date of Sale *
mm/dd/yyyy
Your answer
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