Office of Insurance and Safety Fire CommissionerRalph T. Hudgens
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Vehicle Protection Warrantor Forms

ATTENTION: TO ALL NEW APPLICANTS - EFFECTIVE 1/1/2012. 
In accordance with state law, beginning January 1, 2012, the Office of Insurance and Safety Fire Commissioner will be changing its procedures regarding the verification of lawful presence of persons applying for all licenses, permits, registrations and certificates. Please click HERE for more information.

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Form #: GID-005-NT (same as EN-5) This is in the Adobe Portable Document format (pdf)\nDivision: Insurance Financial OversightPublished: 2013
Title: Vehicle Protection Warrantor Letter
In order to comply with the Official Code of Georgia Annotated, Title 33, Chapter 34A, the attached application for registration as a Vehicle Protection Warrantor should be completed and returned to this office: Room 604 West Tower, 2 Martin Luther King, Jr. Drive, Atlanta, GA 30334. Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-006-NT (same as EN-6) This is in the Adobe Portable Document format (pdf)\nDivision: Insurance Financial OversightPublished: 2014
Title: Vehicle Protection Warrantor - Application
Notice and Registration application form. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Form #: GID-007-NT(same as EN-7) This is in the Adobe Portable Document format (pdf)\nDivision: Insurance Financial OversightPublished: 2013
Title: Vehicle Protection Warrantor - Notice and Registration - Annual Renewal Registration (same as EN-7)
This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal. Effective 1-1-2012, the Citizenship Affidavit Form GID-276-EN is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

Form #: GID-276-EN This is in the Adobe Portable Document format (pdf)\nDivision: Insurance Financial OversightPublished: 2014
Title: Citizenship Affidavit
Effective 1-1-2012, this form is required of persons making application for all licenses, permits, registrations and certifications in order to comply with the Georgia Illegal Immigration Reform And Enforcement Act. This form requires signing to be witnessed by a Notary Public and have them affix their Notary seal.

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