Application For Special Ohio Registration Form. This is a Ohio form and can be use in Bureau Of Motor Vehicles Statewide.
Tags: Application For Special Ohio Registration, BMV 4374, Ohio Statewide, Bureau Of Motor Vehicles
OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES APPLICATION FOR SPECIAL OHIO REGISTRATION 1) PLEASE PRINT LEGIBLY IN INK OR TYPE THE FOLLOWING INFORMATION: BUSINESS NAME BUSINESS TELEPHONE NUMBER BUSINESS STREET ADDRESS FACSIMILE NUMBER CITY 2) STATE ZIP CODE INDICATE STYLE OF BUSINESS PROPRIETORSHIP PARTNERSHIP COUNTY NUMBER CORPORATION EMAIL ADDRESS BUSINESS TRUST LIMITED LIABILITY Owner’s, Partner’s, President’s, Trustee’s, Member’s name, address and SSN Partner’s, Vice President’s, Trustee’s, Member’s name, address and SSN Partner’s, Secretary’s, Trustee’s, Member’s name, address and SSN Partner’s, Treasurer’s, Trustee’s, Member’s name, address and SSN 3) FEDERAL TAX I.D. NUMBER 4) CHECK PAYABLE TO “OHIO TREASURER JOSH MANDEL” (DO NOT SEND CASH). MASTER PLATE (REQUIRED) 1 @ $25.25 = $25.25 POSTAGE (REQUIRED) 1 @ $ 2.75 = $ 2.75 @ $ 5.25 ea. = *ADDITIONAL PLATES TOTAL FEES SUBMITTED FEES ARE NON-REFUNDABLE *Note: Towing businesses may only order one license plate per tow truck plus one additional license plate. Other Businesses: The Bureau may at its discretion reduce the number of additional license plates ordered. THIS APPLICATION AND FEES MUST BE RETURNED TO: The Ohio Bureau of Motor Vehicles, Attn: Dealer Licensing Section, P.O. Box 16521, Columbus, Ohio, 43216-6521. Please allow four to six weeks for processing, manufacture and shipment of the license plates. www.OhioAutoDealers.com BOTH SIDES OF THIS FORM MUST BE COMPLETED BMV 4374 1/11 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 5) CHECK THE PRIMARY PURPOSE FOR WHICH YOU ARE APPLYING FOR SPECIAL OHIO REGISTRATION. (MARK ONLY ONE BOX) Motor vehicles or motorized bicycles owned and being used in testing or being demonstrated for the purpose of sale or lease. Indicate your leasing dealer permit number : Motor vehicles being transported by persons regularly engaged in salvage operations or scrap metal processing from the point of acquisition to their established place of business. Indicate your salvage dealer permit number: Motor vehicles being towed by any persons regularly and primarily engaged in the business of towing motor vehicles while such vehicle is being towed to a point of storage. Indicate how many tow trucks you own: Persons regularly engaged in the business of rust proofing, reconditioning, or installing equipment or trim on motor vehicles for motor vehicle dealers when such motor vehicles are being transported to or from the motor vehicle dealer’s place of business. List all motor vehicle dealers with whom you regularly do business: Motor vehicles subject to the rights and remedies of a secured party being exercised under Sections 1309.01 to 1309.50 of the Revised Code. Motor vehicles being held or transported by any insurance company for purposes of salvage disposition. Motor vehicles owned by or in the lawful possession of an Ohio non-profit corporation while being used in the testing of those motor vehicles. Persons engaged in manufacturing articles for attachment to motor vehicles when such motor vehicles are being transported to or from places where mechanical equipment is attached to the chassis of such new motor vehicles. Trailers being transported by persons engaged in the business of selling tangible personal property other than motor vehicles. YOU WILL LOSE YOUR DRIVER LICENSE FOR AT LEAST 90 DAYS IF YOU DRIVE WITHOUT INSURANCE OR OTHER ACCEPTABLE FINANCIAL RESPONSIBILITY COVERAGE In Ohio, it is illegal to drive any motor vehicle without insurance or other financial responsibility (FR) coverage. It is also illegal for any motor vehicle owner to allow anyone else to drive the owner’s vehicle without FR coverage. PROOF OF COVERAGE IS REQUIRED: Whenever a police officer issues a traffic ticket At all vehicle inspection stops Upon traffic court appearances and Upon random checks by the Registrar of Motor Vehicles. ANY DRIVER OR OWNER WHO FAILS TO SHOW PROOF OF INSURANCE OR OTHER COVERAGE WILL: Lose his or her driver license for 90 DAYS on first Pay reinstatement fees of offense, ONE YEAR on second offense and TWO YEARS on additional offenses Lose his or her license plates and vehicle registration $100.00 for first offense, $300.00 for second offense, $600.00 for third and subsequent offenses Pay a $50.00 penalty for any failure to surrender his or her driver license, license plates, or registration AND Be required to maintain special FR coverage (“High-risk” insurance or equivalent) on file with the Bureau of Motor Vehicles (BMV) for THREE or FIVE YEARS. ONCE THIS SUSPENSION IS IN EFFECT: Any driver or owner who violates the suspension will have his or her vehicle immobilized and his or her license plates confiscated for at least 30 DAYS first offense and 60 DAYS second offense. For third or subsequent offenses, the vehicle will be forfeited and sold and the person will not be permitted to register any motor vehicle in Ohio for FIVE YEARS. IF YOU ARE INVOLVED IN AN ACCIDENT WITHOUT INSURANCE OR OTHER FR COVERAGE: In addition to all the penalties listed above, you may have A SECURITY SUSPENSION for TWO YEARS or more and A JUDGMENT SUSPENSION INDEFINITELY (until all damages have been satisfied). THESE PENALTIES ARE IN ADDITION TO ANY FINES OR PENALTIES IMPOSED BY A COURT OF LAW. WARNING: THESE LAWS DO NOT PREVENT THE POSSIBILITY THAT YOU MAY BE INVOLVED IN AN ACCIDENT WITH A PERSON WHO HAS NO INSURANCE OR OTHER FR COVERAGE. WHEN REQUIRED, PROOF OF COVERAGE MAY BE SHOWN BY ANY OF THE FOLLOWING: AN INSURANCE POLICY showing automobile liability insurance of at least $12,500 bodily injury per person, $25,000 injury two or more persons, and $7,500 property damage AN INSURANCE IDENTIFICATION CARD (same coverage) A SURETY BOND OF $30,000 issued by any authorized surety company or insurance company A BMV BOND SECURED BY REAL ESTATE having equity of at least $60,000 A BMV CERTIFICATE FOR MONEY OR GOVERNMENT BONDS in the amount of $30,000 on deposit with the Ohio Treasurer of State A BMV CERTIFICATE OF SELF-INSURANCE, available only to companies or persons who own at least twenty-six motor vehicles. I affirm that the owners (or lessees of leased vehicle) now have insurance or other FR coverage and will not operate or permit the operation of this motor vehicle(s) without FR coverage; and will not be used as a commercial vehicle unless so registered. I also affirm that all statements in the foregoing application and in any attached sheet(s), are true and correct and that I, as proprietor, or as a partner, member, or trustee, have authority to sign this application and make the statements contained herein. X SIGNATURE (OWNER, PARTNER, OFFICER, MEMBER, OR TRUSTEE) DATE PRINT OR TYPE NAME OF SIGNER NOTARY: Subscribed and sworn to before me this SEAL My commission expires day of , in the county of State of Ohio. X NOTARY PUBLIC BMV 4374 1/11 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com