OHIO BUREAU OF MOTOR VEHICLES APPLICATION FOR LEASING/FLEET ONLINE REGISTRATION COMPANY INFORMATION (Complete a form for each Tax ID number) COMPANY NAME COMPANY TELEPHONE NUMBER ( ) COMPANY ADDRESS CITY STATE * FEDERAL TAX ID NUMBER ZIP CODE COUNTY * L.D. NUMBER *The current Federal Tax ID and Ohio L.D. numbers must be shown. CONTACT PERSON FIRST NAME LAST NAME TELEPHONE NUMBER EMAIL ADDRESS ( ) CONTACT PERSON FIRST NAME LAST NAME TELEPHONE NUMBER EMAIL ADDRESS ( ) AUTHORIZED USER PASSWORD AUTHORIZED USER PASSWORD NOTE: The following Power of Attorney form MUST BE COMPLETED. Oplates Unit – For information regarding this application, please call or email: Telephone 1-866-868-0006 Email info@oplates.com BMV 4630 3/03 American LegalNet, Inc. www.FormsWorkflow.com BLANKET POWER OF ATTORNEY AUTHORIZATION TO REGISTER MOTOR VEHICLES To the Ohio Bureau of Motor Vehicles Registration Section / OPLATES PO Box 16521 Columbus, OH 43216-6521 The undersigned leasing company, "LESSOR" herein, by its duly authorized Agent, hereby states: 1. LESSOR is the owner of certain motor vehicles and is engaged in the business of leasing motor vehicles to LESSEES for use in the state of Ohio; 2. By the terms of its leases, LESSOR requires each LESSEE to maintain proof of financial responsibility for each vehicle registered for use in the state of Ohio; 3. As owner, LESSOR is obligated to annually register each motor vehicle under Ohio Revised Code (R.C.) 4503.10. Under the terms of its leases, LESSOR has passed this obligation to its respective LESSEES; 4. LESSOR desires to appoint and hereby does appoint each respective LESSEE as its attorney in fact to make application for the registration of each motor vehicle leased by the LESSOR to the LESSEE. LESSOR authorizes each respective LESSEE to sign the registration application on behalf of the LESSOR either manually or by electronic means; 5. In signing the registration application either manually or by electronic means, LESSEE shall affirm that LESSEE maintains liability insurance coverage or other acceptable proof of financial responsibility and will continue to maintain financial responsibility coverage continuously throughout the registration period; 6. The LESSOR may revoke this Power of Attorney as to any individual LESSEE or as all LESSEES by giving notice to the Registrar by any written or electronic means authorized by the Registrar; 7. If any person, including any LESSEE, improperly registers any motor vehicle owned by LESSOR, LESSOR at its option may notify the Registrar of Motor Vehicles of that fact. Upon notification, the Registrar may issue certification to the county sheriff or local police officials to recover any license plates erroneously or fraudulently issued pursuant to R.C. 4503.10(E). NAME OF OWNER/LESSOR ADDRESS OF OWNER/LESSOR LIST ALL TAX IDENTIFICATION NUMBERS WITH CORRESPPONDING L.D. NUMBERS SIGNATURE OF AUTHORIZED AGENT TYPE OR PRINT NAME AND TITLE OF AUTHORIZED AGENT X NOTE: Previous application MUST BE COMPLETED. American LegalNet, Inc. www.FormsWorkflow.com