OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES NO FEE TRANSFER OF GRATIS REGISTRATION APPLICATION PUBLIC OWNED VEHICLE BMV USE ONLY MO. EXPIRES LAST DAY OF DAY VALIDATION # LICENSE # MO. YR. YR. CURRENT VEHICLE DATA CERTIFICATE OF TITLE # WILL THE VEHICLE DESCRIBED HEREIN BE USED EXCLUSIVELY FOR GOVERNMENTAL OR PROPRIETARY FUNCTIONS? YES NO INDICATE TYPE OF VEHICLE BY “X” PASSENGER CAR/VAN TRAILER BUS MAKE YEAR TYPE COLOR PURCHASE DATE SERIAL # ODOMETER READING OWNER NAME TRUCK/CARGO VAN MOTORCYCLE CUSTOMER # ADDITIONAL NAME LINE BUSINESS ADDRESS CITY STATE ZIP CODE OTHER OLD VEHICLE DATA YEAR MAKE TYPE SERIAL # BMV USE SOLD TO NAME MAIL TO: ADDRESS STATE CITY ZIP CODE OHIO BUREAU OF MOTOR VEHICLES ATTN: GRATIS UNIT P.O. Box 16521 Columbus, Ohio 43216-6521 IMPORTANT 1. APPLICATION MUST BE FULLY COMPLETED AND SIGNED. 2. ORIGINAL CERTIFICATE OF TITLE FOR THE NEW VEHICLE MUST ACCOMPANY APPLICATION SIGNATURE OF CONTACT PERSON X PHONE # DATE WARNING APPLICANT GIVING FALSE INFORMATION IS SUBJECT TO PROSECUTION—OHIO REVISED CODE (R.C.) 2913.42. APPLICATION MUST BE SIGNED BY OWNER(S) AS NAMED ON CERTIFICATE OF TITLE. BMV 4501 9/08 American LegalNet, Inc. www.FormsWorkflow.com