Ohio Bureau Of Motor Vehicles Application For Auction Owner'S Or Distributor'S License Form
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4OHIO BUREAU OF MOTOR VEHICLES
APPLICATION FOR AUCTION OWNER’S OR DISTRIBUTOR’S LICENSE
Indicate Type of License :
AUCTION OWNER'S LICENSE
DISTRIBUTOR’S LICENSE
1)
PLEASE PRINT LEGIBLY IN BLACK INK OR TYPE THE FOLLOWING INFORMATION:
BUSINESS NAME
BUSINESS TELEPHONE NUMBER
(
)
DBA OR FICTITIOUS TRADE NAME
ALTERNATIVE TELEPHONE NUMBER
(
)
BUSINESS STREET ADDRESS
FACSIMILE NUMBER
(
)
CITY
STATE
ZIP CODE
COUNTY
EMAIL ADDRESS
2)
USING A BLACK PEN, SHADE IN A BOX IN EACH COLUMN, UNDER DEALERSHIP COUNTY, TO INDICATE THE COUNTY
NUMBER IN WHICH YOUR DEALERSHIP IS LOCATED. SEE CHART BELOW FOR THE APPROPRIATE COUNTY NUMBER.
DEALERSHIP
01
ADAMS
16
COSHOCTON
31
HAMILTON
46
LOGAN
61
NOBLE
76
STARK
Butler Co.
COUNTY
= 09
02
ALLEN
17
CRAWFORD
32
HANCOCK
47
LORAIN
62
OTTAWA
77
SUMMIT
03
ASHLAND
18
CUYAHOGA
33
HARDIN
48
LUCAS
63
PAULDING
78
TRUMBULL
0
0
0
0
S
04
ASHTABULA
19
DARKE
34
HARRISON
49
MADISON
64
PERRY
79
TUSCARAWAS
1
1
1
1
05
ATHENS
20
DEFIANCE
35
HENRY
50
MAHOINING
65
PICKAWAY
80
UNION
2
2
2
2
A
06
AUGLAIZE
21
DELAWARE
36
HIGHLAND
51
MARION
66
PIKE
81
VAN WERT
3
3
3
3
M
07
BELMONT
22
ERIE
37
HOCKING
52
MEDINA
67
PORTAGE
82
VINTON
4
4
4
4
P
08
BROWN
23
FAIRFIELD
38
HOLMES
53
MEIGS
68
PREBLE
83
WARREN
5
5
5
5
L
09
BUTLER
24
FAYETTE
39
HURON
54
MERCER
69
PUTNAM
84
WASHINGTON
6
6
6
6
E
10
CARROLL
25
FRANKLIN
40
JACKSON
55
MIAMI
70
RICHLAND
85
WAYNE
7
7
7
7
11
CHAMPAIGN
26
FULTON
41
JEFFERSON
56
MONROE
71
ROSS
86
WILLIAMS
8
8
8
8
12
CLARK
27
GALLIA
42
KNOX
57
MONTGOMERY
72
SANDUSKY
87
WOOD
9
9
9
9
13
CLERMONT
28
GEAUGA
43
LAKE
58
MORGAN
73
SCIOTO
88
WYANDOT
14
CLINTON
29
GREENE
44
LAWRENCE
59
MORROW
74
SENECA
15
COLUMBIANA
30
GUERNSEY
45
LICKING
60
MUSKINGUM
75
SHELBY
99
OUT OF STATE
3)
MAKE CHECK PAYABLE TO "TREASURER, STATE OF OHIO”. DO NOT SEND CASH
AUCTION OWNERS AND DISTRIBUTOR APPLICANTS:
PERMIT (REQUIRED)
1
@
$ 50.00
$50.00
CIVILIAN BACKGROUND CHECK REQUIRED * (See exception on back) CHECK ONE:
@ $15.00 ea
$
Enclosed Fingerprint Card(s)
WebCheck Completed (See instruction sheet)
N/A
MINIMUM REQUIRED FEE
$50.00
AUCTION OWNER APPLICANT’S ONLY OPTIONAL PLATES:
MASTER IN-TRANSIT LICENSE PLATE
1
@
$50.25
$50.25
ADDITIONAL PLATES (OPTIONAL)
@
$ 3.25 ea.
+
POSTAGE
1
@
$ 2.75 ea.
+ $ 2.75
ADDITIONAL FEES DUE
DISTRIBUTOR APPLICANT’S ONLY PLATES (OHIO APPLICANTS ONLY):
MASTER DISTRIBUTOR LICENSE PLATE (REQUIRED)
1
@
$ 25.25
$25.25
ADDITIONAL PLATES (OPTIONAL)
@
$ 5.25 ea.
+
POSTAGE
1
@
$ 2.75 ea.
+ $ 2.75
ADDITIONAL FEES DUE
TOTAL FEES DUE
4325
2/03
BMV
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