Get Bmv Ohio Gov Next Of Kin

OHIO DEPARTMENT OF PUBLIC SAFETY NEXT OF KIN / EMERGENCY CONTACT ENROLLMENT To register please visit our Web site at www. bmv.ohio. gov or complete this form and return it to your local Deputy Registrar or mail it to OHIO BUREAU OF MOTOR VEHICLES Attn Verification Services Document Management P. Bmv.ohio. gov or complete this form and return it to your local Deputy Registrar or mail it to OHIO BUREAU OF MOTOR VEHICLES Attn Verification Services Document Management P. O. Box 16520 Columbus Ohio 43216-6520 NOTE If this form is not filled out completely Next of Kin information will not be updated nor will this form be returned for correction. Any changes to this document will override any previous submissions to add or change the Next of Kin Notification information. PLEASE ENSURE THE ACCURACY OF ANY NEXT OF KIN INFORMATION PROVIDED AND ENSURE THAT THIS INFORMATION IS UPDATED AS APPLICABLE THE BMV IS NOT RESPONSIBLE FOR ANY ERRORS IN INFORMATION PROVIDED OR FOR FAILURE TO PROVIDE UPDATED INFORMATION. PURSUANT TO OHIO REVISED CODE R.C. OHIO DEPARTMENT OF PUBLIC SAFETY NEXT OF KIN / EMERGENCY CONTACT ENROLLMENT To register please visit our Web site at www. bmv*ohio. gov or complete this form and return it to your local Deputy Registrar or mail it to OHIO BUREAU OF MOTOR VEHICLES Attn Verification Services Document Management P. O. Box 16520 Columbus Ohio 43216-6520 NOTE If this form is not filled out completely Next of Kin information will not be updated nor will this form be returned for correction* Any changes to this document will override any previous submissions to add or change the Next of Kin Notification information* PLEASE ENSURE THE ACCURACY OF ANY NEXT OF KIN INFORMATION PROVIDED AND ENSURE THAT THIS INFORMATION IS UPDATED AS APPLICABLE THE BMV IS NOT RESPONSIBLE FOR ANY ERRORS IN INFORMATION PROVIDED OR FOR FAILURE TO PROVIDE UPDATED INFORMATION* PURSUANT TO OHIO REVISED CODE R*C. SECTION 4501. 81 THE BMV WILL NOT BE LIABLE IF CONTACT CANNOT BE MADE WITH A DESIGNATED CONTACT PERSON IN THE EVENT OF AN EMERGENCY. 1. PLEASE CHECK ONE OF THE FOLLOWING Yes I want to add Next of Kin / Emergency Contact information to my Ohio Driver License or Identification Card record. Please remove all Next of Kin / Emergency Contact information listed on my Ohio Driver License or Identification Card record disregard section 3 Please change the Next of Kin / Emergency Contact information on my Ohio Driver License or Identification Card record to the following. 2. OHIO DRIVER LICENSE / IDENTIFICATION CARD HOLDER INFORMATION Required OHIO APPLICANT LAST NAME FIRST NAME ADDRESS CITY MI STATE ZIP CODE Information Required CONTACT 1 LAST NAME RELATIONSHIP HOME PHONE CELL PHONE WORK PHONE EXT. Checking this box means that this person has accurate detailed and up to date medical information about me that may be shared with any medical professionals providing emergency medical treatment to me. 4. SIGNATURE OF OHIO DRIVER LICENSE / IDENTIFICATION CARD HOLDER Required I understand by checking the box and providing contact information for an individual with knowledge of my medical history I am authorizing law enforcement to release my contact person s information to first responders and medical professionals.