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Get OH BMV 3774 2015

Applicant s signature X Is Applicant a Minor Sworn to and subscribed in my presence by this day of Seal BMV 3774 2/15 760-1503. OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES APPLICATION S FOR CERTIFICATE OF TITLE TO A MOTOR VEHICLE Type or Print in Ink CHECK TYPE OF APPLICATION S Fee of 5. 00 for failure to apply for title within 30 days of assignment. COUNTY PRIMARY APPLICANT S NAME SSN / EIN SECONDARY APPLICANT S NAME Hereby declares under penalty of perjury that he/she is the lawful owner / purchaser / lien holder of the following described motor vehicle and hereby makes application for the following ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Title No* Registration etc* Applicant acquired said motor vehicle by state how acquired from Name of Previous Owner Is Seller a Minor Yes No Address of Previous Owner The following is a full statement of all liens on said motor vehicle. If no lien state none if more than one lien attach statement of all additional liens. Lien Holder /E Code Address DUPLICATE CERTIFICATE OF TITLE has been Applicant states that Certificate of Title Number lost stolen destroyed that said motor vehicle has not been sold or disposed of except as stated below The vehicle is in the possession of residing at and that if said Certificate of Title be hereby recovered by this applicant he will deliver same to the Clerk of Courts for cancellation* REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number SALVAGE CERTIFICATE OF TITLE has been surrendered to the Clerk of Courts. YEAR VIN MODEL BODY TYPE MAKE CONVERSION PURCHASE PRICE VENDOR S NUMBER TRADE IN AMOUNT PERMIT NUMBER SALES / USE TAX SALES CREDIT AMOUNT CONDITION OF VEHICLE Check only one TAX EXEMPTION YES GOOD FAIR POOR WRECKED REASON Warning You are required by law to state the true selling price. A false statement is in violation of section 2921. 13 of the Ohio Revised Code and is punishable by six months imprisonment and a fine of up to one thousand dollars or both. All transfers are audited by the Department of Taxation* The seller and buyer must provide any information requested by the Department of Taxation* The buyer may be assessed any additional tax found to be due. OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES APPLICATION S FOR CERTIFICATE OF TITLE TO A MOTOR VEHICLE Type or Print in Ink CHECK TYPE OF APPLICATION S Fee of 5. 00 for failure to apply for title within 30 days of assignment. COUNTY PRIMARY APPLICANT S NAME SSN / EIN SECONDARY APPLICANT S NAME Hereby declares under penalty of perjury that he/she is the lawful owner / purchaser / lien holder of the following described motor vehicle and hereby makes application for the following ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Title No* Registration etc* Applicant acquired said motor vehicle by state how acquired from Name of Previous Owner Is Seller a Minor Yes No Address of Previous Owner The following is a full statement of all liens on said motor vehicle. .

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