Form Bmv 4443 – Fill Out and Use This PDF

OHIO BUREAU OF MOTOR VEHICLES

APPLICATION FOR NAME/DBA, ADDRESS, OR

DEALER LICENSE TYPE CHANGE

APPLICATION TO CHANGE DEALER LICENSE TYPE (New to used or used to new Motor Vehicle dealer’s license)

APPLICATION FOR NAME/DBA CHANGE

APPLICATION FOR ADDRESS

PO BOX CHANGE

(PO Box must be in the same zip code as the business)

PERMIT NUMBER

PLATE NUMBER

1. PLEASE PRINT LEGIBLY IN INK OR TYPE
BUSINESS NAME			BUSINESS PHONE
DBA OR FICTITIOUS TITLE NAME			ALTERNATE TELEPHONE NUMBER
PROPOSED NEW OR CURRENT BUSINESS STREET ADDRESS			PO BOX
CITY	STATE	ZIP CODE	COUNTY

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.

3.FEES PAYABLE TO “TREASURER, STATE OF OHIO,” ARE AS FOLLOWS: DO NOT SEND CASH

MOTOR VEHICLE DEALER PERMIT (REQUIRED)		@	$ 4.00	=
SALVAGE DEALER, POOL OR AUCTION PERMIT (REQUIRED)		@	$ 2.00	=
*AMENDED REGISTRATION CARDS (REQUIRED, IF ISSUED
LICENSE PLATES) (MASTER PLATE + ADDITIONAL PLATES)		@	$2.00 each	=
				=
*Registration card fees do not apply to DBA name changes.	TOTAL FEES DUE

FEES ARE NON-REFUNDABLE

BOTH SIDES OF THIS APPLICATION MUST BE COMPLETED

9/05 BMV 4443

A. Are you or do you intend on sharing the proposed business location with another licensed motor vehicle dealer?	YES	NO
If yes, indicate the business name and, if available, the permit number of the other dealer.

NOTE:		A certificate of compliance form, BMV4347, must be submitted with this application, if you answered
		YES to question 4A.
	B.	Was the proposed business location previously occupied by another licensed motor vehicle dealer?	YES	NO
		If yes, give the business name, if available.
	BUSINESS NAME

C.Submit photographs of the proposed business location’s lot, office, (inside and outside), and business sign.*

5.NAME/DBA CHANGE APPLICANTS ONLY: Submit a photograph of the sign showing the business/ dba name.*

*THE SIGN MUST BE IN THE EXACT BUSINESS/DBA NAME WITH AT LEAST SIX INCH LETTERS.

6.NEW MOTOR VEHICLE DEALERS ONLY: Indicate below each NEW make to be sold and submit Statements of Contract, BMV4319, showing the new business name and/or new business address for each.

FINANCIAL RESPONSIBILITY NOTICE

YOU WILL LOSE YOUR DRIVER LICENSE FOR AT LEAST 90 DAYS IF YOU DRIVE WITHOUT INSURANCE OR OTHER

ACCEPTABLE PROOF OF FINANCIAL RESPONSIBILITY COVERAGE

•In Ohio, it is illegal to drive any motor vehicle without insurance or other financial responsibility (FR) coverage.

•It is also illegal for any motor vehicle owner to allow anyone else to drive the owner's vehicle without FR coverage.

•PROOF OF COVERAGE IS REQUIRED: • Whenever a police officer issues a traffic ticket • At all vehicle inspection stops • After certain automobile crashes and • Upon random checks by the Registrar of Motor Vehicles.

•ANY DRIVER OR OWNER WHO FAILS TO SHOW PROOF OF INSURANCE OR OTHER COVERAGE WILL: • Lose his or her driver license for 90 DAYS on the first offense and ONE YEAR on additional offenses • Lose his or her license plates and vehicle registration • Pay reinstatement fees of $75.00 first offense, $250.00 second offense, and $500.00 any additional offense • Pay a $50.00 penalty for any failure to surrender his or her drivers license, license plates, or registration AND • Be required to maintain special FR coverage ("High-risk" insurance or equivalent) on file with the Bureau of Motor Vehicles (BMV) for FIVE YEARS.

•ONCE THIS SUSPENSION IS IN EFFECT: Any driver or owner who violates the suspension will have his or her vehicle immobilized and his or her license plates confiscated for at least 30 DAYS first offense and 60 DAYS second offense. For a third or subsequent offense, the vehicle will be forfeited and sold and the person will not be permitted to register any motor vehicle in Ohio for FIVE YEARS.

•IF YOU ARE INVOLVED IN AN ACCIDENT WITHOUT INSURANCE OR OTHER FR COVERAGE: In addition to all the penalties listed above, you may have • A SECURITY SUSPENSION for TWO YEARS or more and • A JUDGMENT SUSPENSION for SEVEN YEARS.

•THESE PENALTIES ARE IN ADDITION TO ANY FINES OR PENALTIES IMPOSED BY A COURT OF LAW.

•WARNING: THESE LAWS DO NOT PREVENT THE POSSIBILITY THAT YOU MAY BE INVOLVED IN AN ACCIDENT WITH A PERSON WHO HAS NO INSURANCE OR OTHER FR COVERAGE.

7.I AFFIRM THAT ALL INFORMATION PROVIDED ON THIS APPLICATION IS TRUE AND CORRECT AND THAT I, AS PROPRIETOR, PARTNER, OFFICER, MEMBER OR TRUSTEE HAVE AUTHORITY TO SIGN THIS APPLICATION.

X

SIGNATURE (OWNER, PARTNER, OFFICER, MEMBER, OR TRUSTEE)

DATE

PRINT NAME OF SIGNER

INCOMPLETE INFORMATION WILL RESULT IN THE DELAY OF PROCESSING YOUR APPLICATION.

Upon receipt of a completed application for change of address or dealer license type change, a physical inspection of the proposed new location will be requested. Please allow four to six weeks for processing. Applications for name/dba or PO Box change only do not require an inspection. Notice of change of status is required, in writing, within 15 days [O.R.C. 4517.23 & 4738.08].

Return completed application, all supporting documents and fees to: Ohio Bureau of Motor Vehicles, Attn: Dealer Licensing Section, P. O. Box 16521, Columbus, Ohio, 43216-6521.

www.OhioAutoDealers.com