Are you looking to get an Ohio Form BMV 0399 filled out quickly and easily? If so, this blog post is for you! Here, we'll provide helpful information about what the form is used for, filing instructions and tips, plus answers to frequently asked questions. Whether you're new to the process or just need a refresher on familiar topics, this post will help guide you in correctly completing your Ohio Form BMV 0399.
| Question | Answer |
|---|---|
| Form Name | Ohio Form Bmv 0399 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | bmv0399 bmv 0399 form |
OHIO BUREAU OF MOTOR VEHICLES
REQUEST FOR SERVICE BY COUNTY AGENCY
State and County agencies must complete this form and submit it to the BMV when requesting to make payment for service by way of County Agency Voucher or Intra State Agency Voucher (ISTV). Attach a copy of the voucher, if applicable. A revenue transfer must be completed for the amount of service authorized through an ISTV or by way of check within 30 days after the service was provided.
SERVICE REQUESTED
DATE OF REQUEST:
EXPLAIN TYPE OF SERVICE REQUESTED
AMOUNT OF VOUCHER/ISTV (REQUIRED)
$
BMV CASE # (IF REQUIRED)
OTHER INFORMATION:
CUSTOMER/RECIPIENT INFORMATION
FIRST NAME |
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LAST NAME |
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MIDDLE INITIAL |
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STREET ADDRESS |
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SOCIAL SECURITY # |
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CITY |
STATE |
ZIP |
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PHONE # |
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AGENCY INFORMATION
AGENCY NAME |
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AGENCY CONTACT/CASE WORKER |
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STREET ADDRESS |
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PHONE NUMBER |
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CITY |
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STATE |
ZIP |
FAX NUMBER |
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AGENCY AUTHORIZED SIGNATURE |
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X |
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DO NOT WRITE BELOW THIS LINE
KEY NUMBER (I.E. APP/DL NUMBER) |
SERVICE DATE |
SERVICE PROVIDED BY |
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AMOUNT OF VOUCHER/ISTV |
PAYMENT/ISTV REC’D DATE |
PAYMENT PROCESSED BY |
$ |
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NOTES: |
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Mail to: Ohio Bureau of Motor Vehicles Revenue Management, P.O. Box 16521, Columbus, Ohio
PLEASE DUPLICATE THIS FORM AS NEEDED
BMV 0399 11/04