Prepared and issued as a public service by the office of
Transcript of Prepared and issued as a public service by the office of
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A GUIDEBOOK FOR NOTARIZING OHIO TITLE DOCUMENTS
Prepared and issued as a public service by the office of Erie COUllty Clerk of Courts
This guidebook is based on the original Guidebook for Notarizshying Ohio Title Documents produced and provided by the Frankshylin County Clerk of Courts Maryellen OShaughnessy Clerk
Introduction
A Certificate ofTitle is one of the most notarized documents in the State of Ohio It is an important legal document as it officially signifies ownership of a motor vehicle or watercraft vessel
The following guideline was compiled by the Erie County Clerk of Courts ofshyfice and is provided as a courtesy to you
This booklet serves as a general guideline it does not cover every specific asshypect of notarizing certificates of title If you have any questions concerning the notarization of titles or title-related documents please call our Title Dept at 419-627-7626
wwwfranklincountyohiogovclerk
Table of Contents
General Guidelines 1
Assignment of an Ohio Title 2-3
Application of an Obio Title 4-5
Power of Attorney6-7
Odometer 8
Additional Form Samples 9-16
Clerk of Courts Locations 18
Rev 7113 Title Line (419) 627middot7626
ATPS TITLE OFFICE DISTRICTS
Notarizing an Ohio Title - General Guidelines
+ Do not take the acknowledgment on any instrument wherein blanks are left to be filled in later The legal instrument must be completely prepared before notarization is completed
+ When selling a vehicle or watercraft the seller must sign and print their name(s) as it appears on the face of the title
+ Assignments of ownership must be in the form of legal names - Clifton J Smith not CJ Smith - Richard L Jones Jr not Dick Jones
+ Do not under any circumstances white out or scribble out any errors on the title assignment this will void the title and a replacement must be issued
+ Jl someone signs the back of a title on behalf of a company or other entity they must state their position within that entity
- ABC Trucking Company John F Rees Fleet Mgr - Dixie Candy Corp Dennis T Dix Owner - Abel Family Trust Carol A Abel Trustee
+ If the seller or buyer is under 18 years of age the custodial parent or guardishyan must fill out a notarized minor consent fonn (available from the Clerk of Courts Title Office) The minor must bring this consent fornl-along with the certificate of title-to the Clerk of Courts office or the parentguardian must appear in person with the minor at the time of transfer The guardian must provide the court document indicating that they are the legal guardian of the mmor
+ If you take the acknowledgment from a person appointed as power of attorshyney the notarized power of attorney form (available from any of the Clerk of Courts Title Offices or on our web site) must be surrendered at the time of transfer of ownership
- A Durable Power of Attorney is acceptable - A Health Care Power of Attorney is not acceptable
+ If you take the acknowledgment from a person appointed by the Court the Court Order must bear the Judges signature and seal and must be surrendered at the ti me of transfer of ownership
- Court Order appointing Executor Fiduciary Guardian etc Letter of Authority to Transfer
- Relieftrom Administration of Estate 9C Form
Ohio ORC 450502 requires that each applicant must present an official photo identifieation
httpwwweriecountyohgov 1
Assignment of an Ohio Title (Top portion of the back of Title)
I Selling price
2 Date of SaleDelivery
3 Minor (consent form required)
4 Buyer(s) legal name and address
5 Odometer reading as shown on vehicle
6 If odometer is 5 digits and rolled over place (X) in box
(in excess of mechanical limits)
7 If odometer is broken or any other discrepancy exists place (X) in
box
8 Check appropriate box if applicable
9 Printed name(s) of seller(s)
10 Signature ofseller(s
11 Address of selJer(s)
12 Person(s) name who signed in front of you
13 Notary Date
14 Commission expiration date
15 Printed name of Notary Public
16 Signature of Notary Public
17 Notary Seal
Rev 713 Title Line (419) 627-7626
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
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httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
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Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
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Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
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Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 2: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/2.jpg)
Introduction
A Certificate ofTitle is one of the most notarized documents in the State of Ohio It is an important legal document as it officially signifies ownership of a motor vehicle or watercraft vessel
The following guideline was compiled by the Erie County Clerk of Courts ofshyfice and is provided as a courtesy to you
This booklet serves as a general guideline it does not cover every specific asshypect of notarizing certificates of title If you have any questions concerning the notarization of titles or title-related documents please call our Title Dept at 419-627-7626
wwwfranklincountyohiogovclerk
Table of Contents
General Guidelines 1
Assignment of an Ohio Title 2-3
Application of an Obio Title 4-5
Power of Attorney6-7
Odometer 8
Additional Form Samples 9-16
Clerk of Courts Locations 18
Rev 7113 Title Line (419) 627middot7626
ATPS TITLE OFFICE DISTRICTS
Notarizing an Ohio Title - General Guidelines
+ Do not take the acknowledgment on any instrument wherein blanks are left to be filled in later The legal instrument must be completely prepared before notarization is completed
+ When selling a vehicle or watercraft the seller must sign and print their name(s) as it appears on the face of the title
+ Assignments of ownership must be in the form of legal names - Clifton J Smith not CJ Smith - Richard L Jones Jr not Dick Jones
+ Do not under any circumstances white out or scribble out any errors on the title assignment this will void the title and a replacement must be issued
+ Jl someone signs the back of a title on behalf of a company or other entity they must state their position within that entity
- ABC Trucking Company John F Rees Fleet Mgr - Dixie Candy Corp Dennis T Dix Owner - Abel Family Trust Carol A Abel Trustee
+ If the seller or buyer is under 18 years of age the custodial parent or guardishyan must fill out a notarized minor consent fonn (available from the Clerk of Courts Title Office) The minor must bring this consent fornl-along with the certificate of title-to the Clerk of Courts office or the parentguardian must appear in person with the minor at the time of transfer The guardian must provide the court document indicating that they are the legal guardian of the mmor
+ If you take the acknowledgment from a person appointed as power of attorshyney the notarized power of attorney form (available from any of the Clerk of Courts Title Offices or on our web site) must be surrendered at the time of transfer of ownership
- A Durable Power of Attorney is acceptable - A Health Care Power of Attorney is not acceptable
+ If you take the acknowledgment from a person appointed by the Court the Court Order must bear the Judges signature and seal and must be surrendered at the ti me of transfer of ownership
- Court Order appointing Executor Fiduciary Guardian etc Letter of Authority to Transfer
- Relieftrom Administration of Estate 9C Form
Ohio ORC 450502 requires that each applicant must present an official photo identifieation
httpwwweriecountyohgov 1
Assignment of an Ohio Title (Top portion of the back of Title)
I Selling price
2 Date of SaleDelivery
3 Minor (consent form required)
4 Buyer(s) legal name and address
5 Odometer reading as shown on vehicle
6 If odometer is 5 digits and rolled over place (X) in box
(in excess of mechanical limits)
7 If odometer is broken or any other discrepancy exists place (X) in
box
8 Check appropriate box if applicable
9 Printed name(s) of seller(s)
10 Signature ofseller(s
11 Address of selJer(s)
12 Person(s) name who signed in front of you
13 Notary Date
14 Commission expiration date
15 Printed name of Notary Public
16 Signature of Notary Public
17 Notary Seal
Rev 713 Title Line (419) 627-7626
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
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httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
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Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
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Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
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Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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Table of Contents
General Guidelines 1
Assignment of an Ohio Title 2-3
Application of an Obio Title 4-5
Power of Attorney6-7
Odometer 8
Additional Form Samples 9-16
Clerk of Courts Locations 18
Rev 7113 Title Line (419) 627middot7626
ATPS TITLE OFFICE DISTRICTS
Notarizing an Ohio Title - General Guidelines
+ Do not take the acknowledgment on any instrument wherein blanks are left to be filled in later The legal instrument must be completely prepared before notarization is completed
+ When selling a vehicle or watercraft the seller must sign and print their name(s) as it appears on the face of the title
+ Assignments of ownership must be in the form of legal names - Clifton J Smith not CJ Smith - Richard L Jones Jr not Dick Jones
+ Do not under any circumstances white out or scribble out any errors on the title assignment this will void the title and a replacement must be issued
+ Jl someone signs the back of a title on behalf of a company or other entity they must state their position within that entity
- ABC Trucking Company John F Rees Fleet Mgr - Dixie Candy Corp Dennis T Dix Owner - Abel Family Trust Carol A Abel Trustee
+ If the seller or buyer is under 18 years of age the custodial parent or guardishyan must fill out a notarized minor consent fonn (available from the Clerk of Courts Title Office) The minor must bring this consent fornl-along with the certificate of title-to the Clerk of Courts office or the parentguardian must appear in person with the minor at the time of transfer The guardian must provide the court document indicating that they are the legal guardian of the mmor
+ If you take the acknowledgment from a person appointed as power of attorshyney the notarized power of attorney form (available from any of the Clerk of Courts Title Offices or on our web site) must be surrendered at the time of transfer of ownership
- A Durable Power of Attorney is acceptable - A Health Care Power of Attorney is not acceptable
+ If you take the acknowledgment from a person appointed by the Court the Court Order must bear the Judges signature and seal and must be surrendered at the ti me of transfer of ownership
- Court Order appointing Executor Fiduciary Guardian etc Letter of Authority to Transfer
- Relieftrom Administration of Estate 9C Form
Ohio ORC 450502 requires that each applicant must present an official photo identifieation
httpwwweriecountyohgov 1
Assignment of an Ohio Title (Top portion of the back of Title)
I Selling price
2 Date of SaleDelivery
3 Minor (consent form required)
4 Buyer(s) legal name and address
5 Odometer reading as shown on vehicle
6 If odometer is 5 digits and rolled over place (X) in box
(in excess of mechanical limits)
7 If odometer is broken or any other discrepancy exists place (X) in
box
8 Check appropriate box if applicable
9 Printed name(s) of seller(s)
10 Signature ofseller(s
11 Address of selJer(s)
12 Person(s) name who signed in front of you
13 Notary Date
14 Commission expiration date
15 Printed name of Notary Public
16 Signature of Notary Public
17 Notary Seal
Rev 713 Title Line (419) 627-7626
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
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1~IlnnliH~llfltllfilIlUIII(~ ___~_ _________
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111I~dfl ______~______ wC_~
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httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
SSI4N1L I 01 OlItIII1 I hd nih Jwo uhk 1gt IIII rltl 11 gt111 II r ib-j 111 fli 11( lhfHJ ___~ u tw-Imiddot t __ ~ 1 ltUt bull Ijpow i ~( J
- _-__------ ____-------_
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ukl h tlw bullbull bull 1 ~f Hi tik ~ I IIIniltlt flW fJuWgtI ~1lrtMomI ii
---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
101(11 dlJ - Ifl(ril JJJ~
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-----------shy- -I ~~II n1 imn R l UIIIl( IH 1 01 II(J 1 OI)O1I1fR nRIlrItAnO
178
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t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
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Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
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)1O1llliUf
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lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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ATPS TITLE OFFICE DISTRICTS
Notarizing an Ohio Title - General Guidelines
+ Do not take the acknowledgment on any instrument wherein blanks are left to be filled in later The legal instrument must be completely prepared before notarization is completed
+ When selling a vehicle or watercraft the seller must sign and print their name(s) as it appears on the face of the title
+ Assignments of ownership must be in the form of legal names - Clifton J Smith not CJ Smith - Richard L Jones Jr not Dick Jones
+ Do not under any circumstances white out or scribble out any errors on the title assignment this will void the title and a replacement must be issued
+ Jl someone signs the back of a title on behalf of a company or other entity they must state their position within that entity
- ABC Trucking Company John F Rees Fleet Mgr - Dixie Candy Corp Dennis T Dix Owner - Abel Family Trust Carol A Abel Trustee
+ If the seller or buyer is under 18 years of age the custodial parent or guardishyan must fill out a notarized minor consent fonn (available from the Clerk of Courts Title Office) The minor must bring this consent fornl-along with the certificate of title-to the Clerk of Courts office or the parentguardian must appear in person with the minor at the time of transfer The guardian must provide the court document indicating that they are the legal guardian of the mmor
+ If you take the acknowledgment from a person appointed as power of attorshyney the notarized power of attorney form (available from any of the Clerk of Courts Title Offices or on our web site) must be surrendered at the time of transfer of ownership
- A Durable Power of Attorney is acceptable - A Health Care Power of Attorney is not acceptable
+ If you take the acknowledgment from a person appointed by the Court the Court Order must bear the Judges signature and seal and must be surrendered at the ti me of transfer of ownership
- Court Order appointing Executor Fiduciary Guardian etc Letter of Authority to Transfer
- Relieftrom Administration of Estate 9C Form
Ohio ORC 450502 requires that each applicant must present an official photo identifieation
httpwwweriecountyohgov 1
Assignment of an Ohio Title (Top portion of the back of Title)
I Selling price
2 Date of SaleDelivery
3 Minor (consent form required)
4 Buyer(s) legal name and address
5 Odometer reading as shown on vehicle
6 If odometer is 5 digits and rolled over place (X) in box
(in excess of mechanical limits)
7 If odometer is broken or any other discrepancy exists place (X) in
box
8 Check appropriate box if applicable
9 Printed name(s) of seller(s)
10 Signature ofseller(s
11 Address of selJer(s)
12 Person(s) name who signed in front of you
13 Notary Date
14 Commission expiration date
15 Printed name of Notary Public
16 Signature of Notary Public
17 Notary Seal
Rev 713 Title Line (419) 627-7626
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
~~I~~~~1 L8~ middotl~~~~~~~ d~d bullbull Jill N ~_ L_~_ bullbull 111kf Ir 1 s_ Elf 3- xlkr h~~ J 1 J 0
1~IlnnliH~llfltllfilIlUIII(~ ___~_ _________
rrJkli ~ j1 111 UUOUf 11111 II (It 11111 uhltfto i 111111111(11111111 Ill I n(u lit ~If hlH hI fHllridr ill p idllll
11101 11I1f1l1L 1 1(Iiilt III OI4I1ld t1l 11t1IriIl)tIl 5 ~l r~irl
I hod It~li(~ lJ L L IIIJ llri Iu nr 11 t ull llIolniJl- llul Ilk fltf rulltgt
fitlt t~ tlfO nhal lIIilur If f~ dHk f-IltH - J 1 fIrltI~t MliUtrll j rfltOtti
6f 1 tit tllk~f ~I~ i ill (11 III
---~ Ih 141ljr11 hlloi~
10 L- h)n~ilr 111( ttIUlJllr
11 ---_bull__-__-----shyII ~II- (H rrll f ptli bull-d JjoliflH
011middot ~ II blaobpatr allm l I he tUllllIrlfd bdurr dII~ kd~cmcnl
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111I~dfl ______~______ wC_~
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httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
SSI4N1L I 01 OlItIII1 I hd nih Jwo uhk 1gt IIII rltl 11 gt111 II r ib-j 111 fli 11( lhfHJ ___~ u tw-Imiddot t __ ~ 1 ltUt bull Ijpow i ~( J
- _-__------ ____-------_
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ukl h tlw bullbull bull 1 ~f Hi tik ~ I IIIniltlt flW fJuWgtI ~1lrtMomI ii
---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
101(11 dlJ - Ifl(ril JJJ~
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-----------shy- -I ~~II n1 imn R l UIIIl( IH 1 01 II(J 1 OI)O1I1fR nRIlrItAnO
178
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t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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21 h gtIIiltD~ ~llf_~
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~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
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tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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11li(
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)1O1llliUf
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lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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Notarizing an Ohio Title - General Guidelines
+ Do not take the acknowledgment on any instrument wherein blanks are left to be filled in later The legal instrument must be completely prepared before notarization is completed
+ When selling a vehicle or watercraft the seller must sign and print their name(s) as it appears on the face of the title
+ Assignments of ownership must be in the form of legal names - Clifton J Smith not CJ Smith - Richard L Jones Jr not Dick Jones
+ Do not under any circumstances white out or scribble out any errors on the title assignment this will void the title and a replacement must be issued
+ Jl someone signs the back of a title on behalf of a company or other entity they must state their position within that entity
- ABC Trucking Company John F Rees Fleet Mgr - Dixie Candy Corp Dennis T Dix Owner - Abel Family Trust Carol A Abel Trustee
+ If the seller or buyer is under 18 years of age the custodial parent or guardishyan must fill out a notarized minor consent fonn (available from the Clerk of Courts Title Office) The minor must bring this consent fornl-along with the certificate of title-to the Clerk of Courts office or the parentguardian must appear in person with the minor at the time of transfer The guardian must provide the court document indicating that they are the legal guardian of the mmor
+ If you take the acknowledgment from a person appointed as power of attorshyney the notarized power of attorney form (available from any of the Clerk of Courts Title Offices or on our web site) must be surrendered at the time of transfer of ownership
- A Durable Power of Attorney is acceptable - A Health Care Power of Attorney is not acceptable
+ If you take the acknowledgment from a person appointed by the Court the Court Order must bear the Judges signature and seal and must be surrendered at the ti me of transfer of ownership
- Court Order appointing Executor Fiduciary Guardian etc Letter of Authority to Transfer
- Relieftrom Administration of Estate 9C Form
Ohio ORC 450502 requires that each applicant must present an official photo identifieation
httpwwweriecountyohgov 1
Assignment of an Ohio Title (Top portion of the back of Title)
I Selling price
2 Date of SaleDelivery
3 Minor (consent form required)
4 Buyer(s) legal name and address
5 Odometer reading as shown on vehicle
6 If odometer is 5 digits and rolled over place (X) in box
(in excess of mechanical limits)
7 If odometer is broken or any other discrepancy exists place (X) in
box
8 Check appropriate box if applicable
9 Printed name(s) of seller(s)
10 Signature ofseller(s
11 Address of selJer(s)
12 Person(s) name who signed in front of you
13 Notary Date
14 Commission expiration date
15 Printed name of Notary Public
16 Signature of Notary Public
17 Notary Seal
Rev 713 Title Line (419) 627-7626
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
~~I~~~~1 L8~ middotl~~~~~~~ d~d bullbull Jill N ~_ L_~_ bullbull 111kf Ir 1 s_ Elf 3- xlkr h~~ J 1 J 0
1~IlnnliH~llfltllfilIlUIII(~ ___~_ _________
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6f 1 tit tllk~f ~I~ i ill (11 III
---~ Ih 141ljr11 hlloi~
10 L- h)n~ilr 111( ttIUlJllr
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011middot ~ II blaobpatr allm l I he tUllllIrlfd bdurr dII~ kd~cmcnl
nHI It tIlaquol uIInilltJ III I~ IlfCfiil( 1 t~~ h IJI2 14
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_i) t~( 1~U_1JfI~I_~t I~~~~~ _L ~_I~~fI__ ~_J iI~~~~ all~~Liio~_~~_ j~~~ I~___ _
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II IH-I)I gtIpoundlrhhJlaquotd [l 101111 (h~k ~_-1 kllJf~1 [J IIItJltliI C 1laquoIvuul tt 0 ih~i(
111I~dfl ______~______ wC_~
11 1lt Ilul 11 irt)ffll1II1011 IlllClI ill Illh 1fUUll1lh 1 1- tnol 111011(1
httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
SSI4N1L I 01 OlItIII1 I hd nih Jwo uhk 1gt IIII rltl 11 gt111 II r ib-j 111 fli 11( lhfHJ ___~ u tw-Imiddot t __ ~ 1 ltUt bull Ijpow i ~( J
- _-__------ ____-------_
1~tflif Ill I III ~ h11jr ~ ~Ifd~ 1i Iw bull 1(1 III 1(
ukl h tlw bullbull bull 1 ~f Hi tik ~ I IIIniltlt flW fJuWgtI ~1lrtMomI ii
---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
101(11 dlJ - Ifl(ril JJJ~
ThI wooIl_trr HWllf IIw h1~1 Mlke kli 01011111( r IUmiddotn
01 [ t1~m mc alHHf fllIll bt rOlllpicttd IlduH uJ1I0ILhdJlClllenl
-----------shy- -I ~~II n1 imn R l UIIIl( IH 1 01 II(J 1 OI)O1I1fR nRIlrItAnO
178
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ulJ~ U h 11 lIIUI1lt1U ~I( IIIoIilrd PI) J lkpaIIlUJrIl N bI~ 1 (11 n4 ltUHI Mlhl 1 ~1lI 1I111lkotl ltqI(IUi
1 tlt~ f_~~-~ 11bull~~~l ~~f ~~ ~Iof~~~L~~~~ ~ il~vd_~ ~_~~~~_
1111(1101 OR l ~~1111lt ~rHH 11111 11u IW fm iorlL I bull gt _ h _
t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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lnu( jfKr th l-J I~ _ _ ~
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1 IJUkl llu 111f lir_~lr mt II mtllf hlI ( JlU~ 1laquo1lt1 1 I1l dlliu41~III(
1(1I1tdn tS ddtrH
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19 -ff HI d di~J fI 11 rU-liH h) _
21 h gtIIiltD~ ~llf_~
23 jC~11 i kd I)oPtH (lorA ltl11-li11tmiddot ~~
~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
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I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
~Il bull I~ I~I( u( If hltr~ 1~1t lmllH U 11
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lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 6: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/6.jpg)
Assignment of an Ohio Title (Top portion of the back of Title)
I Selling price
2 Date of SaleDelivery
3 Minor (consent form required)
4 Buyer(s) legal name and address
5 Odometer reading as shown on vehicle
6 If odometer is 5 digits and rolled over place (X) in box
(in excess of mechanical limits)
7 If odometer is broken or any other discrepancy exists place (X) in
box
8 Check appropriate box if applicable
9 Printed name(s) of seller(s)
10 Signature ofseller(s
11 Address of selJer(s)
12 Person(s) name who signed in front of you
13 Notary Date
14 Commission expiration date
15 Printed name of Notary Public
16 Signature of Notary Public
17 Notary Seal
Rev 713 Title Line (419) 627-7626
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
~~I~~~~1 L8~ middotl~~~~~~~ d~d bullbull Jill N ~_ L_~_ bullbull 111kf Ir 1 s_ Elf 3- xlkr h~~ J 1 J 0
1~IlnnliH~llfltllfilIlUIII(~ ___~_ _________
rrJkli ~ j1 111 UUOUf 11111 II (It 11111 uhltfto i 111111111(11111111 Ill I n(u lit ~If hlH hI fHllridr ill p idllll
11101 11I1f1l1L 1 1(Iiilt III OI4I1ld t1l 11t1IriIl)tIl 5 ~l r~irl
I hod It~li(~ lJ L L IIIJ llri Iu nr 11 t ull llIolniJl- llul Ilk fltf rulltgt
fitlt t~ tlfO nhal lIIilur If f~ dHk f-IltH - J 1 fIrltI~t MliUtrll j rfltOtti
6f 1 tit tllk~f ~I~ i ill (11 III
---~ Ih 141ljr11 hlloi~
10 L- h)n~ilr 111( ttIUlJllr
11 ---_bull__-__-----shyII ~II- (H rrll f ptli bull-d JjoliflH
011middot ~ II blaobpatr allm l I he tUllllIrlfd bdurr dII~ kd~cmcnl
nHI It tIlaquol uIInilltJ III I~ IlfCfiil( 1 t~~ h IJI2 14
il~Hi nf tlli- 1l1 U vIIamp( Ohill ~~i-(I (Mt IHI ~ IIHtliurK( ~ 1 lIutfllh inj~fH~U 1 iKM 01 (Il IIHlltr lito
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_i) t~( 1~U_1JfI~I_~t I~~~~~ _L ~_I~~fI__ ~_J iI~~~~ all~~Liio~_~~_ j~~~ I~___ _
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II IH-I)I gtIpoundlrhhJlaquotd [l 101111 (h~k ~_-1 kllJf~1 [J IIItJltliI C 1laquoIvuul tt 0 ih~i(
111I~dfl ______~______ wC_~
11 1lt Ilul 11 irt)ffll1II1011 IlllClI ill Illh 1fUUll1lh 1 1- tnol 111011(1
httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
SSI4N1L I 01 OlItIII1 I hd nih Jwo uhk 1gt IIII rltl 11 gt111 II r ib-j 111 fli 11( lhfHJ ___~ u tw-Imiddot t __ ~ 1 ltUt bull Ijpow i ~( J
- _-__------ ____-------_
1~tflif Ill I III ~ h11jr ~ ~Ifd~ 1i Iw bull 1(1 III 1(
ukl h tlw bullbull bull 1 ~f Hi tik ~ I IIIniltlt flW fJuWgtI ~1lrtMomI ii
---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
101(11 dlJ - Ifl(ril JJJ~
ThI wooIl_trr HWllf IIw h1~1 Mlke kli 01011111( r IUmiddotn
01 [ t1~m mc alHHf fllIll bt rOlllpicttd IlduH uJ1I0ILhdJlClllenl
-----------shy- -I ~~II n1 imn R l UIIIl( IH 1 01 II(J 1 OI)O1I1fR nRIlrItAnO
178
1111bullbull ~ h-i fflt ~4Iruf dln JI htU I ~-~IIIf1d ~-II~~IImiddot~~~rIM IHI( -illttftfmiddot rilT ~UIMWltIlI I amp 1 11 ( -tihA ~f1 Ilnf 1h JIll Jotn~l (n(I41 pjuillt ~ lI1IUlhflllptrlIOI~ t~ lIIi It lolnt f~~u4
ulJ~ U h 11 lIIUI1lt1U ~I( IIIoIilrd PI) J lkpaIIlUJrIl N bI~ 1 (11 n4 ltUHI Mlhl 1 ~1lI 1I111lkotl ltqI(IUi
1 tlt~ f_~~-~ 11bull~~~l ~~f ~~ ~Iof~~~L~~~~ ~ il~vd_~ ~_~~~~_
1111(1101 OR l ~~1111lt ~rHH 11111 11u IW fm iorlL I bull gt _ h _
t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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lnu( jfKr th l-J I~ _ _ ~
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1(1I1tdn tS ddtrH
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19 -ff HI d di~J fI 11 rU-liH h) _
21 h gtIIiltD~ ~llf_~
23 jC~11 i kd I)oPtH (lorA ltl11-li11tmiddot ~~
~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
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lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 7: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/7.jpg)
1 O~IJIlI~H) rier _ ~
filled out Notarize onlv jf all lines are com
~~I~~~~1 L8~ middotl~~~~~~~ d~d bullbull Jill N ~_ L_~_ bullbull 111kf Ir 1 s_ Elf 3- xlkr h~~ J 1 J 0
1~IlnnliH~llfltllfilIlUIII(~ ___~_ _________
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nHI It tIlaquol uIInilltJ III I~ IlfCfiil( 1 t~~ h IJI2 14
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_i) t~( 1~U_1JfI~I_~t I~~~~~ _L ~_I~~fI__ ~_J iI~~~~ all~~Liio~_~~_ j~~~ I~___ _
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II IH-I)I gtIpoundlrhhJlaquotd [l 101111 (h~k ~_-1 kllJf~1 [J IIItJltliI C 1laquoIvuul tt 0 ih~i(
111I~dfl ______~______ wC_~
11 1lt Ilul 11 irt)ffll1II1011 IlllClI ill Illh 1fUUll1lh 1 1- tnol 111011(1
httpwwweriecountyohgov 3
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
SSI4N1L I 01 OlItIII1 I hd nih Jwo uhk 1gt IIII rltl 11 gt111 II r ib-j 111 fli 11( lhfHJ ___~ u tw-Imiddot t __ ~ 1 ltUt bull Ijpow i ~( J
- _-__------ ____-------_
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ukl h tlw bullbull bull 1 ~f Hi tik ~ I IIIniltlt flW fJuWgtI ~1lrtMomI ii
---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
101(11 dlJ - Ifl(ril JJJ~
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01 [ t1~m mc alHHf fllIll bt rOlllpicttd IlduH uJ1I0ILhdJlClllenl
-----------shy- -I ~~II n1 imn R l UIIIl( IH 1 01 II(J 1 OI)O1I1fR nRIlrItAnO
178
1111bullbull ~ h-i fflt ~4Iruf dln JI htU I ~-~IIIf1d ~-II~~IImiddot~~~rIM IHI( -illttftfmiddot rilT ~UIMWltIlI I amp 1 11 ( -tihA ~f1 Ilnf 1h JIll Jotn~l (n(I41 pjuillt ~ lI1IUlhflllptrlIOI~ t~ lIIi It lolnt f~~u4
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1 tlt~ f_~~-~ 11bull~~~l ~~f ~~ ~Iof~~~L~~~~ ~ il~vd_~ ~_~~~~_
1111(1101 OR l ~~1111lt ~rHH 11111 11u IW fm iorlL I bull gt _ h _
t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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lnu( jfKr th l-J I~ _ _ ~
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19 -ff HI d di~J fI 11 rU-liH h) _
21 h gtIIiltD~ ~llf_~
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~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
~Il bull I~ I~I( u( If hltr~ 1~1t lmllH U 11
1middotr)1 rrll~1 I middotf dllt r ~middot d 1 II ~ IT flInlll iIIlPJ~UI~UI1~d fll( (I Uti Iii Ulaquo lnlll]~j
lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
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llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 8: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/8.jpg)
4
Application for an Ohio Title (Bottom portion of the back of Title)
I Type of Title
2 Buyer(s) legal name
3 Buyer(s) Social Security Number
4 Buyer(s) physical address
5 County of res idence
6 Purchase price
7 NA (Dealer sale only)
8 NA (Dealer sale only)
9 NA (Dealer sale only)
10 If sale is exempt from tax place (X) in box
I I Reason for exemption
12 NiA (Dealer sale only)
13 N A (Dealer sale only)
14 Condition of vehiclewatercraft
IS Lienholders name and address (if applicable)
bull Ifno liens state none
16 Minor (consent form required)
17A Buyer(s) signature
17B Buyers acknowledgment of mileage
18 Choose (X) printed or (X) non-printed
19 Persons name who signed in your presence
20 Notary Date
21 Commission expiration date
22 Signature ofNotary Public
23 Notary Seal
Rev 7113 Title Line 419-627-7626
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- _-__------ ____-------_
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---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
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-----------shy- -I ~~II n1 imn R l UIIIl( IH 1 01 II(J 1 OI)O1I1fR nRIlrItAnO
178
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t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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lnu( jfKr th l-J I~ _ _ ~
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~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
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lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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PU- tllwl fltgtLlMII1 mnlrl 111~hll( (t U~r( 1 IN ) 1Wtrlly (~f 1VlII1IAPJ JuIIH~
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 9: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/9.jpg)
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- _-__------ ____-------_
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---~~~ -t~~ l I III bull bullbull thkl J 1 Mf I ~ 1I11t1IIorl dottl
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178
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t ifnf lOr-- It ~hH11ltd1 [J fo Liqjl klIi~tgtJIUlI ____ tH~r Ou~llIj 10gt1 t=J hU
_________ I 3shy_______
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21 h gtIIiltD~ ~llf_~
23 jC~11 i kd I)oPtH (lorA ltl11-li11tmiddot ~~
~ 111 _____ __
Notarize only ifalilines are completely filled out
httpwwweriecountyohgomiddot 5
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
~Il bull I~ I~I( u( If hltr~ 1~1t lmllH U 11
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lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
dO III 111111 IIlIIW I
1 Ak 1-11 W klAi Nit
UKI ~11 )~ I~ I
Iiii)IY (11 Mtlll)l( Nfl
tlIflt1rII(~ NMt1
(II(K liN 111 1111 IplllVlti l1lIMrW_~ rNr tflHUY HldI
I (--J iLl llll~ fl ydk(l pO~iI( K~ f [tIIU( Irll 111~ lIil- )fIVUil iI11tel r~ lite d~I deitJftli 01((11 V(tHJImiddot(lI1IIH Ileodlllfllit- ttllIi-It ttll)IfL~Iilj nIH 0-) tf Iltt kjl~~j [ It
I I ~lLlnll1npIf1ji) 11 Ilumiddot dixiJ lJcui3fd l1Iel Vdlll by (Kitlifill I L PWU1I1 10
Iun jl~l 1O- ~1t1tJ1 41 )(10- 4 1~ III (JI 1 Jt) j4 Ihi~ I~t(~l C)h~_ dl1ft II 11K lilith 11
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PU- tllwl fltgtLlMII1 mnlrl 111~hll( (t U~r( 1 IN ) 1Wtrlly (~f 1VlII1IAPJ JuIIH~
tJI1c-j)((~ h1 1 ~V4qc (ltitlf~tt(middot (ie nl Wh In~lltJy O~jiC1c-rltllllcd f lfI(dlCI (middottic pjj(~~nll~ (il n~Jnk~ dl1 ~CU LK I iNf or III nil nWiNq
I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 10: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/10.jpg)
6
When a Power of Attorney form is necessary
for a Certificate of Title transaction it must
always be notarized
bull A power of attorney (POA) form must always
bull accompany the title and becomes part of the
bull permanent title record
bull A power of attorney form may only be used for one -+
transaction
For instance if you are transferring a title to
someone else but have lost the original title--one POA
is required to obtain a duplicate titc A second
separate POA is required to transfer the title out of the
first owners name
bull An executor of an estate or trustee cannot give power
of attorney to someone else to sign on their behalf
Rev 713 Title Line 419-627-7626
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
~Il bull I~ I~I( u( If hltr~ 1~1t lmllH U 11
1middotr)1 rrll~1 I middotf dllt r ~middot d 1 II ~ IT flInlll iIIlPJ~UI~UI1~d fll( (I Uti Iii Ulaquo lnlll]~j
lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
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11li(
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)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 11: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/11.jpg)
Ohio Bureau of Motor Vehicles
POWER OF ATTORNEY
Know all men by these presents that the undersigned does hereby make constitute and appoint
FIRST NAME LAST NAME IMI
STREET ADDRESS CITY ISTATE IZIPCODE
My true and lawful attorney-in-fact for me and in my name place and stead to make and execute the assignment of or application for my Certificate of Title covering the following described motor vehicle to-wit
IMAKE I YEAR I SERIAL NO
And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever requisite necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or his substitute shall lawfully do or cause to be done by virtue hereof
In Witness whereof the undersigned has caused his name to be subscribed hereto this _________
day of _______ 20 __shy
x SIGNATURE OF PERSON GIVING POWER OF ATTORNEY SOCIAL SECURITY NUMBER OF BUYEROWNER
ACKNOWLEDGEMENT
State of Ohio County of __________-- Subscribed and sworn to before me a Notary Public in
and for said County personally appeared ________________________who
acknowledged the Signing of the foregoing instrument and that such signing is his free act and deed
In Testimony Whereof I have hereunto set my hand and affixed my official seal
this day of 20__in the county of_________ State of Ohio
x NOTARY PUBLIC
My commission expires __________
BMV 3771 404
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
~Il bull I~ I~I( u( If hltr~ 1~1t lmllH U 11
1middotr)1 rrll~1 I middotf dllt r ~middot d 1 II ~ IT flInlll iIIlPJ~UI~UI1~d fll( (I Uti Iii Ulaquo lnlll]~j
lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
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)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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![Page 12: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/12.jpg)
ODOMETER STATEMENT
The seller of a motor vehicle is statutorily required to state the true mileage of the vehicle at the time the title is assigned to the buyer (see feature 5)
Mileage stated as in excess of its mechanical limits should only apply to a 5-digit odometer (sec feature 6) (For addishytional information refer to assignment of title p2)
Vehicles that register 6 digits on the odometer should not be in excess of their meehanieallimils
An odometer that is broken inoperable or replaced should he marked as non actual (see feature 7) For additional inforshymation refer to assignment of title p 2
middot1- 11 1 HI ( I middotmmiddotmiddot J ( Y r
J bullbull lc - bull 1( ~d l
~ 1 L f 5--+ III i-Ir =17 t 1hj 11 bullIlr~ I~liill~ r1lt -- -~ - -_-_ rshy
7~lt~~~ i~~I ~~IL-d
L~ ~~ r ~f ~ I
11111 _ ltl
I ~ f
II middotmiddotI~ I _ ~ to bull
~-- --- ---~------- --__-__-__shy-~ ---~ --shy
~Il bull I~ I~I( u( If hltr~ 1~1t lmllH U 11
1middotr)1 rrll~1 I middotf dllt r ~middot d 1 II ~ IT flInlll iIIlPJ~UI~UI1~d fll( (I Uti Iii Ulaquo lnlll]~j
lul~f ~I hl1l oIllJlII( 1 JxWu 1 l middoti~ 1lt 1 11 r ~IJ r ~I~( ptTitlr If) 1J~middotI~tIImiddotI(r r(quClnl
tIL I~ 11 I iI Ij i J I PJ j 1 J ( ~ --I 1 JImiddot l i lind bull ] f I1C
Rev 713 Title Line 419-627-7626
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
dO III 111111 IIlIIW I
1 Ak 1-11 W klAi Nit
UKI ~11 )~ I~ I
Iiii)IY (11 Mtlll)l( Nfl
tlIflt1rII(~ NMt1
(II(K liN 111 1111 IplllVlti l1lIMrW_~ rNr tflHUY HldI
I (--J iLl llll~ fl ydk(l pO~iI( K~ f [tIIU( Irll 111~ lIil- )fIVUil iI11tel r~ lite d~I deitJftli 01((11 V(tHJImiddot(lI1IIH Ileodlllfllit- ttllIi-It ttll)IfL~Iilj nIH 0-) tf Iltt kjl~~j [ It
I I ~lLlnll1npIf1ji) 11 Ilumiddot dixiJ lJcui3fd l1Iel Vdlll by (Kitlifill I L PWU1I1 10
Iun jl~l 1O- ~1t1tJ1 41 )(10- 4 1~ III (JI 1 Jt) j4 Ihi~ I~t(~l C)h~_ dl1ft II 11K lilith 11
11(1IIIt l (llt1l1c)Ilp fjf HI1 dljl~ In 1~Hfl d JjkUIL1~ I~ 11t PIIrW~f1 mlt~lIiIIUII~ ~I~l(tl~ (~dft
PU- tllwl fltgtLlMII1 mnlrl 111~hll( (t U~r( 1 IN ) 1Wtrlly (~f 1VlII1IAPJ JuIIH~
tJI1c-j)((~ h1 1 ~V4qc (ltitlf~tt(middot (ie nl Wh In~lltJy O~jiC1c-rltllllcd f lfI(dlCI (middottic pjj(~~nll~ (il n~Jnk~ dl1 ~CU LK I iNf or III nil nWiNq
I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
- blank2
- Page 1 Page 1
- page 2 Page 2
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![Page 13: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/13.jpg)
Additional Forms
The following pages contain samples of other title-related forms that may be required to transfer an Ohio Certificate of Title
If used these forms must also be completed entirely and notarized
httpwwweriecountyohgov 9
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
dO III 111111 IIlIIW I
1 Ak 1-11 W klAi Nit
UKI ~11 )~ I~ I
Iiii)IY (11 Mtlll)l( Nfl
tlIflt1rII(~ NMt1
(II(K liN 111 1111 IplllVlti l1lIMrW_~ rNr tflHUY HldI
I (--J iLl llll~ fl ydk(l pO~iI( K~ f [tIIU( Irll 111~ lIil- )fIVUil iI11tel r~ lite d~I deitJftli 01((11 V(tHJImiddot(lI1IIH Ileodlllfllit- ttllIi-It ttll)IfL~Iilj nIH 0-) tf Iltt kjl~~j [ It
I I ~lLlnll1npIf1ji) 11 Ilumiddot dixiJ lJcui3fd l1Iel Vdlll by (Kitlifill I L PWU1I1 10
Iun jl~l 1O- ~1t1tJ1 41 )(10- 4 1~ III (JI 1 Jt) j4 Ihi~ I~t(~l C)h~_ dl1ft II 11K lilith 11
11(1IIIt l (llt1l1c)Ilp fjf HI1 dljl~ In 1~Hfl d JjkUIL1~ I~ 11t PIIrW~f1 mlt~lIiIIUII~ ~I~l(tl~ (~dft
PU- tllwl fltgtLlMII1 mnlrl 111~hll( (t U~r( 1 IN ) 1Wtrlly (~f 1VlII1IAPJ JuIIH~
tJI1c-j)((~ h1 1 ~V4qc (ltitlf~tt(middot (ie nl Wh In~lltJy O~jiC1c-rltllllcd f lfI(dlCI (middottic pjj(~~nll~ (il n~Jnk~ dl1 ~CU LK I iNf or III nil nWiNq
I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
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![Page 14: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/14.jpg)
DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES
APPLICATION(S) FOR CERTIFICATE OF rl1LE TO A MOTOR VEHICLE (Type OJ Print In Inkl
CHECK TYPE OF APPLICATION(S) Fee of $500 for failure to apply for tille within 30 days of assignment
COUNTY
PRIMARY APPLICANTS NAME SSNIEIN
PRIMARY APPLICANTS ADDRESS
SECONDARY APPLICANTS NAME SSNIEIN
SECONDARY APPLICANTS ADDRESS
Hereby declares under penalty of perjUry thai heShe IS the lawful (ownerpurchaserhen holder) of the following descnbed motor vehicle and hereby makes application for the following
D ORIGINAL CERTIFICATE OF TITLE Evidence of ownership MCO Previous Tille No Registration etc
Applicant acquired said motor vehicle by (state haw acquired)
from Name of Previous Owner
Address af Previous Owner
The following is a full statement of all liens on said motor vehicte If no lien stale none if more than one lien attach statement of all additional liens
Lien Holder IE Code Address
D DUPLICATE CERTIFICATE OF TITLE
Applicant states that Certificate of Title Number
that said motor vehicle has not been sold or disposed of except as stated below
has been lost stolen destroyed
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
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 additionaillena
Lien Holder IE Code Address
D REPLACEMENT CERTIFICATE OF TITLE for Certificate of Title Number
D MEMORANDUM CERTIFICATE OF TITLE for Certificate of Title Number
D SALVAGE CERTIFICATE OF TITLE
Applica nt states that the original Certificate of Title Number
has been surrendered to the Clerk of Courts YEAR
BODY TYPE
PURCHASE PRICE $
VENDORS NUMBER
CONDITION OF VEHICLE (Check only one)
VIN
MAKE
TRADE IN AMOUNT $
PERMIT NUMBER
o GOOD o FAIR
MODEL
CONVERSION
SALESUSE TAX $
SALES CREDIT AMOUNT $
o POOR o NRECKED
TAX EXEMPTION REASON DYES
Warning You are reqUired by law to state the true seiling pnce A false statement IS
In Violation of section 292113 of the OhiO ReVised Code and IS
punishable by six months imprisonment and a fine 01 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
Applicants signature
Sworn to and subscribed in my presence by _______________________________
this ______ day of 20
(Seal) Clerk Deputy of Clerk of Courts - Notary _X__________________ BMV 3774 12107
_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
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)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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_________ s
OIO~ COliSEliT FORM SCf (131 OR C
rf~ d ~(i I-Jifl Cltt1 r~~yeni 1~lt1 fur rn1( ~f~ ) il1~ )f
llI~~M (f J rmiddot(r ntli -I) t)t r~
~ -------shylCX11 ryo _______
Minor Consent Form
httpwwweriecountyohgov 11
12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
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lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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12
AfFIOAIIH FO~ DESIGNATION OF eENE~IClIoAY 011 BfHEFIClloAlES By THE SOLE OWNER FOR MoIOTOR VEHICLE WATERCRAFT OR OVTeOARO WTOR CERmlCATE
OF nTLE ORC 11311~A)
tlI-oIlitlOrltdltrf~14 dpltIutWlrd y~________ I1kF _______
_____________ TIIII- NII1tVll ____________
x__________
Affidavit for Designation of Beneficiary
Rev 713 Title Line 419-627-7626
DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
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)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
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Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
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DO NOT DETACH FROM TITLE ERASUR ES ampALTERATIONS VOID THIS STAT EMENT
STATE OF OHIO SELLERS AFFIDAVIT
ODOMETER READING DISCLOSURE STATEMENT (TYPE OR PRINT IN INK)
IIOTICE TO TR~~poundROR VOtJARE RpoundOUIREDBY IAW TO OHpoundR All mIlI4ATON REOUIRIDHEREIN NCUQwG fHI OOOMpoundTER READ~ Of THE WOIOR VEHICLE iN HiE AHfOAVn ~MpoundD1ATElY
fOlLOiIINC Tl1e IIAKtG OF AfgtLSe STMeMENT UNDER OgtTH OR AHIRNATION IS IN IOLATION OF SECTION 2921 130~ Tgt1f REVItO CODE ANOIPUNIHAIllE BY SIX MONTHS PRSClNMENT ANOA FtlEOflJPTOONE HiOUSANOOOLLARSQR 8011lt
STATEQFQI-tIQ COUNTYSS DATE 20
YEAR MFRS SERIAL NO
MAKE MODEL
BODY TYPE
PURCHASERS NAME
I (_) cerlJfy 10JT Ire mlOag regslltred On Ihs nd al ~h 1 01 ~Slgnmlnt Il
miles
CHECK ONE OF THE FOLLOWING STATEMENTS I (WE) CERTIFY THAT o To be of my Iom Knoo1dg Ih Qdo readlfl9 feleds 1M oetuBI trile ageo The Odorne rudln~ reft~cts bullbullge In excess of the deSigned chaniCa Ollt 01 09999
milOgt o To Ihlt nest j my QJO kno1C$t u~c Odcrneter r~adllg IS nct the actual mlcaQe and Shoold
not be r~led upon
CHECK ONE Of THE fOlLDWlNG t (WE) CERTIfY THAT WHILE IN MY (OUR) POSSESSION
o Th Odometer oIlhls vehICle was n(t altered set bBCllt 01 ocmcteo o The Odon1ltllaquo r1lhs vohcie wa flared 01 replaceo
X (TRANSFERORSSIGNATURE
SEAL My ComrsslOn expires
COCmiddotA1MV03IRev 6lt]1J
Sellers Odometer Affidavit
bttpllwwweriecountyohgovl 13
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
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PU- tllwl fltgtLlMII1 mnlrl 111~hll( (t U~r( 1 IN ) 1Wtrlly (~f 1VlII1IAPJ JuIIH~
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I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
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lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
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AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
- blank2
- Page 1 Page 1
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![Page 18: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/18.jpg)
14
ERASURES amp Al TERATIONS VOID THIS STATEMENT STATE OF OHIO
APPLICANTS AFFIDAVIT ODOMETER READING DISClOSURE STATEMENT
(TYPE OR PRINT IN INK)
httpvwwcriecounly ohgovl
flll(1 IlllIIlirIlNII()IiIIltIIIIL~IIIH IIII ~()IAIII lltlqIlIIHIIlYIIW I INllii ~Ii INi(lI~MlliIN 1~II)IltIllII1IIIN (llliJl1l1l III ()I)~IIIH 1111I11NI I 1i1MliflltVlllnIINIIII AlIIIWiil IMWIIIAIIIYlillliliIN 1111 MAKIN 01 IfdSI IAIIMINI IlNIIIII 1lt111 t)il iIIlIMAIIlN I~ IN VlllllllilN Ii gt11ljoN 1)1 n II 1111 III VHi ((ll~ M 1 1liNIIi~lli IlY IX MilI 1 IMI~OINMI N ANIlA IINIII 1111111)111 l1l)NlllhXIIII 1llllfl
dO III 111111 IIlIIW I
1 Ak 1-11 W klAi Nit
UKI ~11 )~ I~ I
Iiii)IY (11 Mtlll)l( Nfl
tlIflt1rII(~ NMt1
(II(K liN 111 1111 IplllVlti l1lIMrW_~ rNr tflHUY HldI
I (--J iLl llll~ fl ydk(l pO~iI( K~ f [tIIU( Irll 111~ lIil- )fIVUil iI11tel r~ lite d~I deitJftli 01((11 V(tHJImiddot(lI1IIH Ileodlllfllit- ttllIi-It ttll)IfL~Iilj nIH 0-) tf Iltt kjl~~j [ It
I I ~lLlnll1npIf1ji) 11 Ilumiddot dixiJ lJcui3fd l1Iel Vdlll by (Kitlifill I L PWU1I1 10
Iun jl~l 1O- ~1t1tJ1 41 )(10- 4 1~ III (JI 1 Jt) j4 Ihi~ I~t(~l C)h~_ dl1ft II 11K lilith 11
11(1IIIt l (llt1l1c)Ilp fjf HI1 dljl~ In 1~Hfl d JjkUIL1~ I~ 11t PIIrW~f1 mlt~lIiIIUII~ ~I~l(tl~ (~dft
PU- tllwl fltgtLlMII1 mnlrl 111~hll( (t U~r( 1 IN ) 1Wtrlly (~f 1VlII1IAPJ JuIIH~
tJI1c-j)((~ h1 1 ~V4qc (ltitlf~tt(middot (ie nl Wh In~lltJy O~jiC1c-rltllllcd f lfI(dlCI (middottic pjj(~~nll~ (il n~Jnk~ dl1 ~CU LK I iNf or III nil nWiNq
I II tjl~ i_oll~ my (nlll) kill vlIh~_ UH~ 1)jlllUh1 1Ildll~ 1(1 h lill~ i( IIlltl 1ll11t~~ I he lOhmdt1 I~W~IUI wUn I nk-qp III IX (I d 111(1 11C-I(itUfl ilHlIHllk ll hnJoI or ~ ~rl
11li(
I llt III of my IJUI) kllll--lt1h( lltl OJ-IIIlaquoiC ~dulq l lH~ 11K llllllmitdqmiddot 111ft 1~Jl~d JUj
)1O1llliUf
I (t(lj~) (1ti11 lJt Ihtmtl~Ilf~)liIId 011111101 1H1l1 14 Itl I l if~irJp ii nlj~WHt fililtllil illfln Ie fllit I In(lt
lOll I hi lIftl 1111 lhL~j III 111 plLl( hy Ir d(~ 01 III
)11
SEAL
APPLICANTS AffiDAVIT
Applicants Odometelt A rfidavij
Rev 713 Title Line 419~27-7626
11
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
- blank2
- Page 1 Page 1
- page 2 Page 2
- Page 3 Page 3
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![Page 19: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/19.jpg)
IN THE COURT OF COMMON PIEAS COUNTY OHIO
CIERK OF COURTS
BfELDA V1I SrCnON 10(1 Ifl
~~frlL Of C)tliU
~Injri)nq ~JI JiI) tlthVI 1-1 jU
fVfIj
ttf+
utIT1 middotjqf tt t~ ~rlftigtff le 1- bulli-dt~l
AVln Allin l Ya[ Yfa MIll ~()[If tI Mtlti ~~f~)ll n Mlil Mlhr
llml Iyp( Bodv ryp~
Mniltll MnI 1 Ohic (11 of ll~ 11 C(t el lIt1i) q Apnr Jrniht Vll~j $ APtVfWli1~ tlUf $
Surviving Spouse Affidavit
httpwwweriecountyohgov
fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
- blank2
- Page 1 Page 1
- page 2 Page 2
- Page 3 Page 3
- Page 4 Page 4
- Page 5 Page 5
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fhll ntOIt1
DflPlvtttI(Jllt of Nfltutill Rtlfgt(UJU~pound
DIVISION OF WATEHcrIAfT 4l4lJf nrtnlln ~Quru Orfy-~
Golmbulgt OhIO nl4 00
WATERCRAFT OR OUTBOARD MOTOR AFFIDAVIT OF OWNERSHIP
Tgto ~ Indlvllly1 lolling fI duly w~rn Y hOI h or I 11 fIIt 0_ fI~ of 111 101111 M(lrlt~ watrCJft Qr 9utbQud motor
Watercraft or Outboard Motor Affidavit of Ownership
Rev 713 Title Line (419) 627-7626
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
- blank
- blank2
- Page 1 Page 1
- page 2 Page 2
- Page 3 Page 3
- Page 4 Page 4
- Page 5 Page 5
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![Page 21: Prepared and issued as a public service by the office of](https://reader031.fdocuments.net/reader031/viewer/2022020702/61fb04ae116e045f7d04e2fa/html5/thumbnails/21.jpg)
This booklet is intended to serve as a general guideline for notarizing Ohio Title Documents
Please contact us at our Title Line at (419) 627-7626 if you have specific inquiries not addressed in this booklet
httpwwweriecountyohgov
Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
- Text1 wwweriecountyohgov
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Rev 713
Erie County Clerk of Courts Administration Offices
323 Columbus Ave Sandusky OH 4870
(419) 627-7705
Title Locations Main Branch - Title
247 Columbus Ave Room 131 Sandusky Ohio 44870
(419) 627-7626
Please direct all auto-title related mailings and correspondence to this address
Title Line (419) 627-7626
Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
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Erie County Clerk of Courts Auto Title Divisionshy247 Col umbus Ave Room 131 Sandusky Ohio 44870 419-627-7626
Revised 713
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