Form BMV4202 "Unclaimed Motor Vehicle Affidavit" - Ohio

What Is Form BMV4202?

This is a legal form that was released by the Ohio Department of Public Safety - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2019;
  • The latest edition provided by the Ohio Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form BMV4202 by clicking the link below or browse more documents and templates provided by the Ohio Department of Public Safety.

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Download Form BMV4202 "Unclaimed Motor Vehicle Affidavit" - Ohio

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OHIO DEPARTMENT OF PUBLIC SAFETY
BUREAU OF MOTOR VEHICLES
UNCLAIMED MOTOR VEHICLE AFFIDAVIT
Section 4505.101 of the Ohio Revised Code (R.C.)
The purpose of the affidavit is to affirm that the requirements of section 4505.101 of the R.C. have been satisfied in order to obtain a
certificate of title for an unclaimed motor vehicle with a vehicle value less than three thousand five hundred dollars ($3500).
BUSINESS NAME OF REPAIR GARAGE / PLACE OF STORAGE OR TOWING SERVICE / STORAGE FACILITY
BUSINESS STREET ADDRESS
P.O. BOX
COUNTY
CITY
STATE
ZIP CODE
BUSINESS OWNER / AUTHORIZED AGENT NAME
BUSINESS TELEPHONE
ALTERNATIVE TELEPHONE
The owner’s information as identified from the search of the records of the Bureau of Motor Vehicles (BMV)
VEHICLE INFORMATION
OWNER’S NAME ON TITLE
OWNER’S ADDRESS
LIENHOLDER’S NAME ON TITLE (if applicable)
LIENHOLDER’S ADDRESS
VEHICLE IDENTIFICATION NUMBER (VIN)
YEAR
MAKE
MODEL
VEHICLE VALUE
(must be less than $3500 to use this affidavit)
Wholesale Value
(A) $
(as provided in a vehicle valuation guide recognized by the motor vehicle industry)
Estimated cost of repairs to restore vehicle to wholesale value
(B) $
Cost of agreed upon repairs
(C) $
(A) – (B) – (C) = $
VEHICLE VALUE
Towing fees*
(1) $
Storage fees*
(2) $
(only for the period of time the vehicle was stored without payment)
VEHICLE VALUE - (1) – (2) = $
AMOUNT PAID TO THE CLERK
* Maximum fees for Towing Services, see page 2 of the affidavit.
CHECK ONE BOX IN SECTION A OR B AND COMPLETE REQUIRED INFORMATION
SECTION A - REPAIR GARAGE / PLACE OF STORAGE (with an agreement)
A motor vehicle has been left unclaimed for 15 days or more after the completion of a requested repair or agreed term of storage.
Repair garage with a repair agreement
Place of Storage with a storage agreement
DATE OF COMPLETED REPAIR / TERM OF STORAGE
DATE CERTIFIED MAIL SENT
DATE OF SIGNED RECEIPT OR UNDELIVERABLE NOTICE
SECTION B FOR TOWING SERVICE / STORAGE FACILITY UNDER AUTHORITY OF SECTION R.C. 4513.601
(must include copies of notices and certified returned mail receipts)
Towing Service that removed the vehicle under
Storage Facility where a for-hire motor carrier delivered
division (B) of section R.C. 4513.601.
a motor vehicle under section R.C. 4513.601.
DATE VEHICLE WAS DROPPED OFF / TOWED
DATE OF 1ST NOTICE (within 5 business days of received BMV records search)
DATE OF 2ND NOTICE (30 days after 1st notice)
DATE OF 3RD NOTICE (45 days after 1st notice)
DATES OF SIGNED RECEIPTS OR UNDELIVERABLE NOTICES
UNLESS OTHERWISE SPECIFIED, DAYS ARE EQUAL TO CALENDAR DAYS.
BMV 4202 9/19 [17601081] Page 1 of 2
OHIO DEPARTMENT OF PUBLIC SAFETY
BUREAU OF MOTOR VEHICLES
UNCLAIMED MOTOR VEHICLE AFFIDAVIT
Section 4505.101 of the Ohio Revised Code (R.C.)
The purpose of the affidavit is to affirm that the requirements of section 4505.101 of the R.C. have been satisfied in order to obtain a
certificate of title for an unclaimed motor vehicle with a vehicle value less than three thousand five hundred dollars ($3500).
BUSINESS NAME OF REPAIR GARAGE / PLACE OF STORAGE OR TOWING SERVICE / STORAGE FACILITY
BUSINESS STREET ADDRESS
P.O. BOX
COUNTY
CITY
STATE
ZIP CODE
BUSINESS OWNER / AUTHORIZED AGENT NAME
BUSINESS TELEPHONE
ALTERNATIVE TELEPHONE
The owner’s information as identified from the search of the records of the Bureau of Motor Vehicles (BMV)
VEHICLE INFORMATION
OWNER’S NAME ON TITLE
OWNER’S ADDRESS
LIENHOLDER’S NAME ON TITLE (if applicable)
LIENHOLDER’S ADDRESS
VEHICLE IDENTIFICATION NUMBER (VIN)
YEAR
MAKE
MODEL
VEHICLE VALUE
(must be less than $3500 to use this affidavit)
Wholesale Value
(A) $
(as provided in a vehicle valuation guide recognized by the motor vehicle industry)
Estimated cost of repairs to restore vehicle to wholesale value
(B) $
Cost of agreed upon repairs
(C) $
(A) – (B) – (C) = $
VEHICLE VALUE
Towing fees*
(1) $
Storage fees*
(2) $
(only for the period of time the vehicle was stored without payment)
VEHICLE VALUE - (1) – (2) = $
AMOUNT PAID TO THE CLERK
* Maximum fees for Towing Services, see page 2 of the affidavit.
CHECK ONE BOX IN SECTION A OR B AND COMPLETE REQUIRED INFORMATION
SECTION A - REPAIR GARAGE / PLACE OF STORAGE (with an agreement)
A motor vehicle has been left unclaimed for 15 days or more after the completion of a requested repair or agreed term of storage.
Repair garage with a repair agreement
Place of Storage with a storage agreement
DATE OF COMPLETED REPAIR / TERM OF STORAGE
DATE CERTIFIED MAIL SENT
DATE OF SIGNED RECEIPT OR UNDELIVERABLE NOTICE
SECTION B FOR TOWING SERVICE / STORAGE FACILITY UNDER AUTHORITY OF SECTION R.C. 4513.601
(must include copies of notices and certified returned mail receipts)
Towing Service that removed the vehicle under
Storage Facility where a for-hire motor carrier delivered
division (B) of section R.C. 4513.601.
a motor vehicle under section R.C. 4513.601.
DATE VEHICLE WAS DROPPED OFF / TOWED
DATE OF 1ST NOTICE (within 5 business days of received BMV records search)
DATE OF 2ND NOTICE (30 days after 1st notice)
DATE OF 3RD NOTICE (45 days after 1st notice)
DATES OF SIGNED RECEIPTS OR UNDELIVERABLE NOTICES
UNLESS OTHERWISE SPECIFIED, DAYS ARE EQUAL TO CALENDAR DAYS.
BMV 4202 9/19 [17601081] Page 1 of 2
By completing this form, I am hereby affirming that ALL of the requirements of sections 4505.101 and/or 4513.601 of the R.C. have
been met and I attest that all the information contained on this form is true and accurate. I understand that providing false information
may constitute a criminal offense of falsification under section 2921.13 of the R.C. and is a misdemeanor of the first degree.
SIGNATURE OF BUSINESS OWNER / AUTHORIZED AGENT
DATE OF APPLICATION
X
Notary
Sworn to and subscribed in my presence this
day of
, 20
in
County,
State of
.
(Notary Seal)
X
My commission expires
Signature of Notary Public or other Authorized Officer by law
ADDITIONAL DOCUMENTATION MAY BE REQUIRED UPON REQUEST OF THE CLERK OF COURTS.
THE ACCEPTANCE OF PRESENTED DOCUMENTATION FOR THE ISSUANCE OF A TITLE IS AT THE DISCRETION OF THE CLERK
.
FEES
The following storage and tow removal fees for Towing Services are as is, until such time that rules have been
established by the Public Utilities Commission of Ohio (PUCO).
REMOVAL OF VEHICLE
Maximum fee
$ 129
Maximum fee for vehicles that exceed 10,000 lbs. (mfg. GVW*)
$ 216
STORAGE OF VEHICLE
Maximum fee per 24 hour period
$ 17
Maximum fee for vehicles that exceed 10,000 lbs. (mfg. GVW*) per 24 hour period
$ 29
*Manufacturer’s Gross Vehicle Weight
BMV 4202 9/19 [17601081] Page 2 of 2
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