BMV Prepaid Accounts Request Letter

Complete and return this information with your deposit and Record Request Form (BMV 1173)

Company Name:

Date:

Please indicate what type of Prepaid Account you are requesting:

	Ohio Driver Abstract (505)			Vehicle Title Record Search (503)
	Ohio Driver License Search (504)			Unclaimed Motor Vehicle Affidavits 3702 (510)
	Vehicle Registration Record Search (501)

Make check payable to: Ohio Treasurer Richard Cordray

Remit to:

Ohio Department of Public Safety

Amount Enclosed: $

Revenue Management-Prepaid Accounts

P.O. Box 16521

Columbus OH 43216-6521