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Statement Of Military Absence BMV 5717 - Ohio
| Statement Of Military Absence Form. This is a Ohio form and can be used in Vehicle Registration Bureau Of Motor Vehicles Statewide . |
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OHIO DEPARTMENT OF PUBLIC SAFETY STATEMENT OF MILITARY ABSENCE New License Number Validation Sticker Number Printed Application Number Owner(s) Name (as appears on Ohio Title) Ohio Address City License Number State SS. Zip STATE OF OHIO COUNTY OF Name (Affiant) Agent's Address City State Zip Certifies that: Owner/Co-owner Name Military Address is the owner of the following described motor vehicle: Make Vehicle Identification Number Type Year Certificate of Title Number Relationship And, that he is of said owner/co-owner who is in the military service of the United States and located outside of the borders of the United States and the affiant further says that he has authority to execute the application for registration on behalf of the owner and obtain license plates for such motor vehicles. The affiant further states that the above described car is encumbered by a lien. The lien holder is: Name of Lien Holder Address If the affiant applies for the registration of the above described motor vehicle, and the Registrar grants such application, the affiant agrees to surrender the registration card and plates to the Registrar upon his request with or without cause, without a refund. Affiant Signature Date DEPUTY: Send this statement with (NOT ATTACHED TO) original copy of Registration Application. If a lien exists. "Lien Holders Consent" form must also accompany application. BMV 5717 10/04 American LegalNet, Inc. www.FormsWorkflow.com
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