Fill a Valid Ohio Bmv 0399 Form

The Ohio BMV 0399 form is a request document used by state and county agencies to seek payment for services rendered through the Ohio Bureau of Motor Vehicles (BMV). This form must be completed and submitted when agencies wish to utilize a County Agency Voucher or Intra State Agency Voucher (ISTV). Timely submission and proper documentation are essential to ensure the processing of these requests.

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Preview - Ohio Bmv 0399 Form

OHIO BUREAU OF MOTOR VEHICLES

REQUEST FOR SERVICE BY COUNTY AGENCY

State and County agencies must complete this form and submit it to the BMV when requesting to make payment for service by way of County Agency Voucher or Intra State Agency Voucher (ISTV). Attach a copy of the voucher, if applicable. A revenue transfer must be completed for the amount of service authorized through an ISTV or by way of check within 30 days after the service was provided.

SERVICE REQUESTED

DATE OF REQUEST:

EXPLAIN TYPE OF SERVICE REQUESTED

AMOUNT OF VOUCHER/ISTV (REQUIRED)

BMV CASE # (IF REQUIRED)

OTHER INFORMATION:

CUSTOMER/RECIPIENT INFORMATION

FIRST NAME			LAST NAME			MIDDLE INITIAL

STREET ADDRESS				SOCIAL SECURITY #

CITY	STATE	ZIP		PHONE #
				(	)

AGENCY INFORMATION

AGENCY NAME			AGENCY CONTACT/CASE WORKER

STREET ADDRESS			PHONE NUMBER
			(	)

CITY	STATE	ZIP	FAX NUMBER
			(	)

AGENCY AUTHORIZED SIGNATURE			E-MAIL ADDRESS
X

DO NOT WRITE BELOW THIS LINE

KEY NUMBER (I.E. APP/DL NUMBER)	SERVICE DATE	SERVICE PROVIDED BY

AMOUNT OF VOUCHER/ISTV	PAYMENT/ISTV REC’D DATE	PAYMENT PROCESSED BY
$

NOTES:

Mail to: Ohio Bureau of Motor Vehicles Revenue Management, P.O. Box 16521, Columbus, Ohio 43216-6521

PLEASE DUPLICATE THIS FORM AS NEEDED

BMV 0399 11/04

Document Properties

Fact Name	Details
Form Purpose	The Ohio BMV 0399 form is used by state and county agencies to request payment for services through County Agency Voucher or Intra State Agency Voucher (ISTV).
Submission Requirement	Agencies must complete and submit this form to the Bureau of Motor Vehicles (BMV) when requesting payment.
Voucher Attachment	If applicable, a copy of the voucher must be attached to the completed form.
Revenue Transfer Deadline	A revenue transfer must occur within 30 days after the service is provided, either through an ISTV or by check.
Required Information	The form requires details such as the type of service requested, amount of the voucher/ISTV, and customer/recipient information.
Governing Law	The use of the BMV 0399 form is governed by Ohio Revised Code § 4501.03, which outlines the duties of the BMV.
Contact Information	Agencies must provide contact information, including the name of the agency, case worker, and phone numbers.
Mailing Address	The completed form should be mailed to the Ohio Bureau of Motor Vehicles Revenue Management at P.O. Box 16521, Columbus, Ohio 43216-6521.

Documents used along the form

The Ohio BMV 0399 form is a critical document for state and county agencies when requesting payment for services. Along with this form, several other documents may be required or useful in the process. Below is a list of these documents, each described briefly.

County Agency Voucher: This document serves as a request for payment from the county agency to the BMV for specific services rendered. It details the services provided and the associated costs.
Intra State Agency Voucher (ISTV): Similar to the County Agency Voucher, the ISTV is used for inter-agency transactions within the state, allowing for payment for services between state agencies.
Revenue Transfer Form: This form is necessary for transferring funds between agencies. It ensures that payments are properly accounted for within the agency's financial records.
Service Request Form: This form outlines the specific services requested by the agency. It provides clarity on what services are being billed and helps prevent misunderstandings.
Non-compete Agreement Form: For employers looking to protect their interests, the necessary Non-compete Agreement FAQs can provide vital information on implementation and legal implications.
Payment Receipt: After payment is processed, a receipt is generated. This document serves as proof of payment and is important for record-keeping.
Agency Authorization Letter: This letter grants permission for a designated individual to request services on behalf of the agency. It may be necessary to accompany the BMV 0399 form.
Client Information Release Form: This form allows the agency to share the client's information with the BMV. It is essential for ensuring compliance with privacy regulations.
Proof of Identity Documents: Depending on the service requested, proof of identity may be required. This can include a driver's license, state ID, or other government-issued identification.
Contact Information Sheet: This document provides updated contact information for the agency and the case worker involved. It ensures that communication remains clear and effective.
Service Completion Report: This report summarizes the services provided and confirms that they were completed as requested. It may be needed for finalizing payments.

Each of these documents plays a role in ensuring that the process runs smoothly and that all parties have the necessary information for proper record-keeping and compliance. It is advisable to have these documents organized and readily available when submitting the BMV 0399 form.

Guidelines on Filling in Ohio Bmv 0399

Completing the Ohio BMV 0399 form is a straightforward process. This form is essential for state and county agencies to request payment for services rendered. Follow these steps carefully to ensure accurate submission.

Obtain the Ohio BMV 0399 form. This can be done online or through your agency's resources.
Fill in the DATE OF REQUEST field at the top of the form.
In the SERVICE REQUESTED section, clearly explain the type of service being requested.
Enter the AMOUNT OF VOUCHER/ISTV in the designated field. This amount is required.
If applicable, provide the BMV CASE # in the specified area.
Complete the CUSTOMER/RECIPIENT INFORMATION section with the recipient's first name, last name, middle initial, street address, social security number, city, state, zip code, and phone number.
Fill out the AGENCY INFORMATION section, including the agency name, agency contact or case worker's name, street address, phone number, city, state, zip, fax number, and e-mail address.
Ensure that the AGENCY AUTHORIZED SIGNATURE field is signed by an authorized representative.
Leave the section labeled DO NOT WRITE BELOW THIS LINE blank, as it is for BMV use only.
Make a copy of the completed form for your records.
Mail the form to the Ohio Bureau of Motor Vehicles Revenue Management at the address provided: P.O. Box 16521, Columbus, Ohio 43216-6521.

Common mistakes

When filling out the Ohio BMV 0399 form, many individuals make common mistakes that can delay processing. One frequent error is failing to provide the amount of the voucher or ISTV. This field is required, and without it, the form may be returned for correction.

Another mistake is not including the BMV case number when it is required. Omitting this information can lead to confusion and may result in the request being processed incorrectly. Always double-check if the case number is necessary for your submission.

Many people also overlook the importance of the customer/recipient information. Missing details such as the social security number or phone number can cause delays. Ensure that all fields are filled out accurately and completely.

Providing an incomplete or incorrect agency information section is another common issue. This includes the agency name, contact person, and their phone number. If any of this information is missing or incorrect, it could lead to communication issues later on.

Another mistake is neglecting to include the agency authorized signature. This signature is crucial for validating the request. Without it, the form may not be accepted, and the request will not be processed.

Some individuals fail to attach a copy of the voucher when applicable. This attachment is necessary for the BMV to verify the request. If you have a voucher, make sure to include it with your submission.

People often forget to check the date of request. If the date is missing, it can create confusion about the timeline of the service request. Always ensure this date is clearly indicated.

Additionally, not providing a valid email address can hinder communication. The BMV may need to reach out for further information or clarification. Make sure to include a current email address for any follow-up.

Finally, neglecting to mail the form to the correct address can result in significant delays. Always verify that you are sending it to the Ohio Bureau of Motor Vehicles Revenue Management at the address provided on the form.

FAQ

What is the Ohio BMV 0399 form?
The Ohio BMV 0399 form is a request form used by state and county agencies to request payment for services provided through a County Agency Voucher or Intra State Agency Voucher (ISTV). This form must be submitted to the Bureau of Motor Vehicles (BMV) along with any applicable vouchers.
Who needs to complete the BMV 0399 form?
State and county agencies that are seeking reimbursement for services rendered are required to complete this form. It is essential for agencies to document the services provided and the associated costs.
What information is required on the form?
The form requires several key pieces of information, including:
- Date of request
- Type of service requested
- Amount of the voucher or ISTV
- BMV case number (if applicable)
- Customer or recipient information (name, address, social security number, etc.)
- Agency information (name, contact details, and authorized signature)
How should the completed form be submitted?
After completing the form, it should be mailed to the Ohio Bureau of Motor Vehicles Revenue Management at the address specified on the form: P.O. Box 16521, Columbus, Ohio 43216-6521.
What is the deadline for submitting the revenue transfer?
A revenue transfer must be completed within 30 days after the service has been provided. This is crucial to ensure timely processing and reimbursement.
Is there a specific format for the amount of the voucher or ISTV?
Yes, the amount must be clearly indicated in the designated section of the form. It is important to provide the exact dollar amount to avoid any processing delays.
Can I duplicate the BMV 0399 form?
Yes, the form can be duplicated as needed. Agencies are encouraged to make copies to ensure they have sufficient forms for future requests.
What happens if the form is incomplete?
If the form is submitted without all required information, it may be returned for completion or delayed in processing. It is advisable to double-check all entries before submission.
Who can I contact if I have questions about the form?
For questions regarding the BMV 0399 form, agencies should contact the Ohio Bureau of Motor Vehicles directly. The contact information is typically available on the BMV's official website.
What is the significance of the authorized signature on the form?
The authorized signature confirms that the agency is officially requesting the service and acknowledges the validity of the information provided. It is a necessary step for processing the request.