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The Ohio BMV 0399 form is an essential tool for state and county agencies seeking reimbursement for services rendered. When an agency requests payment through a County Agency Voucher or an Intra State Agency Voucher (ISTV), this form must be completed and submitted to the Bureau of Motor Vehicles (BMV). It captures crucial details such as the type of service requested, the amount of the voucher, and any relevant case numbers. Additionally, the form requires specific customer information, including the recipient's name, address, and social security number, ensuring proper identification and processing. Agencies must also provide their contact details and an authorized signature to validate the request. Timely submission is critical, as a revenue transfer must occur within 30 days after the service is provided. This form streamlines the reimbursement process, making it easier for agencies to manage their finances and ensure that services are compensated efficiently.

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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

Form Specifications

Fact Name Details
Form Purpose The Ohio BMV 0399 form is used by state and county agencies to request payment for services rendered through County Agency Vouchers or Intra State Agency Vouchers (ISTV).
Submission Requirement Agencies must complete and submit this form to the Bureau of Motor Vehicles (BMV) along with a copy of the voucher, if applicable.
Revenue Transfer A revenue transfer must be completed within 30 days after the service has been provided, either through an ISTV or by check.
Governing Laws This form is governed by Ohio Revised Code § 4501.03, which outlines the responsibilities of the BMV and county agencies.
Form Version The current version of the form is BMV 0399, with a revision date of November 2004.

Ohio Bmv 0399: Usage Guidelines

To proceed with your request using the Ohio BMV 0399 form, follow these steps carefully. Ensure all information is accurate and complete before submission.

  1. Begin by filling in the date of request at the top of the form.
  2. In the section labeled service requested, clearly explain the type of service you are requesting.
  3. Enter the amount of voucher/ISTV in the designated box. This is a required field.
  4. If applicable, provide the BMV case number in the next field.
  5. Complete the customer/recipient information section. Include the first name, last name, middle initial, street address, social security number, city, state, zip code, and phone number.
  6. Fill out the agency information section. Include the agency name, agency contact/case worker name, street address, phone number, city, state, zip code, and fax number.
  7. Obtain the agency authorized signature and provide the email address of the agency.
  8. Leave the section labeled do not write below this line blank, as it is for BMV use only.
  9. Once completed, mail the form to the address provided: Ohio Bureau of Motor Vehicles Revenue Management, P.O. Box 16521, Columbus, Ohio 43216-6521.

Your Questions, Answered

What is the purpose of the Ohio BMV 0399 form?

The Ohio BMV 0399 form is designed for state and county agencies to request payment for services rendered. When an agency provides a service that requires reimbursement, they must complete this form and submit it to the Bureau of Motor Vehicles (BMV). This process is essential for maintaining accurate records and ensuring that payments are processed efficiently. If applicable, agencies should also attach a copy of the County Agency Voucher or Intra State Agency Voucher (ISTV) to the form.

How should I fill out the Ohio BMV 0399 form?

Filling out the Ohio BMV 0399 form requires careful attention to detail. Start by entering the date of the request and clearly explaining the type of service requested. It is crucial to include the amount of the voucher or ISTV, as this is a required field. If there’s a BMV case number, make sure to include that as well. The customer or recipient information section must be completed with accurate details, including the first name, last name, and address. Lastly, the agency information section should include the agency name, contact person, and relevant contact details. An authorized signature from the agency is also necessary to validate the request.

What happens after I submit the Ohio BMV 0399 form?

Once the Ohio BMV 0399 form is submitted, the BMV will process the request. It is important to note that a revenue transfer must be completed for the amount authorized through an ISTV or by check within 30 days after the service was provided. This ensures that funds are transferred promptly and accurately. Agencies should keep track of their submissions and follow up if they do not receive confirmation of payment within a reasonable timeframe.

Where should I send the completed Ohio BMV 0399 form?

The completed Ohio BMV 0399 form should be mailed to the Ohio Bureau of Motor Vehicles Revenue Management at P.O. Box 16521, Columbus, Ohio 43216-6521. Make sure to send it to the correct address to avoid delays in processing. If you need multiple copies of the form, feel free to duplicate it as needed for your records or additional requests.

Common mistakes

  1. Not providing the date of request. This information is crucial for processing and tracking the request.

  2. Failing to specify the type of service requested. Clearly stating the service helps avoid confusion and ensures the correct action is taken.

  3. Leaving out the amount of voucher/ISTV. This field is required and must be filled out to process the request properly.

  4. Not including the BMV case number when required. This can delay processing if the case number is needed for reference.

  5. Providing incomplete customer/recipient information. Ensure all fields, including name, address, and phone number, are filled out accurately.

  6. Omitting the agency information. This section must be completed to identify the agency making the request.

  7. Not obtaining the authorized signature from the agency. An unsigned form may be rejected or delayed.

  8. Forgetting to attach a copy of the voucher if applicable. This documentation is often necessary for approval.

  9. Neglecting to mail the form to the correct address. Double-check the mailing address to avoid delays in processing.

Documents used along the form

The Ohio BMV 0399 form is a crucial document for state and county agencies requesting services from the Bureau of Motor Vehicles. However, several other forms and documents often accompany it to ensure a smooth transaction. Below is a list of these forms, each serving a specific purpose in the process.

  • County Agency Voucher: This document outlines the specific services requested by a county agency and includes details about the payment amount. It is essential for processing payments related to services rendered.
  • Intra State Agency Voucher (ISTV): Similar to the County Agency Voucher, the ISTV is used when one state agency pays another for services. It helps track inter-agency transactions and ensures proper accounting.
  • Payment Receipt: This is a confirmation of payment made for services requested. It serves as proof that the transaction was completed and helps in record-keeping.
  • Service Request Form: This form details the type of service being requested, including the date and the nature of the service. It is often required to initiate the process before submitting the BMV 0399 form.
  • Authorization Letter: Sometimes, agencies need to provide a letter authorizing a specific individual to request services on their behalf. This letter adds an extra layer of verification to the process.
  • Client Information Form: This document collects essential information about the client receiving the service. It ensures that all necessary details are available for processing.
  • Agency Contact Information Sheet: This sheet includes the contact details of the agency responsible for the request. It helps the BMV reach out for any clarifications or follow-ups.
  • Revenue Transfer Form: This form is used to document the transfer of funds between agencies. It must be completed within 30 days of the service being provided to ensure timely processing.
  • Service Completion Report: After the service has been rendered, this report confirms that the service was completed satisfactorily. It is often required for finalizing payment and closing the request.

Using these forms and documents in conjunction with the Ohio BMV 0399 form helps streamline the process for agencies and ensures compliance with state regulations. Proper documentation minimizes errors and enhances the efficiency of service requests.

Similar forms

The Ohio BMV 0399 form, designed for service requests by county agencies, shares similarities with several other forms used in various governmental and administrative contexts. Each of these documents facilitates a specific type of transaction or request, often involving payment or service authorization. Below are six documents that are similar to the Ohio BMV 0399 form:

  • County Agency Voucher Form: This document is used by county agencies to request reimbursement for services rendered. Like the BMV 0399, it requires detailed information about the service provided and the amount being requested for payment.
  • Intra State Agency Voucher (ISTV): Similar to the BMV 0399, the ISTV is specifically designed for inter-agency transactions within the state. It also necessitates a clear description of the service and the corresponding payment details.
  • Payment Request Form: This form is often utilized by various departments to request payment for services. It parallels the BMV 0399 in that it requires a breakdown of the service, the amount requested, and pertinent recipient information.
  • Service Authorization Request Form: This document is used to authorize payment for services provided by external vendors. Like the BMV 0399, it must include details about the service and the authorized amount for payment.
  • Grant Reimbursement Request Form: Non-profit organizations and agencies use this form to request reimbursement for expenses incurred under a grant. Similar to the BMV 0399, it includes a detailed account of services rendered and the financial amount being claimed.
  • Invoice Submission Form: Businesses and service providers use this form to submit invoices for payment. It shares a commonality with the BMV 0399 in that it requires a description of the service, payment amount, and recipient information.

Understanding these similarities can help streamline processes for those involved in service requests and payment authorizations across various agencies and organizations.

Dos and Don'ts

When filling out the Ohio BMV 0399 form, it's essential to pay attention to the details. Here are some important do's and don'ts to keep in mind:

  • Do provide accurate and complete information in all fields.
  • Do attach a copy of the voucher if applicable.
  • Do ensure the agency authorized signature is included.
  • Don't leave any required fields blank, especially the amount of the voucher.
  • Don't forget to mail the form to the correct address: Ohio Bureau of Motor Vehicles Revenue Management, P.O. Box 16521, Columbus, Ohio 43216-6521.
  • Don't submit the form without checking for errors or typos.

Following these guidelines can help ensure that your request is processed smoothly and efficiently.

Misconceptions

Understanding the Ohio BMV 0399 form can be challenging, especially with the various misconceptions that exist. Here are ten common misunderstandings about this form, along with clarifications to help you navigate the process more effectively.

  1. Only government agencies can use the BMV 0399 form. Many people believe that only state or county agencies can submit this form. However, while it is primarily designed for these entities, individuals can also be involved in the process, especially if they are working with an agency.
  2. The form is only for payment requests. Some assume that the BMV 0399 form is solely for requesting payments. In reality, it also serves as a means to document the type of service requested and the relevant details surrounding that service.
  3. You don’t need to attach any documents. A common misconception is that the form can be submitted without any supporting documents. In fact, if a voucher is applicable, it must be attached to the form to ensure proper processing.
  4. The form can be submitted at any time. Many believe that there are no time constraints for submitting the BMV 0399 form. However, a revenue transfer must be completed within 30 days after the service has been provided, making timely submission crucial.
  5. It’s not necessary to provide detailed service information. Some individuals think that filling out the service requested section is optional. This is incorrect; providing a clear explanation of the service is essential for processing the request.
  6. You can submit the form online. There is a misconception that the BMV 0399 form can be submitted electronically. Currently, it must be printed and mailed to the designated address.
  7. Any agency can authorize the form. Some people believe that any agency employee can sign the form. However, it must be signed by an authorized representative of the agency to be valid.
  8. The form is only valid for specific types of services. While certain services may be more common, the BMV 0399 form can be used for various services, making it a versatile tool for agencies.
  9. There is no need to keep a copy of the form. Many assume that once the form is submitted, they do not need to retain a copy. In fact, keeping a copy for your records is a good practice, as it can help in case of any discrepancies.
  10. The BMV processes all requests immediately. Lastly, some believe that once the form is submitted, the BMV will process it right away. Processing times can vary, so it’s important to allow for adequate time before following up on the request.

By understanding these misconceptions, individuals and agencies can navigate the Ohio BMV 0399 form process more effectively and ensure that their requests are processed smoothly.

Key takeaways

Here are some key takeaways about filling out and using the Ohio BMV 0399 form:

  • The form is used by state and county agencies to request payment for services.
  • It must be submitted to the Bureau of Motor Vehicles (BMV) along with any applicable vouchers.
  • Be sure to attach a copy of the County Agency Voucher or Intra State Agency Voucher (ISTV) if you have one.
  • Complete the revenue transfer within 30 days after the service has been provided.
  • Fill in the date of the request and clearly explain the type of service requested.
  • Include the amount of the voucher or ISTV, as this is a required field.
  • Provide accurate customer and agency information, including names and contact details.
  • Make sure the agency authorized signature is included before submitting the form.
  • Mail the completed form to the address provided: Ohio Bureau of Motor Vehicles Revenue Management, P.O. Box 16521, Columbus, Ohio 43216-6521.

Remember, it’s important to duplicate the form as needed to ensure you have enough copies for your records and any additional requests.