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BMV 3771

The document is a Power of Attorney form from the Ohio Department of Public Safety, Bureau of Motor Vehicles, appointing Rocky Bentkowski as the attorney-in-fact for Roderick Neil Hamilton II to handle the assignment or application for a Certificate of Title for a 2005 Chevrolet. It grants full authority to the attorney-in-fact to perform necessary actions regarding the motor vehicle title. The document requires notarization, although licensed motor vehicle dealers are exempt from this requirement.

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rhamil56
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60 views1 page

BMV 3771

The document is a Power of Attorney form from the Ohio Department of Public Safety, Bureau of Motor Vehicles, appointing Rocky Bentkowski as the attorney-in-fact for Roderick Neil Hamilton II to handle the assignment or application for a Certificate of Title for a 2005 Chevrolet. It grants full authority to the attorney-in-fact to perform necessary actions regarding the motor vehicle title. The document requires notarization, although licensed motor vehicle dealers are exempt from this requirement.

Uploaded by

rhamil56
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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OHIO DEPARTMENT OF PUBLIC SAFETY

BUREAU OF MOTOR VEHICLES

POWER OF ATTORNEY

Know all men by these presents, that the undersigned does hereby make, constitute and appoint

LAST NAME (Including Suffix: Sr. Jr. III etc.) FIRST NAME MI
Bentkowski Rocky D
STREET ADDRESS CITY STATE ZIP CODE
4485 State Road Cleveland OH 44109-4353

My true and lawful attorney-in-fact for me and in my name, place and stead, to make and execute the assignment of or
application for my Certificate of Title covering the following described motor vehicle, to-wit:

MAKE YEAR VIN.


Chevrolet 2005 2G1WH52K759336085

And granting to my said attorney-in-fact full authority to do and perform all and every act and thing whatsoever, requisite,
necessary and proper to be done in and about the premises as fully and to all intents and purposes as the undersigned
might or could do with full power of substitution and revocation hereby ratifying and confirming all that said attorney or
his/her substitute shall lawfully do or cause to be done by virtue hereof.

In Witness whereof, the undersigned has caused his/her name to be subscribed hereto this
day of , 20 .

PRINTED NAME OF PERSON GIVING POWER OF ATTORNEY


Roderick Neil Hamilton II
LAST 4 DIGITS OF SOCIAL SECURITY NUMBER OF PERSON GIVING POWER OF ATTORNEY
5782
SIGNATURE OF PERSON GIVING POWER OF ATTORNEY

X
ACKNOWLEDGEMENT

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

NOTE: A motor vehicle dealer licensed in accordance with 4517 of the Ohio Revised Code (R.C.), who is the owner or purchaser of the
motor vehicle, is not required to have this document notarized under section 4505.063 of the R.C.

BMV 3771 3/23 [17601081]

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