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YOU WILL LOSE YOUIIDRIVER ueENSE FOR AT LEAST 10 DAYS IF YOU DRIVE wmtOUT INSURANCE OR OTHER ACCEPTABLE FINANCIAl. RESPONSIBILITY COVERAGE . In Ohio, 't 's illegal to drive any motar vehicle without insurance or other financial responsibility (FR) coverage, . It,is also illegal for any motor vehicle owner to allow anyone else to drive the owner's vehicle without FR coverage. . PROOF OF COVERAGE IS REQUIRED: . Whenever a police officer issues a traffic ticket. At all vehicle inspection stops' Upon traffic court appearances and' Upon random checks by tpe Registrar 01 Motor Vehicles. . ANY DRIVER OR OWNER WHO FAILS TO SHOW PROOF OF INSURANCE OR OTHER COVERAGE WILL. Lose his or her driver license for HO DAYS on first offense and ONE YEAR on additionai offenses' Lose his or her license plates and vehicle registration' Pay reinstatement fees of $75,00 first offense, $250,00 second offense, and $500.00 any additionai offense' Pay a $50.00 penalty for any failure to surrender his or her driver license, license plates, or registration AND. Be required to maintain special FR coverage ("High-risk" insurance or equivalent) on file with the Bureau of Motor Vehicles (BMV) for FIVE YEARS. . ONCE THIS SUSPENSION IS IN EFFECT: Any driver or owner who violates the suspension will have his or her vehicle immobilized and his or her license plates confiscated tor at least 30 DAYS first offense and 60 DAYS second offense, For third or subsequent offenses, the vehicle will be forleited and sold and the person will not be permitted 10 register any motor vehicle in Ohio for FIVE YEARS, . IF YOU ARE INVOLVED IN AN ACCIDENT WITHOUT INSURANCE OR OTHER FR COVERAGE: In addition to all the penalties listed above, you may have' A SECURITY SUSPENSION for TWO YEARS or more and' A JUDGMENT SUSPENSION for SEVEN YEARS, . THESE PENALTIES ARE IN ADDITION TO ANY FINES OR PENALTIES IMPOSED BY A COURT OF LAW. . WARNING: THESE LAWS DO NOT PREVENT THE POSSIBILITY THAT YOU MAY BE INVOLVED IN AN ACCIDENT WITH A PERSON WHO HAS NO INSURANCE OR OTHER FR COVERAGE. POWER OF ATTORNEY FOR REGISTRATION PURPOSES ONLY . ~_. " TO BE COMPLETED BY OWNER OR PURCHASER OF VEHI?LE~~) LISTED BELOW 'f I, Awl /;'5 ~ D/..) Z /?./6 ~- I t,;;;; /JII,).:J IL., of If '1 t(l-f 5 i-.It' f?wr i"t""; iN tJ ~-;c. /~1 rOil ..( 'I Jt( j Name " ./, Address hereby name /1// c: no! t'k SCh t.(.j e'6-{'1. () f-f-r',:- of Name Address as my attorney in fact to make application for registration or transfer of registration for the following vehicle(s): Plate No. Veh. Year Make Type Serial Number 1.04 2 () f & 'II "'71 f) w)zi., wi ~,.; /fv>tJ f' t/t?~1 de 4 7 D7~~l{) PZ7 'Y-te/v 0 ~of/ *NOTE: IN THE CASE OF A LEASE OR JOINT OWNERSHIP, YOU MAY BE REQUIRED TO PROVIDE: THE LESSEE/ADDITIONAL OWNER'S SOCIAL SECURITY NUMBER (SSN) OR TAX IDENTIFICATION NUMBER (TIN). Lessee/Additional Owner Name SSNfrlN I affirm that the owners (or lessees of leased vehicle) now have insurance or other financial responsibility coverage covering this vehicle and will not operate or permit the operation of this vehicle without FR coverage; and that the vehicle will not be used as a commercial vehicle unless so registered. .'/') ~~~/-4I.f CJi~U-?'L 2 -/ ~-Vf '1 Date of Birth II F. '3 if wi 7 ;-'2- Soc. Sec. or Tax 1.0. Number tJr)rz n+r;,'lf County of Residence gz /"ht {;vlJ City or Township of Residence /2 ~ t-oi Date