Agency Schedule Detail

Authorization Number : 760-1546

Agency Series No. : 4010

Status : Active

Agency Web Link :

Agency : DHS

Confidential Description :

Division : DHSOBMV

Vital Description :

Section : DHSOBMVB060

Record Title : Self-Insurance

Revision : 0

Record Description : This series consists of applications and certificates for Self-Insurance in accordance with sections 4509.72, 4509.59, and 4509.62 of the Revised Code. BMV 3148 – Application For Self-Insurance General BMV 3149 – Application For Self-Insurance Religious Organization BMV 3140 – Certificate of Self-Insurance BMV 3146 - Application for Certificate Deposit of $30,000 in Money or Government Bonds BMV 2182 - Certificate of Financial Responsibility, R.C. 4509.62 BMV 2180 - Application – Certificate of Financial Responsibility BMV 2181 - Certificate of Financial Responsibility, R.C. 4509.59

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain in BMV Compliance Unit office files for current registration period (five years), plus one year following date of expiration.	All certificates of self-insurance are issued for five-year periods. Records will be retained one year following a certificate''s expiration for reference during renewals.	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Pamela Watkins	Records Officer	8/20/2014 7:25:00 AM
Approved	Bunnie Jones	Record Administrator	9/15/2014 2:26:00 PM
Approved	Fred Previts	State Archivist	9/16/2014 4:36:00 PM
Approved	Martin Meeks	State Auditor	9/18/2014 12:10:00 PM

Notes

Date	Reason	User