Instructions for Application Completion

The registration application is a PDF file, files which require Adobe Acrobat to download.  If you do not have Adobe on your computer, it can be acquired at no cost from their website:

** DOWNLOAD REGISTRATION APPLICATION **

Please Type or print in black ink all information

Application ( Please Type or Print information)

  • Provide the complete name, address, zip code+4, and county of the business.

  • Provide the FEIN (Federal employer/taxpayer identification number). This is the number the Internal Revenue Service uses to identify the person or business for taxpaying purposes. To obtain one contact the IRS at (800) 829-3676, ask for Form #SS4 Employer ID.

  • Provide the State Taxpayer withholding identification number. If you need an employer withholding permit , contact the Ohio Department of Taxation at (888) 405-4089 or use the Ohio Business Gateway to register on line at www.obg.ohio.gov

  • Provide your Worker's compensation identification number. This number is assigned to businesses paying insurance premiums for workplace injuries. To obtain a number contact the Ohio Bureau of Workers Compensation at (800) 644-6292. (Sole Proprietors with no employees are not required to have this ID number)

  • Provide your Ohio Department of Job and Family Services (ODJFS) Unemployment Compensation tax account No. To obtain one employers should complete a Report To Determine Liability (JFS 66300). This identifies those businesses required to provide monetary benefits to unemployed workers. To obtain the JFS 66300 Form, contact the Bureau at (614) 466-2319 or find it on their website http://jfs.ohio.gov/ouc/uctax/index.stm

  • Provide your Hazardous Waste Generator Number. Depending on the amount of waste you generate per month, your shop may or may not need a number. Refer to Ohio EPA's Guidance for Owners/ Operators of Automotive Collision Repair Shops. This guide can be found at http://www.epa.state.oh.us/dhwm/pdf/AutoRepairGuidance.pdf . For assistance, contact Ohio EPA's Office of Compliance Assistance and Pollution Prevention at 1-800-329-7518 or Division of Hazardous Waste Management at 614-644-2917

  • Provide your 10-digit Air Pollution Facility Identification number. If you have an air permit from Ohio EPA, the number is on the permit. If you have submitted a Permit-by-Rule Notification Form to Ohio EPA, you can find your Facility ID number at http://www.epa.state.oh.us/ dapc/pbr/permitbyrule.html. If your shop is exempt as a de minimis air pollution source per OAC 3745-15-05, check "de minimis" on the form. If your business does not paint vehicles, write "No Painting" on the form. For assistance, contact Ohio EPA's Office of Compliance Assistance and Pollution Prevention at 1-800-329-7518

  • Provide your current vendor license number. This number is assigned to those businesses recognized by and allowed to conduct business transactions in the state of Ohio. To obtain one, contact the Department of Taxation (888) 405-4089, www.tax.ohio.gov

  • Circle business type: Corporation, partnership, sole proprietorship, LLC.
    Provide the name, address, and telephone number for each company, owner, partner, shareholder, or other associated entity that has an ownership interest in that business.

  • Sign the application in the presence of a notary public; they will countersign and affix a seal on the application. This section is mandatory By signing you are providing a sworn statement indicating that the business being registered meets or exceeds all federal, state and local requirements related to the operation of a motor vehicle collision repair facility.

  • Each application is to be accompanied by a check in the amount of $225.00 and made payable to Treasurer of the State of Ohio, CRB. The application will not be processed without payment. All returned checks will result in a $20.00 fee

Photographs
Provide 2 photographs

  1. One print must show the sign and the building together.

  2. The second print must show the street leading to your business (ingress & egress) with your business in the background (usually this can be accomplished by going across the street and taking the picture).

    Mobile business' one picture of the side of vehicle and the other picture of the inside of the work/storage area of the vehicle. Photographs can be Polaroid, digital or prints. The digital or print photographs must be 3 x 5 minimum on 8 ½" x 11 paper. Label pictures with shop name and address. Digital images may be emailed to Kimberly.Sherfield@crb.state.oh.us

Proof of Insurance

  • We need to verify General Liability and Garage Keepers insurance coverage. Insert in space provided your renewal/ expiration date of coverage. Request from your agent / insurer a CERTIFICATE OF LIABILITY INSURANCE COVERAGE. On this form they will have the dates of coverage, limits and they will list us as Certificate Holder (notifying us of any changes to your policy). We do not accept copies of declaration pages.

  • Included with your Certificate of Coverage should be the name, address, fax number and phone number of your agent for verification or questions regarding your coverage. This may be faxed to (614) 995-0717.

  • Contact us if you have any questions:
    Phone Number (614) 995 - 0714
    Fax Number (614) 995 - 0717

Checklist

  1. Application (Notarized)
  2. Check for $225 (Made out to Treasurer of the State of Ohio, CRB)
  3. Certificate of Insurance Coverage (Garage Keepers & General Liability)
  4. Pictures (2)
Contact us if you have any questions

Phone Number (614) 995 – 0714
Fax Number (614) 995 – 0717
Website collisionboard.ohio.gov
Email:CRB eMail
37 W Broad Street, Suite 880
Columbus, OH 43215-4159

The application can be downloaded and printed from our website at collisionboard.ohio.gov


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