In Ohio, the process to obtain a title is much more involved. A search must be done thru the system to ensure it isn't stolen or a lein-applied vehicle and if clears that hurdle, it must then be inspected by the state highway patrol or someone at the DMV. They verify that a VIN tag is present and it has not been tampered with. If the car passes step two, you're then issued a form that you take, with any supporting paperwork you might have (notarized bill of sale, etc), to your county courthouse where you're issued a court date to appear before a judge where you literally will plead your case. If the judge agrees, he will issue a request for a title which you then take to the title bureau for your state assigned document.
Oh, and at every step, there's a fee involved. The total cost can amount to somewhere around $500, not including any sales tax on the money paid for the vehicle when purchased.