Fillable Form Dmv-136 - Application For Restricted License printable pdf download

Central Services & Records

Driver’s License Assessment Team

555 Wright Way

Carson City, Nevada 89711-0400

Phone: 775-684-4364 Option 2

Fax: 775-684-4543

RESTRICTED LICENSE INFORMATION

A restricted license may be obtained for a variety of reasons.

 Juveniles in certain rural areas who need to drive in order to attend school or to transport themselves or a

family member to medical appointments may apply for a restricted license.

 Individuals who have had their license suspended or revoked and have served at least half of their

withdrawal period may apply for a restricted license to drive on the job or to/from work, school, grocery

store, medical appointments or for court-ordered child visitation.

Exceptions apply for ignition interlock requirements, child support suspensions and some juvenile suspensions.

Please call the phone number listed above if any of these exceptions pertain to you.

APPLICATION: A restricted license cannot be approved for commercial driving purposes, to seek employment,

or for public school students in Carson City, Clark, Douglas or Washoe Counties.

Complete all sections of the Application for Restricted License that pertain to you. Attach all required documents.

•

Drive to/from work or drive on the job: Your employer must complete certain information on the application. Self-

employed applicants must attach a copy of their business license or other acceptable document(s) to substantiate

self-employment. Workdays and hours are limited to a maximum of six (6) days per week, ten (10) hours per day.

•

Drive for medical purposes: A physician’s statement is required.

•

Drive to/from medical appointments or a grocery store: The “Verification of Need” affidavit must be completed by

an unbiased individual and signed in front of a DMV authorized representative.

•

Minor drive to/from school or work: School authorities and parents/guardians must complete certain sections.

SR-22: Proof of financial responsibility (SR-22 Certificate of Insurance) must be filed after any revocation and certain

suspensions before a restricted license will be issued. The SR-22 insurance must be in place for a continuous three (3)

year period from the date your driving privilege is reinstated.

TESTING & FEES: Applicants may be required to successfully complete written, vision, and drive examinations before a

restricted license is issued. A reinstatement fee may be required.

IGNITION INTERLOCK DEVICE: If you have been ordered to install an ignition interlock device on your vehicle, proof of

that installation must be submitted with your application for a restricted license. Nevada law requires that an applicant

wait 45 days after a 1

DUI and one (1) year after a 3

DUI before applying for a restricted license. A restricted license is

prohibited by law after a 2

DUI.

POINT VIOLATOR SUSPENSION: Per NAC 483.225, proof of completion or enrollment in an approved traffic safety

course within the past 6 months is required for individuals whose license was suspended due to an accumulation of

demerit points as outlined in NRS 483.475.

DENIAL OF AN APPLICATION: A restricted license application will be denied if your license was suspended or revoked

for any of the following:

A financial responsibility, medical or failure to appear suspension

Certain driving record convictions within the past five (5) years

The third demerit point suspension within the past five (5) years

DMV-136 (Rev. 03/2015)

Form Dmv-136 - Application For Restricted License

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