Fillable Form Dmv-204 - Application For Nevada Driver'S License By Mail printable pdf download

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Application for Nevada Driver’s License by Mail

NRS 483.347, NRS 483.383-483.384, NAC 483.456-483.4595

Nevada residents who are temporarily residing outside Nevada and meet all other Department requirements may use this form to apply for

a driver’s license renewal or duplicate by mail. Only one renewal may be completed by mail in consecutive renewal periods. Unless

you are a U.S. Government employee on active military duty or a dependent of such a person, your next license renewal must be completed

in a Nevada DMV office. Within 24 days of your return to Nevada, you are required by law to surrender your driver’s license and obtain a

license which bears your photograph. If you are unsure about your eligibility to renew by mail, please contact the Driver’s License Renewal

by Mail Section at one of the above telephone numbers before submitting your application.

U.S. Government employees on active military duty or dependents of such persons who wish to renew their license must submit a copy of

an employment or military record (leave/earnings statement) indicating Nevada as your state of residence. Active duty military personnel

are not subject to late penalty fees for a driver’s license expired over 30 days.

If you are no longer a resident of Nevada, surrender your Nevada driver’s license to the Department of Motor Vehicles in the state where

you now reside and apply for a driver’s license in that state.

Please complete the appropriate section(s) on the reverse side of this application.

An incomplete application will be returned to you.

Please clearly PRINT the following information:

Driver’s License Number ________________________________

Full Name (Last, First, Middle) ____________________________________________________________________________________

Date of Birth

Mother’s Maiden Name ______________________________________

Nevada Mailing Address _________________________________________________________________________________________

Nevada Residential Street Address __________________________________________________________________________________

Out-of-State Mailing Address (

_________________________________________________________

license will be mailed to this address)

____________________________________________________________________________________________________________

Description:

Sex ____________

Height ____________ Weight ____________ Hair ____________ Eyes ____________

If you are a U.S. citizen and already registered to vote in Nevada, this form will update your voter registration address information

Voter

 I do or  I do not want my address updated for voter registration purposes.

Address

If you moved to a different county, you must submit a new voter registration form for that county.

Change

 AFFIDAVIT – NO SOCIAL SECURITY NUMBER: I, the undersigned, do hereby certify that I have never been assigned a Social

Security number under the provisions of the Social Security Act of the United States.

1. Would you like to be an organ donor and have that information indicated on your license? ........................................... … Yes  No

2. I declare myself a U.S. Armed Forces veteran and authorize the DMV to send my personal information to the Office

of Veterans Services to provide me with benefits information.…………………………………………………………………  Yes  No

3. I have a U.S. Armed Forces honorable discharge and wish to have a veteran designation placed/retained .....................  Yes  No

on my license. If your card does not already have a designation, you must attach a copy of an honorable discharge document.

 IF A DISCHARGE DOCUMENT IS NOT ATTACHED, YOUR LICENSE WILL NOT SHOW A VETERAN DESIGNATION.

4. If you are a male at least 18 and less than 26 years of age, would you like to register with the Selective Service?

By registering, you remain eligible for federal student loans, grants, job training benefits, most federal jobs and,

if applicable, U.S. citizenship………………………………………………………………………………………………………… Yes  No

Complete this form and mail it to the DMV address noted above with the appropriate fees in the form of a check, money order

or debit/credit card authorization (use form VP205). Do NOT send cash. Fees are outlined on the DMV website at

I attest that I am a legal resident of Nevada temporarily residing out of state. I certify under penalty of perjury that all statements

made in this application are true. I understand that any misstatement of facts on this application may cause cancellation or denial

of my driver’s license pursuant to NRS 483.420.

Applicant’s Signature

Date _________________________________

(sign in black ink)

E-Mail Address

Phone No. (out-of-state) (

)_________________

DMV-204 (Revised 12-2015)

Form Dmv-204 - Application For Nevada Driver'S License By Mail

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