Form Vp136 - Power Of Attorney
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1555 WRIGHT WAY
CARSON CITY, NV 89711-0700
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas Area (702) 486-4DMV (4368)
Rural Nevada or Out of State (877) 368-7828
POWER OF ATTORNEY
Please print or type
KNOW ALL MEN BY THESE PRESENTS
That the undersigned, ______________________________________________________________
in the County of __________________________ State of __________________________________
being the Registered and/or Legal Owner of the following described motor vehicle:
Year _______________ Make ________________ Model ________________
Vehicle Identification Number ________________________________________________________
Does hereby make, constitute and appoint ______________________________________________
of the County of ___________________________ State of _________________________________,
true and lawful Attorney in Fact to sign in the name, place and stead of the undersigned, any
Certificate of Title or Vehicle Registration Certificate issued by the Department of Motor Vehicles of
the State, covering the motor vehicle described above, in whatever manner necessary to transfer any
Registration Certificate or Certificate of Title. Granting and giving unto said Attorney in Fact, full
authority and power to do and perform any and all other acts authorized hereby, as fully to all intents
and purposes as the grantor might, or could do if personally present, with full power of substitution.
Note: This form may not be used to disclose the odometer reading of a vehicle.
Full Legal Name ___________________________________________________________________
First
Middle
Last
Nevada Driver’s License, Identification Card
Number, Date of Birth, or FEIN for businesses ___________________________________________
Physical Address __________________________________________________________________
Street
City
State
Zip Code
Mailing Address ___________________________________________________________________
Street
City
State
Zip Code
State of Nevada, County of _____________________
Subscribed and sworn to before me on ____________
Date
By __________________________
Signature of Affiant
_______________________________________
Notary Public or Authorized Nevada DMV Representative
Notary Stamp
Signatures must be originals. Photocopies are not acceptable.
VP136 (Rev. 8-2012)
Changes may not be made to this form once it is signed and witnessed.
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Parent category: Legal