State-Owned Motor Vehicle Insurance Changes Page 2
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2Vehicle 6
Vehicle 5
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Budget Account & Category ________________
Budget Account & Category ________________
Effective Date (Added or Deleted) _____________
Effective Date (Added or Deleted) _____________
Year ______ Make (e.g., FORD) ______________
Year ______ Make (e.g., FORD) ______________
Model (F150/F250)_________________________
Model (F150/F250) ________________________
VIN ____________________________________
VIN ____________________________________
VEHICLE CLASSIFICATION CODE___________
VEHICLE CLASSIFICATION CODE____________
Lic. #____________ Coverage
Lic. #____________ Coverage
N/A
N/A
L - Liability (mandatory)
L - Liability (mandatory)
CC - Comprehensive & Collision (optional)
CC - Comprehensive & Collision (optional)
VEHICLE CLASSIFICATION
PEV
Police Emergency Vehicle
FEV
Fire Emergency Vehicle
EHFV
Extra Heavy Fire Vehicle
AV
Agency Vehicle
ASUV
Agency SUV
AMIV
Agency Mini Van
C1
Class 1 Truck (<6,001 lbs)
C2
Class 2 Truck (6,001 – 10,000 lbs)
C3
Class 3 Truck (10,001 – 14,000 lbs)
C4
Class 4 Truck (14,001 – 16,000 lbs)
C5
Class 5 Truck (16,001 – 19,500 lbs)
C6
Class 6 Truck (19,501 – 26,000 lbs)
C7
Class 7 Truck (26,001 – 33,000 lbs)
C8
Class 8 Truck (33,001 and greater)
MC
Motorcycle
B1
Bus 1 (seating 1-8 people)
B2
Bus 2 (seating 9-20 people)
B3
Bus 3 (seating 21-60 people)
B4
Bus 4 (seating 60 people or more)
AGC
Agency Golf Cart
AT
Agency Trailer
APV1
Agency Passenger Van (seating 1-8 people)
APV2
Agency Passenger Van (seating 9-20 people)
APV3
Agency Passenger Van (seating 21-60 people)
APV4
Agency Passenger Van (seating 60 people or more)
Return by clicking "Submit Form" below to send by email:
SUBMIT FORM
To return by mail or fax:
Office of the Attorney General
DMV Legal/Tort Claims
555 Wright Way
Carson City, Nevada 89711
775-684-1263 telephone
775-684-4601 facsimile
agfleet@ag.nv.gov
Rev. 11/15
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Parent category: Legal