Form Dmv22 - Change Of Address Notification By Mail Page 3

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555 Wright Way
Please remit $4.25 for a Change of Address and $6
Carson City, NV 89711
for each updated vehicle if you are requesting a
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas area (702) 486-4DMV (4368)
Certificate. If ordering by mail, you may also pay by
Rural Nevada or Out of State (877) 368-7828
check or money order.
$
_
Payment Type:
Master Card
Visa
Discover Card
Payment Amount
Debit or Credit Card Number
(one number per box)
-
-
-
Cardholder Information
Expiration Date
Please Print or Type
/
Printed Name
Print your name as it appears on your card
Month
Year
Mailing Address
Street / P.O. Box
City
State
Zip Code
Plate/Driver Lic./Bus. Lic./Records/MC Number
of the transaction being processed.
Telephone
Authorized Signature
Date
By signing this form, you give us permission to debit your account for the amount indicated on or after the indicated date.
VP-205 (Rev. 5/2017)
I authorize the DMV to charge the credit/debit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the
amount indicated above only and is valid for one-time use only. I certify that I am an authorized user of this credit/debit card and that I will not dispute the payment
with my credit/debit card company so long as the transaction corresponds to the terms indicated in the form.
*Printed form is 3.5” x 7.5”

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