Fillable Form Vp-222 - Application For Vehicle Registration printable pdf download

Form Vp-222 - Application For Vehicle Registration

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555 Wright Way

Carson City, NV 89711

Reno/Sparks/Carson City (775) 684-4DMV (4368)

Las Vegas Area (702) 486-4DMV (4368)

Rural Nevada or Out of State (877) 368-7828

APPLICATION FOR VEHICLE REGISTRATION

PLEASE PRINT OR TYPE

Year ___________ Make _________________________ Model ____________________________

Vehicle Identification Number ________________________________________________________

Nevada evidence of insurance must be presented to the Department of Motor Vehicles at the

time of application for registration.

I hereby apply for registration for the above described vehicle and I declare that:

In my name, I will continuously provide, while the vehicle is registered with Nevada, security

as required by NRS 485.185, either by a motor vehicle liability insurance policy or by

qualifying as a self-insurer in compliance with law.

NOTE: VEHICLE MUST BE INSURED BY

AN INSURANCE COMPANY LICENSED IN THE STATE OF NEVADA. The statement “the

coverage meets the requirements set forth in NRS.485.185” must be included on the card.

Out-

of-State insurance will not be accepted. Trailers are exempt from insurance requirements.

•

Truck or bus: The declared gross weight (for commercial vehicles, include trailer and load) is

___________________________ lbs.

• Trailer (excluding travel trailers): the unladen weight is ___________lbs.

• The vehicle will be based in ______________________________ County.

REGISTERED OWNERS NAME ______________________________________________________

SIGNATURE _____________________________________________ DATE___________________

Registered Owner (or authorized person with POA)

RESIDENT ADDRESS _____________________________________________________________

Address

City

State

Zip Code

MAILING ADDRESS _______________________________________________________________

Address

City

State

Zip Code

TELEPHONE NUMBER (_____) ______________ E-MAIL ADDRESS _______________________

NOTE: It is a gross misdemeanor to use a false or fictitious name or address in this application for registration, or to

knowingly make a false statement or knowingly conceal a material fact or otherwise commit a fraud in this application.

VP-222 (Revised 11/2009)

Form Vp-222 - Application For Vehicle Registration

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