Fillable ACTIVE DUTY MILITARY COMBAT AFFIDAVIT (Department of Motor Vehicles )

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ACTIVE DUTY MILITARY COMBAT AFFIDAVIT (Department of Motor Vehicles )

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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)
dmvnv.com
VP258 (8/2012) Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this for once it is signed and witnessed.
ACTIVE DUTY MILITARY – COMBAT AFFIDAVIT
2011 Senate Bill 406 (NRS 482)
The completed Active Duty Military – Combat Affidavit must be submitted at the time of the vehicle
registration renewal to claim this exemption of all late fees. The dates for your deployment must have
occurred when your vehicle registration expired.
Please type or print
Vehicle Identification Number
Year
Make
Model
License Plate
Full Legal Name
First Middle Last
Nevada Driver’s License, Identification Card Number, or
Date of Birth
Physical Address
Address City State Zip Code
Mailing Address
Address City State Zip Code
Telephone
I declare under penalty of perjury that the foregoing is true and correct. My position was combat
or
combat support from the beginning date of ___________________________ until
the ending date of ___________________________.
Affiant’s Printed Full Legal Name ______________________________________________
State of Nevada, County of ___________________
Signed and sworn to before me on _____________
By ___________________________.
Signature of Affiant
__________________________________
Notary Public or Authorized Nevada DMV Representative
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ACTIVE DUTY MILITARY COMBAT AFFIDAVIT (Department of Motor Vehicles )

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Completed 24 December 2020

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