Fillable APPLICATION FOR DUPLICATE CERTIFICATE OF REGISTRATION AND/OR SUBSTITUTE (Department of Motor Vehicles )

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APPLICATION FOR DUPLICATE CERTIFICATE OF REGISTRATION AND/OR SUBSTITUTE (Department of Motor Vehicles )

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555 WRIGHT WAY
CARSON CITY, NV 89711-0700
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas Area (702) 486-4DMV (4368)
Fax (775) 684-4797
dmvnv.com
VP013 (Rev 07-01-2015) Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed and witnessed.
APPLICATION FOR DUPLICATE CERTIFICATE OF REGISTRATION AND/OR
SUBSTITUTE DECAL
NRS 482.500
There is a $6 fee for the duplicate certificate of registration or a substitute decal, which includes a Technology fee. You must request
the document(s); duplicate certificate of registration and/or substitute decal. When requesting a substitute decal you will also receive a
new certificate of registration with the new decal number. A substitute decal will not be provided when only requesting a duplicate
certificate of registration. You must provide the department with your current Nevada evidence of insurance. When submitting this
request through the mail, please include a photocopy of your evidence of insurance, originals will not be returned.
Please Print or Type
Select document(s) you are applying for: Duplicate Certificate of Registration Substitute Decal
Vehicle Identification Number
Nevada License Plate Number
Registration Expiration Date
Make
Model
Body Type
Year
Registered Owner/ Lessee Name The document will be mailed to the address on file with DMV. If your address has
changed, please complete the Address Change form DMV022. If more than one owner, complete and attach an
additional Duplicate Registration/Decal forms.
Full Legal Name
Nevada Driver’s License, Identification Card Number, Date of Birth, or FEIN
for businesses
Physical Address
Mailing Address
Telephone No
E-Mail Address
Signature of Applicant
Date
LIMITED POWER OF ATTORNEY
To be completed by the registered owner of record ONLY when allowing another to apply for a duplicate certificate of registration or
substitute decal on behalf of the registered owner.
Known All Men By These Presents:
That the Undersigned __________________________________ of the County of ___________________ State of _______________,
being the registered owner of the above-described motor vehicle 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, for a Duplicate Certificate of Registration and/or Substitute Decal issued by the Department of
Motor Vehicles of the State of Nevada.
In Testimony Whereof, the undersigned has hereunto set my hand on this _______day of ___________20_______
Signature of Applicant
Subscribed and sworn to before me on_________________
Date
Notary Public or Authorized Nevada DMV Representative
555 Wright Way
Carson City, NV 89711
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas area (702) 486-4DMV (4368)
dmvnv.com
PAYMENT AUTHORIZATION FORM
DO NOT EMAIL FORM
Debit or Credit Card Number
(one number per box)
-
-
-
Expiration Date
Payment Type:
Master Card
Visa
Discover Card
/
Month
Year
-----------------------------------------------------------------------------------------------------------------------
Cardholder Information
Printed Name
Payment
Cardholder Billing Address
Print your name as it appears on your card
Pursuant to NRS 353.1467, credit card
payments of $10,000 or more are not permitted
and cannot be split between multiple payments
and/or card types.
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
ADM-205 (Rev. 6/2019)
By signing this form, you give us permission to debit your account for the amount
indicated on or after the indicated date.
I au
thorize 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.
Do not email this authorization form. E-mail is NOT a secure form of transmittal to protect
your card information.
“
Office Use Only
Super Tran ID
Last four of Card Number
Technician Number
Comments:
Please remit $6.00 for each Registration Certificate.
If ordering by mail, you may also remit a check
or money order.
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APPLICATION FOR DUPLICATE CERTIFICATE OF REGISTRATION ANDOR SUBSTITUTE (Department of Motor Vehicles )

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Completed 24 December 2020

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