Occupational and Business Licensing
555 Wright Way
Carson City, Nevada 89711-0100
(775) 684-4690
www.dmvnv.com
CHILD SUPPORT INFORMATION
Nevada Revised Statute 482.319 requires all professional and occupational licensing agencies to
request statements regarding child support from applicants for new licenses and for renewal of all
occupational licenses.
Each new business and occupational license applicant, business principal or salesperson applying for
a new or to renew his or her license must complete and sign the Child Support Information below.
Statute prohibits the Department from processing your application without submission of the
information below. Please mark the appropriate response and complete the remainder of the form.
Failure to mark one of the three and completion of the form will result in denial of the application.
I am not subject to a court order for the support of a child.
I am subject to a court order for the support of one or more children and am in
compliance with a plan approved by the district attorney or other public agency
enforcing the order for the repayment of the amount owed pursuant to the order;
or
I am subject to a court order for the support of one or more children and am not
in compliance with the order or plan approved by the district attorney or other
public agency enforcing the order for the repayment of the amount owed
pursuant to the order.
Applicant’s Social Security No.
Applicant's Name (please print)
Signature of Applicant
Date
Business or Occupational License Number
OBL268 (11/2011)
