Fillable Central Services Division 555 Wright Way Carson City, (Department of Motor Vehicles )

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Central Services Division 555 Wright Way Carson City, (Department of Motor Vehicles )

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Central Services Division
555 Wright Way
Carson City, NV 89711
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas Area (702) 486-4DMV (4368)
Fax: (775) 684-4829
dmvnv.com
DLD-33 (Revised 9/2016)
Signatures must be originals. Photocopies are not acceptable
.
Changes may not be made to this form once it is signed.
Signed and sworn to before me this
day of
20
day
month
year
By
ONE YEAR DEFAULT AFFIDAVIT
(NRS 485.230)
Driver’s License Number:
Date of Crash:
Case #:
Date of last payment:
I, hereby request the termination of the suspension of my driving privilege and/or vehicle registration
in the State of Nevada, as provided for in the Motor Vehicle Insurance and Financial Responsibility
Act, and in support of said request. I submit the following affidavit:
I, the undersigned, being first duly sworn, depose and state:
That my driving privilege and/or motor vehicle registration was/were suspended on
___________________ in connection with the crash described above; and
That one year has elapsed following the date of the last payment on the promissory note signed
by myself in regards to this case; and
That during this period no legal action has been instituted and/or is pending against me involving
any claim for damages or injuries arising out of this crash and/or case.
Signature:
Mailing address:
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Central Services Division 555 Wright Way Carson City, (Department of Motor Vehicles )

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Completed 24 December 2020

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