Fillable Electronic Lienholder Reassignment Affidavit (Department of Motor Vehicles )

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Electronic Lienholder Reassignment Affidavit (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)
dmvnv.com
VP- 268 1/2016
Electronic Lienholder Reassignment Affidavit
This affidavit must be completed to request an Electronic Lienholder Reassignment.
The current electronic title(s) will not be changed to reflect the new lienholder.
The lienholder reassignment will allow the reassigned lienholder to:
Request a printed title with the assigning lienholder listed or;
Release a lien on a title for the assigning lienholder.
All areas must be completed in full, either typed or printed in ink.
This affidavit must be notarized or witnessed by an authorized Nevada DMV representative.
Documentation must be submitted with this affidavit that grants the authority for the lienholder reassignment.
Please note any alteration or erasure will require a new form be completed.
I,
Printed Full Legal Name
Title or Position
hereby swear under penalty of NRS 482.545, that the following assertions are true of my own personal knowledge:
Current Lienholder Information
Lienholder Name
Nevada ELT #
FEIN
Address
City
State
Zip Code
Reassigned To Lienholder Information
Lienholder Name
Nevada ELT #
FEIN
Address
City
State
Zip Code
Requested Date of Reassignment
Signature
State of Nevada, County of
Subscribed and sworn to before me on
by
Date
Name of person making statement
Notary Public or Authorized Nevada DMV Representative
Notary Stamp
Office Use Only
Approved by
Tech Number
Date
Office
Phone
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Electronic Lienholder Reassignment Affidavit (Department of Motor Vehicles )

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Completed 24 December 2020

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