VP159 (Rev. 8/2012) Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed and witnessed.
INSTRUCTIONS
1. Complete a separate affidavit for each power unit or attach a list of all vehicles.
2. Have unladen vehicle or combination of vehicles weighed using a scale certified by the State Sealer of Weights and Measures
pursuant to NRS 706.141.
Note: DMV offices with scales are Certified Public Weigh Stations.
3. Farmer / Rancher Affidavit and weight certificate and / or weight receipt submissions:
3.a. Submit the completed affidavit, weight certificate or weight receipt and documents for registration in person to the
nearest DMV or where applicable, county assessor’s office, or by mail to the address below.
3.b. If the unladen weight exceeds 26,000 pounds, submit the completed affidavit, weight certificate or weight receipt and
documents for registration to the nearest DMV with a Motor Carrier Division. To find locations with a Motor Carrier
Division office check the internet at www.dmvnv.com
or mail to: Department of Motor Vehicles, Motor Carrier Division,
Licensing Section, 555 Wright Way, Carson City, NV 89711.
4. Nevada based carriers operating 100% in Nevada are not required to file quarterly special fuel tax returns. Interstate carriers,
with vehicles with a gross or combined gross weight in excess of 26,000 pounds, are required to file quarterly special fuel use
tax returns through the International Fuel Tax Agreement (IFTA). IFTA carriers are required to obtain a special fuel users
license.
Note: Effective January 1, 2010, a special fuel user’s license will no longer be required for 100% Nevada only
registered vehicles due to the passage of SB332
5. If the gross or combined weight exceeds 55,000 pounds an IRS Form 2290 Heavy Vehicle Use Tax must be filed.
6. An affidavit and weight certificate or weight receipt must be submitted:
• Upon original registration
• When the vehicle is altered or modified
• When the vehicle combination has been changed
Note: Neither the affidavit nor the weight certificate is required upon a renewal.
Please print or type
Vehicle Identification No.
Gross or Combined Gross Vehicle Weight
Nevada Driver’s License, Identification Card
Number, Date of Birth, or FEIN for businesses
Motor Carrier Account Number (if applicable)
Affiant’s Full Legal Name
County of _______________________
Signed and sworn to before me on ___________________
Date
By _________________________________
Signature of Affiant
______________________________________________
Signature of Notary Public or DMV Representative