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

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

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Field 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
Website: dmvnv.com
VOLUNTARY LICENSE/IDENTIFICATION CARD SURRENDER
I hereby voluntarily surrender my Nevada driver’s license or identification card to the Department of Motor
Vehicles.
Printed Name DL/ID Card No.________________________
AS IT APPEARS ON SURRENDERED CARD
Address Date of Birth____________
Reason: Insurance Reasons Moving out of Nevada
Confidential Medical Purposes Choose not to drive
Other
Signature of Person Surrendering Card Date
Field Services Representative Date
DP-5(9/2015)
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Field Services Division 555 Wright Way Carson City, (Department of Motor Vehicles )

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Completed 24 December 2020

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