VP-242 (8/2012) Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed and witnessed.
TRUST AFFIDAVIT FOR EXEMPTIONS
Nevada Revised Statute 371.101 through 371.103 allows for certain qualifying individuals to obtain an
exemption against Governmental Services Tax owed if they have “ownership interest” in a vehicle.
A person wishing to use a Governmental Services Tax Exemption must present to the Department an
exemption voucher for “Motor Vehicle or Personal Property” obtained from the Assessor in their
county of residence.
The affiant completing this affidavit must be the same person named on the exemption certificate.
“Ownership interest” means the affiant claiming the exemption is a current registered owner.
However, their name is not listed on the registration certificate because the vehicle is registered in the
name of their trust.
Please print or type
I,___________________________________________________ declare that I have an ownership
interest in the vehicle described below and I am a direct participant in the Trust of
______________________________________________________________________________
Name of Trust
The affiant has an ownership interest and is claiming an exemption against Governmental Services
Tax for the vehicle described below.
Year _______________Make ________________Model ________________
Vehicle Identification Number ________________________________________________________
I declare under penalty of perjury that the foregoing is true and correct.
Affiant’s Printed Full Legal Name ______________________________________________________
Nevada Driver’s License, Identification Card
Number, Date of Birth, or FEIN (Business only) ___________________________________________
Physical Address _______________________________________________________________________________
City State Zip Code
Mailing Address _________________________________________________________________________________
City State Zip Code
State of Nevada, County of _____________________
Signed and sworn to before me on _______________
Date
By _________________________________
Signature of Affiant
______________________________ Notary Stamp
Notary Public or Authorized Nevada DMV Representative
555 WRIGHT WAY
CARSON CITY, NV 89711
Reno/Sparks/Carson City (775) 684-4DMV (436
8)
Las Vegas Area (702) 486-4DMV (4368)
dm
vnv.com
