Occupational and Business Licensing
555 Wright Way
Carson City, NV 89711
(775) 684-4690
dmvnv.com
OBL275 (11/2016)
REPORT OF SALE EXTENSION REQUEST
NAC 482.565 and NAC 490.095
(For Highway and Off-Highway Vehicle Dealers)
Date:
DMV License Number:
Business Name:
Mailing Address:
Physical Address:
Phone Number
FAX Number
Date of Sale:
DRS/ORS Issuance Date:
Year:
Make:
VIN:
Reason extension is being requested (explain in detail):
Requested by:
Printed Name of Business Principal or Authorized Representative
Signature of Business Principal or Authorized Representative
Title of Authorized Representative
Instructions:
1. Extension requests must be submitted within the statutory time frame required for submission of the
DRS/ORS:
Twenty (20) days from the DRS issuance date on new highway vehicles.
Thirty (30) days from the DRS issuance date on used highway vehicles.
Thirty (30) days from the ORS issuance date on new or used off-highway vehicles.
2. A photocopy of the DRS/ORS must accompany this form.
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To Be Completed by Occupational and Business Licensing Personnel Only:
An extension of time for submitting this DRS/ORS has been granted until:
An extension of time for submitting this DRS/ORS has been denied for the following reason(s):
Not submitted within the statutory time frame.
A photocopy of the DRS/ORS was not attached.
A detailed explanation for the delay in submitting extension request is required.
The reason given for the extension is not sufficient to have an extension granted and has
been submitted to Compliance Enforcement Division office.
Request by or Signature line not completed.
Other:
Signed By:
Date: