OBL308 (10/2012)
Occupational and Business Licensing
555 Wright Way
Carson City, NV 89711
(775) 684–4690
www.dmvnv.com
LICENSEE / REGISTRANT ACKNOWLEDGEMENT
Please print or type
I ____________________________________ having made application with the Department of Motor
Name (please print)
Vehicles, for a business or occupational license, acknowledge that I have been provided with the
Department website address and directions on how to access the Nevada Revised Statute and
Nevada Administrative Code pertaining to the license/registration for which I am applying and have
been encouraged to review those laws and rules, since they affect the manner in which my business
is conducted.
445B & 482
& 490
487 & 597 (Body Shop
licensing.
Distributor, Long Term
Lessor, Manufacturer,
Rebuilder, Salesman,
Short Term Lessor and
licensing.
Salvage Pool and
Wrecker licensing.
DMV WEBSITE Select Business link for specific type of license.
www.dmvnv.com
NRS/NAC WEBSITE Select the appropriate NRS Chapter Link from this website.
www.leg.state.nv.us
Name: DMV Lic. #:
Mailing Address:
Street City State Zip
Physical Address:
Street City State Zip
Telephone Number: ( ) - Social Security #: - - Date of Birth:
Height: Weight: Hair: Eyes: Gender:
I certify under penalty of perjury that all information contained in this application is true and correct. I
agree to comply with all NRS/NAC requirements applicable to the license that I am applying for.
__________________________________________
Applicant’s Signature Date
__________________________________________
DMV Representative’s Signature Date