555 Wright Way
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas Area (702) 486-4DMV (4368)
dmvnv.com
VP203 (9/2017) Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed.
NON-RESIDENT, ACTIVE DUTY MILITARY GOVERNMENTAL SERVICES TAX EXEMPTION AFFIDAVIT
Requirements to Claim Exemption - This form and a copy of a Leave Earnings Statement (LES) showing the home state is one other
than Nevada and is dated within the previous 30-days; these must be presented during each registration period. Confidential
information may be blacked out on the LES. If the exemption is being claimed by mail, the LES will not be returned.
(Please type or print)
Part 1 Must be completed by Commander or Authorized Officer
I hereby certify that I have examined the service record of (full legal name of active duty military servicemember)
________________________________________________________________________________________________,
First Middle Last
Rank ________________________________, driver’s license or ID card number _________________________ issued in
the State of____________________________, and a member of ____________________________ unit and is assigned
to duty at ________________________________________________________________________________, installation
effective ____________________________.
Date Ordered to Duty Station
I declare under penalty of perjury that the foregoing is true and correct.
___________________________________________________________ ________________________________
Printed Name of Commander or Authorized Officer Rank
___________________________________________________________ ________________________________
Signature (in ink) Date
(______)____________________________________________________ ________________________________
Telephone Number (Mandatory) Email Address
Part 2 Must be completed by non-resident active duty servicemember claiming exemption
Under the provisions of the Servicemember’s Civil Relief Act of 2003 and the United States Supreme Court decision in the
case of California vs. Buzard, 382 U.S. 386 (1966), I hereby claim exemption for Governmental Services Tax on the
described vehicle registered in _____________________________________ County, State of Nevada.
_________________________________________________________________________________________________
Year Make Model License Plate Number
Vehicle Identification Number
Full Legal Name______________________________________________________________________
First Middle Last
Email Address _____________________________________________________________________________________
Physical Address _____________________________________________________________________
Address City State Zip-Code
Mailing Address _____________________________________________________________________
Address City State Zip-Code
Telephone Number (_____) ____________________________________
I declare under penalty of perjury that the foregoing is true and correct.
__________________________________________________ __________________________
Signature (in ink) Date
