Fillable TWO YEAR AFFIDAVIT Central Services Division 555 Wright (Department of Motor Vehicles )

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TWO YEAR AFFIDAVIT Central Services Division 555 Wright (Department of Motor Vehicles )

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Central 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
dmvnv.com
DLD-93 (Revised 9/2016)
Signatures must be originals. Photocopies are not acceptable
.
Changes may not be made to this form once it is signed.
TWO YEAR AFFIDAVIT
(NRS 485.190)
Case Number:
Crash Date:
Driver License Number:
I hereby request the termination of the suspension of my driving and/or registration privilege in the State
of Nevada, as provided for in the Motor Vehicle Insurance and Financial Responsibility Act, and in
support of said request, I submit the following affidavit:
I, the undersigned, being first duly sworn, depose and state:
1. My driving and/or motor vehicle registration was/were suspended in connection with the
crash described above.
2. Two years have elapsed following the date of the crash and during such period, no action at
law has been instituted and is pending against me involving any claim for damages or injuries
out of said crash.
Signature:
Mailing Address:
Signed and sworn to before me this
day of
20
day
year
By
Notary Public or Authorized Nevada DMV Representative
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TWO YEAR AFFIDAVIT Central Services Division 555 Wright (Department of Motor Vehicles )

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Completed 24 December 2020

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