555 WRIGHT WAY
CARSON CITY, NV 89711
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas Area (702) 486-4DMV (4368)
dmv
vnv.com
Moped / Motorcycle Declaration
NRS 482.070
The vehicle identified below is a motorcycle and not a moped due to the following reason(s):
Check 3 all that apply
Travels faster than 30mph
on a 1% grade
Greater than 2 horsepower Engine Greater than 50cc
Please print or type
Applicant’s Full Legal Name ___________________________________________________________________
First Middle Last
Nevada Driver’s License, Identification Card
Number, Date of Birth, or FEIN (Business only) ____________________________________________________
Applicant’s P
hysical Address ___________________________________________________________________
City State Zip Code
Applicant’s Mailing Address ____________________________________________________________________
City State Zip Code
Daytime Telephone No. (______)______________________
Vehicle Identification Number or DMV Assigned Identification Number
Year _____
____________ Make_______________ Model _________________
Importan
t: By signing this declaration I understand I may not return at a later date for a refund by claiming my
motor vehicle is a moped and not a motorcycle. Once classified as a motorcycle the vehicle may not be returned
to exempt status as a moped.
I declare and affirm that the above information is tru
e and correct to the best of my knowledge. I have read the
above paragraph titled “Important” and agree to the terms of that paragraph.
Signature of Applicant ________________________________________________________________________
VP238 (6/2011)
