DMV-002E Revised 6/2019
STOP
Affidavits and Signatures Must Be Witnessed by an Authorized DMV Representative
I hereby certify, under penalty of perjury, that all statements in this application are true and correct. I understand that any and all other
driver’s licenses or identification cards issued by any other jurisdiction will be surrendered upon issuance of a Nevada license or
identification card. I agree and understand that any misstatement of material facts may cause cancellation and/or denial of my license
or identification card under NRS 483.420 and NRS 483.530, respectively. I further understand that any misstatement of facts may be a
misdemeanor or felony under NRS 483.530 and may be punishable pursuant to NRS 193.130.
Applicant Signature _________________________________________________________________Date _________________________
Parent/Guardian Signature if Applicant is under 18 _________________________________________ DL/ID________________________
Sworn before me this ___________________ Day of _______________________________________________20___________________
Authorized DMV Representative/Notary Public ______________________________________________________________________
Signatures must be originals. Photocopies are not acceptable. Changes may not be made to this form once signed.
Unless you decline in writing, federal and state laws require this DMV transaction to serve as an application to register to vote
or update existing voter registration information and authorizes the transmission of information to the applicable election
officials. You may decline to use this transaction for voter registration on a form provided at the end of this transaction.
A voter registration record must indicate a major political party in order to vote for candidates in a primary election. You may
indicate your political party on the form provided at the end of this transaction.
Note: A new voter registration record will default to “nonpartisan” (no political party) unless a political party is indicated on the
form provided at the end of this transaction.
Your decision to apply, update or decline to use this transaction for voter registration will not affect the assistance or services
provided. Both the source of your information and decision to apply, update or decline to register to vote will remain
confidential and will only be used for voter registration purposes.
Voter registration may impact the following groups:
Uniformed Service Members should note changes to home of record for voting, and impacts on residency and/or tax status.
Confidential Voters might need to take additional action to prevent disclosure of public information.
Voting Rights are immediately restored for all felony convictions upon release from prison.
Are you a citizen of the United States of America?
Will you be 18 years or over on or before Election Day? YES NO → If No, are you 17 and would like to preregister?
If applicable, check one of the following:
Domestic Military (or military spouse or dependent) on active duty and absent from Nevada voting residence
Overseas Military (or military spouse or dependent) on active duty and absent from Nevada voting residence
Overseas Citizen residing outside the U.S. (not applicable to those traveling/vacationing outside the U.S.)
CONSENT FOR MINOR’S LICENSE: I consent to the issuance of an instruction permit/license to ,
whose relationship to me is . I understand I can be held responsible for any liability caused by
his/her negligence or willful misconduct in the operation of a motor vehicle (NRS 483.300 and/or NRS 486.101). I understand I
may have the permit/license cancelled & be released from liability by signing a cancellation request. I understand, before a
license is issued, he/she may need to present a DMV-301 Certification of Attendance, a Certificate of Completion from a Nevada
DMV-approved Driver Education Course, & a DLD-130 Beginning Driver Experience Log attesting he/she has completed at least
50 hours of behind-the-wheel driving experience.
INSTRUCTION PERMIT: I certify that I understand my instruction permit is valid for up to one (1) year from
date of issuance and I must carry it with me when I am driving. I understand the restrictions of my permit
and agree to follow them.
MINOR ORGAN DONOR: I, parent/guardian of minor applicant, understand unless the anatomical gift is
amended or revoked by the donor before his/her death, I may not amend or revoke the anatomical gift.
Parent/Guardian Signature
NON-USE OF NEVADA DRIVING PRIVILEGE: I have not operated a motor vehicle since: _________Date
NO SOCIAL SECURITY NUMBER: I certify I have never been assigned a Social Security Number under
the provisions of the Social Security Act of the United States.
DISCLOSURE STATEMENTS:
*The Privacy Act of 1974 is a federal law authorizing the use of your Social Security Number to verify identity. You are required
to submit your Social Security Number so the State may administer laws related to licensing drivers (NRS 483.290).
The driver’s license or identification card application you are submitting will cause any driving record from your previous State to
be transferred to Nevada and will show as surrendered. NRS 482.385 requires you to register each vehicle you own and operate
within 30 days of becoming a resident.
