VP012 Rev APPLICATION FOR DUPLICATE NEVADA CERTIFICATE OF TITLE NSTRUCTIONS150 PLEASE READ CAREFULLYIf an original Nevada Certificate of Title has been lost stolen or mutilated a duplicate ti ID: 849827
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1 555 WRIGHT WAYCARSON CITY, NV 897110700R
555 WRIGHT WAYCARSON CITY, NV 897110700Reno/Sparks/Carson City (775) 6844DMV (4368)Las Vegas Area (702) 4864DMV (4368)dmvnv.com VP012 (Rev) APPLICATION FOR DUPLICATE NEVADA CERTIFICATE OF TITLE NSTRUCTIONS– PLEASE READ CAREFULLYIf an original Nevada Certificate of Title has been lost, stolen, or mutilated, a duplicate title may be applied for 30 days after the lastcertificate of title was issued. The application must be completed by the legal owner of ��APPLICATION FOR DUPLICATE NEVADA CERTIFICATE OF TITLE��VP012 (Rev 6/2021) Signatures must be originals. Photocopies are not acceptable. Changes may not be made to this form once it is signed. &#x/MCI; 0 ;&#x/MCI; 0 ;Please Print or Type Vehicle Identification Number Year Make Model NevadaLicense Plate Number ___________________________________Registered Owner(s)/ Lessee Name(s) – (as listed on latest certificate of title). more than two owners, complete and attach an additional Duplicate Title form. Full Legal Name First Middle Last Nevada Driver’s License, Identification Card Number, Date of Birth, or FEIN for businesses Physical Address Address City State Zip Code Mailing Address Address City State Zip Code Full Legal Name First Middle Last Nevada Driver’s License, Identification Card Number, Date of Birth, or FEIN for businesses Physical Address Address
2 City State Zip Code Mailing Address
City State Zip Code Mailing Address Address City State Zip Code Legal Owner – (as listed on latest certificate of titleif applicable) Lienholder Name N V Driver’s License, I D Card Number, Date of Birth, NV ELT # or FEIN for businesses Address Address City State Zip Code Lessor Name N V Driver’s License, I D Card Number, Date of Birth, or FEIN for businesses Address Address City State Zip Code Complete if certificate of title is to be mailed to an address other than the address listed above. If requested by a third party, other than a licensed Nevada Dealer, a notarized letter of authorization must be attached. Requested By Address Address City State Zip Code ERTIFICATION I hereby declare under penalty of perjury that the foregoing is true and correct. I certify that I am the legal owner of the described vehicle and the original Certificate of Title has been: Lost Stolen Mutilated Other Please ExplainState of Nevada, County of: __________________________ By: Date Signature of person making statement. If signing for a business, include company stamp or print the company name . Address Address City State Zip Code This instrument was acknowledged before me on_____________Date__________________________________________Notary Public orAuthorized Nevada DMV Representative 4 4 4 4 4 4 4 4