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Download Dmv 005 Template

The DMV 005 form serves as a Certification of Nevada Residency, essential for individuals claiming residency in Nevada. This form is necessary for obtaining a Driver’s License, Driver Authorization Card, or Identification Card. To ensure a smooth application process, fill out the DMV 005 form accurately and completely.

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Dmv 005 Example

Reno/Sparks/Carson City (775) 684-4DMV (4368)

Las Vegas Area (702) 486-4DMV (4368)

Rural Nevada (877) 368-7828

Fax: (775) 684-4992

Website: www.dmvnv.com

Certification of Nevada Residency

This certification is used to support a claim that you are a Nevada resident. You must be a resident of Nevada to be eligible for a Driver’s License (DL), Driver Authorization Card (DAC) or Identification Card (ID) [NRS 483.250 (7), 483.290 (5)(b), and 483.934]. The definition of “resident” is found in NRS 483.141.

This certification will be accepted as one form of evidence for your principal residence address.

Customer Information

Name

Residence Address

City

State

 

Zip

 

 

 

 

 

Mailing Address if different

City

State

 

Zip

 

 

 

 

 

DL/DAC/ID Number

Social Security Number (not required for a DAC)

 

 

 

 

 

 

An original or certified copy of any of the following documents must be submitted with this form. Each document must be dated within the previous 60 days or be the most current available.

A pr oper t y t ax r ecor d, ut ilit y bill, m or t gage docum ent or deed, r ent r eceipt , or a lease or r ent al agr eem ent

Enr ollm ent r ecor ds or st udent ident ificat ion car d fr om an educat ional inst it ut ion locat ed in Nev ada r eflect ing y our Nev ada r esidence addr ess

Mot el, hot el, cam pgr ound or r ecr eat ional v ehicle par k r eceipt s show ing t hat y ou hav e been r esiding in Nev ada for at least 3 0 consecut iv e day s

Or iginal, cur r ent cer t ificat e of v ehicle liabilit y insur ance issued by a Nev ada- based car r ier w hich r eflect s y our Nev ada r esidence addr ess ( CANNOT BE HANDW R IT T EN )

Cr edit car d st at em ent , m edical bill, cellular t elephone bill, or ot her st at em ent or r equest for pay m ent m ailed t o y our Nev ada r esidence addr ess

A st at em ent fr om a r elief agency or shelt er ( For m DMV1 1 5 ) t hat y ou hav e no act ual r esidence, but cur r ent ly r eceiv e assist ance in Nev ada

Vot er r egist r at ion car d issued by t he Nev ada Secr et ar y of St at e for t he m ost r ecent elect ion per iod w hich r eflect s y our Nev ada r esidence addr ess

Docum ent s show ing y ou hav e a cur r ent account at a bank or cr edit union in Nev ada

Milit ar y Leav e and Ear nings St at em ent ( LES) t o ev idence Nev ada r esidency w hen deploy ed out side of Nev ada

A docum ent show ing r eceipt of public assist ance fr om St at e of Nev ada agency

This certification must be signed by a second party attesting to Nevada residency if the applicant is not able to produce one of the above required documents with this certification. The second party must reside at the same residential address, accompany the applicant, and present proof of residency in the form of one document listed above.

DISCLOSURE STATEMENT: The Privacy Act as passed by the United States Congress authorizes the use of your Social Security number for the purpose of verifying your identity. This number must be provided and will be used in the administration of driver license laws as required by NRS 483.290. (This is not required for a DAC.)

I hereby certify under penalty of perjury that all statements in this application are true and correct. I agree and understand that any misstatement of material facts may cause cancellation and/or denial of my driver’s license or identification card under NRS 483.420 and NRS 483.530, respectively. I further understand that anymisstatement of facts maybe a misdemeanor or felonyunder NRS 483.530 and may be punishable pursuant to NRS 193.130.

Applicant’s Signature

 

Date

 

 

 

Signature of Additional Resident Attesting to Nevada Residency

 

Driver’s License or Identification Card No.

DMV-005 (Rev. 10/2013)

Guide to Writing Dmv 005

Completing the DMV 005 form is an important step for individuals seeking to certify their residency in Nevada. After filling out the form, it will need to be submitted along with supporting documents to verify your residency. Here are the steps to fill out the form correctly.

  1. Obtain the DMV 005 form from the DMV website or your local DMV office.
  2. Fill in your full name in the "Customer Information" section.
  3. Provide your residence address, including city, state, and zip code.
  4. If your mailing address is different from your residence address, fill in that information as well.
  5. Enter your Driver’s License (DL), Driver Authorization Card (DAC), or Identification Card (ID) number.
  6. Include your Social Security number. Note that this is not required for a DAC.
  7. Gather and attach an original or certified copy of one of the acceptable documents listed on the form, ensuring it is dated within the last 60 days or is the most current available.
  8. If you cannot provide the required documents, arrange for a second party to sign the certification, confirming your residency. This person must also provide proof of residency.
  9. Sign the certification statement to affirm that all information provided is true and correct.
  10. Date your signature.
  11. If applicable, have the additional resident sign and provide their Driver’s License or Identification Card number.

More PDF Documents

Understanding Dmv 005

What is the DMV 005 form used for?

The DMV 005 form is used to certify that you are a resident of Nevada. This certification is necessary for obtaining a Driver’s License (DL), Driver Authorization Card (DAC), or Identification Card (ID). It serves as proof of your principal residence address in the state, which is a requirement according to Nevada law.

What documents do I need to submit with the DMV 005 form?

When submitting the DMV 005 form, you must include an original or certified copy of specific documents that prove your Nevada residency. Acceptable documents include a utility bill, mortgage document, rental agreement, or a school enrollment record. These documents must be dated within the last 60 days or be the most current available. A full list of acceptable documents is provided on the form.

Is my Social Security number required when filling out the DMV 005 form?

Your Social Security number is required for the DMV 005 form if you are applying for a Driver’s License or Identification Card. However, it is not necessary for a Driver Authorization Card (DAC). This information is used to verify your identity as part of the application process.

What should I do if I cannot provide the required documents?

If you are unable to provide the necessary documents to prove your Nevada residency, a second party can attest to your residency. This individual must live at the same address as you, accompany you during the application process, and provide proof of their own residency using one of the acceptable documents listed on the form.

What happens if I provide false information on the DMV 005 form?

Providing false information on the DMV 005 form can lead to serious consequences. If any material facts are misrepresented, it may result in the cancellation or denial of your driver’s license or identification card. Additionally, such misstatements could be classified as a misdemeanor or felony under Nevada law, carrying potential legal penalties.

How do I contact the DMV for more information about the DMV 005 form?

If you have further questions about the DMV 005 form, you can contact the DMV directly. For the Reno, Sparks, and Carson City areas, call (775) 684-4DMV (4368). If you are in the Las Vegas area, dial (702) 486-4DMV (4368). Rural Nevada residents can reach the DMV at (877) 368-7828. Additionally, you can visit their website at www.dmvnv.com for more resources and information.

When was the DMV 005 form last updated?

The DMV 005 form was last revised in October 2013. It is important to use the most current version of the form to ensure that you meet all requirements and guidelines set forth by the Nevada DMV.

Common mistakes

  1. Failing to provide an original or certified copy of required documents. Each document must be dated within the last 60 days or be the most current available.

  2. Not including the Social Security number when required. This number is essential for verifying identity, except for a Driver Authorization Card.

  3. Incorrectly completing the applicant's name or residence address. Accuracy is crucial for processing the application.

  4. Using handwritten documents for vehicle liability insurance. Only original, current certificates issued by a Nevada-based carrier are acceptable.

  5. Neglecting to include a mailing address if it differs from the residence address. This can lead to communication issues.

  6. Forgetting to have a second party sign the certification if the applicant cannot provide required documents. This party must reside at the same address and present proof.

  7. Submitting documents that do not reflect a Nevada residence address. All evidence must clearly indicate residency in Nevada.

  8. Overlooking the signature section. Both the applicant and any additional resident must sign the form to validate the information provided.

Document Data

Fact Name Fact Details
Purpose The DMV 005 form certifies Nevada residency, which is essential for obtaining a Driver’s License, Driver Authorization Card, or Identification Card.
Governing Laws This form is governed by Nevada Revised Statutes (NRS) 483.250, 483.290, and 483.934.
Supporting Documents Applicants must submit an original or certified copy of specific documents, such as utility bills or rental agreements, dated within the last 60 days.
Second Party Requirement If an applicant cannot provide the necessary documents, a second party must attest to their residency, presenting proof of residency themselves.
Privacy Act Compliance The form complies with the Privacy Act, allowing the use of Social Security numbers for identity verification, although it's not required for a Driver Authorization Card.
Penalties for Misstatement Misstatements on this form may lead to cancellation of the driver's license or identification card and could be classified as a misdemeanor or felony under NRS 483.530.

Documents used along the form

The DMV 005 form is a crucial document for individuals seeking to certify their residency in Nevada. Along with this form, several other documents may be required to provide sufficient proof of residency. Below is a list of commonly used forms and documents that often accompany the DMV 005 form.

  • Utility Bill: A recent utility bill, such as electricity or water, can demonstrate that you reside at a specific address in Nevada. It must be dated within the last 60 days to be considered valid.
  • Lease or Rental Agreement: A signed lease or rental agreement serves as proof of residency. This document outlines the terms of your rental arrangement and must clearly indicate your Nevada address.
  • Non-disclosure Agreement Form: This vital document is essential for protecting sensitive information between parties. For more details, visit arizonapdfforms.com/non-disclosure-agreement.
  • Voter Registration Card: This card, issued by the Nevada Secretary of State, confirms your registration to vote in Nevada. It must display your name and address as a resident of the state.
  • Military Leave and Earnings Statement (LES): For military personnel stationed outside Nevada, the LES can verify residency when it reflects a Nevada address. This document is essential for those who may not have other forms of residency proof.

These documents collectively support the application process for obtaining a driver's license, identification card, or driver authorization card in Nevada. Ensuring that all required documents are submitted accurately will facilitate a smoother application experience.

Similar forms

The DMV 005 form serves as a certification of residency in Nevada, essential for obtaining a driver's license or identification card. Several other documents share similarities with this form in terms of their purpose and requirements. Here is a list of those documents:

  • Utility Bill: Like the DMV 005 form, a utility bill can serve as proof of residency. It must be current and show the individual's name and Nevada address.
  • Lease Agreement: A lease agreement is similar in that it provides evidence of residency. It must be signed and dated, confirming the individual’s residence in Nevada.
  • Articles of Incorporation: This document formally establishes a corporation in California, requiring details such as company name and purpose, similar to how the DMV 005 verifies residency; for more information, visit legalformspdf.com.
  • Voter Registration Card: This card confirms residency and is issued by the state. It must reflect the individual's current Nevada address, similar to the DMV 005 form's requirements.
  • Bank Statement: A current bank statement showing a Nevada address can also serve as proof of residency. This document must be official and contain the individual's name and address.
  • Mortgage Document: A mortgage document provides evidence of residence ownership in Nevada. It must be current and include the individual's name and address.
  • Military Leave and Earnings Statement (LES): This document can verify residency for military personnel stationed outside of Nevada. It must indicate the individual’s Nevada residence.
  • School Enrollment Records: Enrollment records from a Nevada educational institution can demonstrate residency. These documents must show the individual's name and Nevada address.
  • Public Assistance Receipt: A document showing receipt of public assistance from a Nevada agency can serve as proof of residency. It must be official and current.
  • Insurance Policy Document: A current vehicle liability insurance policy issued by a Nevada-based carrier can validate residency. The document must clearly reflect the individual's Nevada address.

Each of these documents functions similarly to the DMV 005 form by providing evidence of residency in Nevada, which is crucial for various legal and administrative purposes.