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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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
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)
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.
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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.
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.
Not including the Social Security number when required. This number is essential for verifying identity, except for a Driver Authorization Card.
Incorrectly completing the applicant's name or residence address. Accuracy is crucial for processing the application.
Using handwritten documents for vehicle liability insurance. Only original, current certificates issued by a Nevada-based carrier are acceptable.
Neglecting to include a mailing address if it differs from the residence address. This can lead to communication issues.
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.
Submitting documents that do not reflect a Nevada residence address. All evidence must clearly indicate residency in Nevada.
Overlooking the signature section. Both the applicant and any additional resident must sign the form to validate the information provided.
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.
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.
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:
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.