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REPORT OF SALE EXTENSION REQUEST NAC 482.565 and …

Occupational and Business Licensing 555 Wright Way Carson City, NV 89711 (775) 684-4690 OBL275 (11/2016) REPORT OF SALE EXTENSION REQUEST NAC and NAC (For Highway and Off-Highway Vehicle Dealers) Date: DMV License Number: Business Name: Mailing Address: Physical Address: Phone Number FAX Number DRS/ORS Number: Date of Sale: DRS/ORS Issuance Date: Year: Make: VIN: Reason EXTENSION is being requested (explain in detail): Requested by: Printed Name of Business Principal or Authorized RepresentativeSignature of Business Principal or Authorized Representative Title of Authorized Representative Instructions: requests must be submitted within the statutory time frame required for submission of theDRS/ORS: Twenty (20) days from the DRS issuance date on new highway vehicles. Thirty (30) days from the DRS issuance date on used highway vehicles.

Occupational and Business Licensing 555 Wright Way Carson City, NV 89711 (775( 684-4690 www.dmvnv.com OBL275 (11/2016) REPORT OF SALE EXTENSION REQUEST

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