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STATE OF NEVADA - dmvnv.com

DEPARTMENT OF PUBLIC SAFETYH ighway Patrol DivisionThe following is an application for exemption from the NEVADA Window Tint guidelines as set forth in NRS ; NAC thru .290. Street/Road Street/Road City STATE City STATE Please list the vehicle's for which this permit has been requested:Form DO - 200, Window Tint Exemption Application (-)Application for Window Tint ExemptionName:FirstSTATE OF NEVADAMIM ailing Address:Legal Address: (if different)Phone No:Drivers License No:Date of birth:Registered Owner:Make:Model:PRIMARY VEHICLEYear:VIN:Plate Number:Registered Owner:Make:Model:SECONDARY VEHICLEVIN:Plate Number:Year:A completed application must be submitted to: NEVADA Highway Patrol, Department of Public Safety 555 Wright Way, Carson City 89711 If approved, the original will be forwarded back to the applicant and serve as authorization for exemption to the window tint law based on identified and approved criteria set forth in this document.

Declaration: I hereby certify it is a medical necessity that the windows of the aforementioned motor vehicle (s) be tinted for the purpose stated above for said Applicant's medical condition. DEPARTMENT OF PUBLIC SAFETY

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