VP 213 - Application for Salvage Title or Non …

1 555 Wright Way Carson City, NV 89711-0700 Reno/Sparks/Carson City (775) 684-4 DMV (4368) Las Vegas Area (702) 486-4 DMV (4368) Rural Nevada or Out of State (877) 368-7828 Signatures must be originals. Photocopies are not acceptable. Alterations or Erasure VOIDS this Document VP213 (Rev 06-16) Application FOR Salvage Title OR NON-REPAIRABLE CERTIFICATE NRS Please type or print in blue or black ink Insurance Company, Licensed Nevada Business, Wrecker or Recycler Information: Business Name Nevada DMV Business License Number or FEIN Physical Nevada Address Address City State Zip Code Current Mailing Address Address City State Zip Code Telephone: ( ) - Email Address Individual Information: Full Legal Name Nevada Driver s License, ID Number or DOB Physical Nevada Address Address City State Zip Code Current Mailing Address Address City State Zip Code Telephone: ( ) - Email Address Signature of Applicant Date The original, properly endorsed Certificate of Title , and/or other required documents, must be attached for the vehicle listed on this Application .

2 Vehicle Identification Number Year Make Model Insurance Company or Individual Owner: Please check appropriate box Please check if duplicate: Duplicate Licensed Wrecker Only: Salvage In compliance with NRS Total Loss Flood Damaged In compliance with NRS Non-Repairable Vehicle (No fee required for Non-Repairable Vehicle certificate) NOTE: A Non-Repairable Vehicle may only be processed as parts or scrap metal by a licensed automobile wrecker, dismantler, or recycler. State law prohibits a Non-Repairable Vehicle from being rebuilt, reconstructed, or restored for operating on the highways of Nevada. NOTE: Please include a check or money order for the $ Salvage Title fee, which includes a Technology fee for each Salvage Title requested. Licensed Nevada Automobile Wreckers are exempt from the Salvage Title fee.