Form DMV-128 at a glance
What it is: DMV-128 (10/2026) is the Declaration Of Homeless Status.
Who signs: Sign on the Signature of Applicant line and write the Date.
What to bring and attach to Form DMV-128
This form must be submitted along with the DMV-002 (Application for Driving Privileges or ID Card).
A filled-in Form DMV-128 example: an applicant under 25 asks for an original license
How to fill out Form DMV-128, box by box
Your name and the Address Where I am Staying
Enter your Last Name (Please Print), First Name, Middle Name and Suffix.
Enter the Address Where I am Staying, with City, State and Zip Code.
25 And Older
If you are 25 And Older, mark Non-Commercial Driver's License, Instruction Permit or Identification Card under I am requesting a duplicate:.
Fees will be waived one time only and you must reimburse the Department the cost of the photo fee when you renew your card, if employed at that time.
Under 25
If you are Under 25, mark Original, Duplicate or Renewal under I am requesting an/a:.
Choose one: Non-Commercial Driver's License, Driver Authorization Card, Instruction Permit or Identification Card.
All fees for this issuance will be waived one time only and are not required to be reimbursed at any time.
More rules for Form DMV-128
Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed.
Common questions about Form DMV-128
Who signs it?
Sign on the Signature of Applicant line and write the Date.
Is there a penalty?
You further understand that any misstatement of facts may be a misdemeanor or felony under NRS 483.530 and may be punishable pursuant to NRS 193.130.
What am I certifying when I sign?
You certify under penalty of perjury that all statements in this application are true and correct. You agree and understand that any misstatement of material facts may cause cancellation and/or denial of your driver's license, instruction permit or identification card under NRS 483.420 and 483.530.
Sources
[1] Form DMV-128 (10/2026), Declaration Of Homeless Status, Nevada Department of Motor Vehicles (the Official source link on this page).