Please print or type.
Business: Business Name, Business License Number, Address, City State Zip Code and Telephone Number.
Changes: to protect your business, notify the Department immediately of any changes to the above information.
No longer authorized: the form lists the printed names of agents who are no longer authorized to represent the business.
Principal: the form has the Printed Name of Principal, Signature of Principal and Date.
| Question | Answer |
|---|---|
| Form Name | Form OBL276 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 31 |
| Avg. time to fill out | 6 min |
| Edition | Rev 02/2022 |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | OBL276, OBL 276, Form OBL276, DMV Letter of Authorization, Nevada DMV authorization letter, authorization letter DMV |
| Official source | OBL276 (02/2022) |
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