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Compliance Enforcement Division
555 Wright Way
Carson City, NV 89711
(775) 684-4690
dmv.nv.gov
Report an ID Theft
Please read the following information before continuing:
Use this form to report identity theft to the Department of Motor Vehicles. You should also contact your
local law enforcement agency to file a police report. For more information regarding identity theft, please
visit the Nevada Identity Theft Program on the Attorney General’s website at:
http://ag.nv.gov/Hot_Topics/Victims/IDTheft/
The Nevada DMV is not able to investigate cases of this nature that occurred more than 3 years ago.
By initialing this checkbox, I acknowledge that I have read and agree to the guidance above ☐
My Information:
To ensure a complete and thorough investigation, your full name, address, social security number,
driver’s license and email are required to submit and process a fraud complaint.
Prefix: Suffix:
Social Security Number
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Driver’s License #
State:
Suite/Unit #
Zip: -
Zip:
Physical address:
Street:
City: State:
If your mailing address is different, please provide:
Street:
City: State:
Suite/Unit #
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Fraud Details:
Please provide the fraud details below:
Did you authorize anyone to use your name or personal information to obtain any DMV license,
registration, or service?
Yes
☐
No
☐
If yes, please explain:
CED13 11/2022
Phone: Email Address:
First Name:
Middle Name:
Last Name:
DOB:
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Compliance Enforcement Division
555 Wright Way
Carson City, NV 89711
(775) 684-4
690
dmv.nv.gov
My identification documents were:
Stolen
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Lost
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Other
What documents were Lost, Stolen, or Other?
Driver’s License
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Driver’s Authorization Card
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Social Security Card
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State ID
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Birth Certificate
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Other
Approximate date of occurrence:
Do you know who used your information/documents to get DMV services in your name?
Yes
☐
No
☐
If yes, please provide the individuals information:
First Name:
Last Name:
Phone:
Mobile Phone:
Email:
Fraud Explanation:
Describe the fraud that occurred and how the person gained access to your information:
Document Attachments:
Please remember to attach copies of your supporting documents prior to sending this form to the DMV.
Attestation:
☐
By checking this checkbox, I hereby attest that the information I provided is true, accurate and
complete. I understand that any falsification, omission, or concealment of material fact may subject
me to administrative, civil, or criminal liability.
Signature of Complainant:
Date:
Forward the completed form with attachments to your local Compliance Enforcement Division office as listed below.
SOUTHERN NEVADA
NORTHERN NEVADA
Department of Motor Vehicles
Department of Motor Vehicles
Compliance Enforcement Division
Compliance Enforcement Division
8250 West Flamingo Road
9155 Double Diamond Pkwy
Las Vegas, NV 89147
Reno, NV 89521
CED13 11/2022
