Form DO-200 "Application for Window Tint Exemption" - Nevada

What Is Form DO-200?

This is a legal form that was released by the Nevada Department of Public Safety - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the Nevada Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DO-200 by clicking the link below or browse more documents and templates provided by the Nevada Department of Public Safety.

ADVERTISEMENT
ADVERTISEMENT

Download Form DO-200 "Application for Window Tint Exemption" - Nevada

Download PDF

Fill PDF online

Rate (4.8 / 5) 55 votes
Print Form
STATE OF NEVADA
DEPARTMENT OF PUBLIC SAFETY
Highway Patrol Division
Application for Window Tint Exemption
The following is an application for exemption from the Nevada Window Tint guidelines as set forth in NRS 484D.440;
NAC 484D.280 thru .290.
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. The approved document, or
copy of, must be carried in the vehicle at all times.
SECTION 1 - Application
.
* No window tint exemption less than 20% VLT will be approved by the Department of Public Safety
Name:
MI
First
Last
:
Mailing Address
Street/Road
City
State
Zip Code
Legal Address:
(if different)
Street/Road
City
State
Zip Code
Drivers License No:
Phone No:
Date of birth:
Please list the vehicle's for which this permit has been requested:
PRIMARY VEHICLE
Registered
Year:
Make:
Model:
Owner:
VIN:
Plate Number:
SECONDARY VEHICLE
Registered
Make:
Model:
Year:
Owner:
VIN:
Plate Number:
Form DO - 200, Window Tint Exemption Application (-)
Print Form
STATE OF NEVADA
DEPARTMENT OF PUBLIC SAFETY
Highway Patrol Division
Application for Window Tint Exemption
The following is an application for exemption from the Nevada Window Tint guidelines as set forth in NRS 484D.440;
NAC 484D.280 thru .290.
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. The approved document, or
copy of, must be carried in the vehicle at all times.
SECTION 1 - Application
.
* No window tint exemption less than 20% VLT will be approved by the Department of Public Safety
Name:
MI
First
Last
:
Mailing Address
Street/Road
City
State
Zip Code
Legal Address:
(if different)
Street/Road
City
State
Zip Code
Drivers License No:
Phone No:
Date of birth:
Please list the vehicle's for which this permit has been requested:
PRIMARY VEHICLE
Registered
Year:
Make:
Model:
Owner:
VIN:
Plate Number:
SECONDARY VEHICLE
Registered
Make:
Model:
Year:
Owner:
VIN:
Plate Number:
Form DO - 200, Window Tint Exemption Application (-)
STATE OF NEVADA
DEPARTMENT OF PUBLIC SAFETY
Highway Patrol Division
Please check the rationale for the application of this exemption:
MEDICAL (SECTION 2 MUST also be completed and submitted).
OTHER (SECTION 3 MUST also be completed and submitted).
Declaration: I hereby certify that the above information is true and correct and I am the Primary Driver of all
vehicles listed on this application. I further attest that I have read and understand the law surrounding my
application for exemption and agree to abide by the conditions outlined.
(It is a felony to knowingly make any false or
fictitious statement or entry on this form. If any such statement or entry is made, the signatory will be subject to criminal prosecution.)
Applicant Signature
Date signed
SECTION 2 - MUST BE completed by a currently licensed State of Nevada Physician
Clinical Diagnosis (explanation of exact nature of the impairment)
VLT Percentage
20%
Recommended Percentage of Visible Light Transmittance (VLT) for Applicant:
Recommended duration of permit for Applicant (check one):
4 - year permit (temporary condition)
Indefinite (permanent-stable condition)
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.
Physician's Signature
Physician's Name (please print)
Date
:
Mailing Address
City
Zip Code
State
Street/Road
License No:
Phone No:
Sheet 2 of 3
Form DO - 200, Window Tint Exemption Application (-)
STATE OF NEVADA
DEPARTMENT OF PUBLIC SAFETY
Highway Patrol Division
SECTION 3 - MUST BE completed by Applicant for NAC 484D.285 exemptions.
Please check the rationale for the application of this exemption:
The motor vehicle(s) referenced in this application are operated
Exclusively as an Ambulance or Hearse (Copy of the permit issued must be submitted).
by Fed, State or Local Law Enforcement for canine transportation ,surveillance, undercover or forensic purposes .
Declaration: I hereby certify that the above information is true and correct.
(It is a felony to knowingly make any false or
fictitious statement or entry on this form. If any such statement or entry is made, the signatory will be subject to criminal prosecution.)
.
* No window tint exemption less than 20% VLT will be approved by the Department of Public Safety
Applicant Signature
Date signed
Business/Agency Name:
:
Mailing Address
Street/Road
City
State
Zip Code
Drivers License No:
Phone No:
DEPARTMENT USE ONLY SECTION - DO NOT WRITE BEYOND THIS POINT
This letter of exemption is valid for the period indicated and must be carried, at all times, in the vehicle(s) described
above. If the vehicle is sold, this waiver is not transferable, and this letter must be returned to the Department of
Public Safety at the above-referenced address.
Exemption approved indefinitely.
Exemption approved for 4 years.
Visible Light Transmittance (VLT) for Application approved at:
VLT Percentage
20%
Signature DPS Director
Date
Name DPS Director
Signature NHP Chief
Date
Name NHP Chief
Page 3 of 3
Form DO - 200, Window Tint Exemption Application (-)
Page of 3