MC 101 Application for Farm License Plate and Decal

Brian Sandoval
Terri L. Albertson
Governor
Director
Motor Carrier Division
555 Wright Way
Carson City, Nevada 89711-0600
Telephone (775) 684-4711
Fax Number (775) 684-4619
www.dmvnv.com
February 22, 2016
IMPORTANT – PLEASE READ CHANGES TO
FARM “IMPLEMENTS OF HUSBANDRY” PLATE
(FARMERS & RANCHERS)
To: All Farm “Implements of Husbandry” Permanent License Plate Applicants
The 2015 Legislative Session enacted SB155, a portion of which changed the definition of
“Implements of Husbandry” in NRS 484D.020 and added a requirement to display a farm plate or
USDOT approved slow moving vehicle triangle on any implement of husbandry operated on
public highways in this state.
Before you apply for the farm plate you must verify the unit you seek to identify as an Implement of
Husbandry qualifies for the Farm Plate. The revised NRS 484D.020 is provided at the bottom of this
notice for your convenience. Once the plates are issued; they are NON-REFUNDABLE and NONTRANSFERABLE, even if it is later determined the vehicle was improperly identified as an implement of
husbandry.
Please note: Farm Vehicles do not qualify as an implement of husbandry if used even incidentally:
1) For both personal and agricultural purposes;
2) To transport persons or commodities from field to processing plants;
3) In interstate commerce.
Applicants must be an agricultural user with a minimum gross income of $5,000 from agricultural
pursuits during the immediately preceding calendar year, NRS 361A.030.
The agricultural user must hold a policy of liability insurance which provides at least $300,000 in
coverage for bodily injury and property damage resulting from any single accident caused by the
agricultural user while operating implement of husbandry, NRS 482.276.
The total cost for each Farm Plate is $105.00, which includes, the $100 lifetime fee and applicable
plate and technology fees.
If you have any questions about this change in procedure, please contact the Tax and Licensing
Team at (775) 684-4711, option 1.
NRS 484D.020
1.“Implement of husbandry” means a vehicle manufactured, designed or reconstructed exclusively for
agricultural operations and primarily designed for off-highway use. An implement of husbandry is not subject
to registration if used upon the highways of this State. 2. The term includes:
(a) A farm vehicle that is used by a farmer or rancher exclusively for agricultural purposes on the farm
or ranch of the farmer or rancher;
(b) A farm tractor;
(c) A self-propelled application-type vehicle, including a combine, self-propelled forage harvester or
self-propelled fertilizer application implement;
(d) A farm wagon, farm trailer or trailer adapted to tow or pull another implement of husbandry;
(e) Any vehicle used by a farmer or rancher exclusively to feed or water livestock; and
(f) Any other equipment substantially similar to the equipment described in paragraphs (a) to (e),
inclusive, and used to transport agricultural products necessary for agricultural production.
3. The term does not include:
(a) Except as otherwise provided in paragraph (a) of subsection 2, a farm vehicle;
(b) A truck tractor, motor truck or any vehicle designed for use on a controlled access highway;
(c) Any vehicle used in the operation of a common motor carrier or contract motor carrier;
(d) Any vehicle used for both personal purposes and agricultural purposes;
(e) Any feed or water truck used even incidentally for purposes other than agricultural purposes; or
(f) Any vehicle which is registered for operation interstate pursuant to chapter 706 of NRS.
4. As used in this section, “farm vehicle” has the meaning ascribed to it in NRS 482.036.
MOTOR CARRIER DIVISION
555 WRIGHT WAY
CARSON CITY, NV 89711-0600
(775) 684-4711
FAX (775) 684-4619
www.dmvnv.com
APPLICATION FOR FARM “IMPLEMENTS OF HUSBANDRY”
PERMANENT LICENSE PLATE
Registration Year:
Registration Information:
20
Registrant Name (Legal Business Name)
Account Number
Principal’s Full Legal Name and Title
Principal’s Driver License Number
Contact Name and Title
Federal Employer Identification Number (FEIN)
(
Federal DOT Number (if applicable)
)
Telephone Number
Physical Address
City
State
Zip
Mailing Address (If different from the physical)
City
State
Zip
Please check the appropriate type of application:
 Initial Issuance $105 (Farm Plate fee $100, Plate Production fee $3.50, Prison Industry fee $0.50 & Technology fee $1.00)
 Substitute/Replacement $10 (Cab Card $5.00, Plate Production fee $3.50, Prison Industry fee $0.50 & Technology fee $1.00)
 Surrender (Plate needs to be returned to Motor Carrier Division)
General Information
Applicant must be an agricultural user with a minimum gross income of $5,000 from agricultural pursuits during the
immediately preceding calendar year, NRS 361A.030.
The agricultural user is the holder of a policy of liability insurance which provides at least $300,000 in coverage for bodily
injury and property damage resulting from any single accident caused by the agricultural user while operating the implement
of husbandry, NRS 482.276.
Applicant must complete this form and submit it to the Department along with a photo of the equipment; copies of any
ownership documents (if available); and evidence of a liability insurance policy of $300,000. Applicants must surrender any
plates issued if the vehicle is sold and/or insurance coverage for the vehicle is cancelled.
The Farm plate is a permanent plate. Once issued, they are NON-REFUNDABLE and NON-TRANSFERABLE.
A completed vehicle application Schedule B form (MC003) must accompany this application in order to be
processed.
PLEASE NOTE: THIS APPLICATION MUST BE SIGNED OR IT WILL BE RETURNED TO YOU
Printed Full Legal Name (and title if applicable)
(
Phone #
)
Date Received
MC 101 (03/2016)
Signature
Date
Date
E-Mail Address
Date Approved
For Office Use Only
Date Issued
Initials
Account #
Fleet #
MOTOR CARRIER DIVISION
555 WRIGHT WAY
CARSON CITY, NV 89711-0600
(775) 684-4711
fax (775) 684-4619
www.dmvnv.com
LICENSE YEAR
VEHICLE APPLICATION: SCHEDULE B
ACCOUNT #
FULL LEGAL NAME
ADDRESS
CITY, STATE, ZIP
FLEET #
Check here for address change
☐ IFTA
☐ IRP
☐ NV Only
☐ Permanent Trailer (only full & semi-trailers)
All fields below must be completed. Please write “N/A” for fields that do not apply:
TRANS CODE
(1)
VEHICLE
(7)
FUEL
(8)
A-ADD
TR-TRACTOR
D-DIESEL
C-CHANGE
TK-TRUCK
(SINGLE)
G-GAS
D-DELETE
BS-BUS
P-PROPANE
R-REFUND
ST-SEMI
TRAILER
O-OTHER
T-TRANSFER
FT-FULL
TRAILER
1
2
3
4
5
6
7
8
9
10
11
12
13
14
TRANS
CODE
NEVADA
COUNTY
PLATE #
OPERATOR'S
VEHICLE #/
UNIT #
YEAR AND
MAKE
SERIAL OR VIN #
VEHICLE
TYPE
FUEL
TYPE
#OF
AXLES/
SEATS
#OF
COMBINED
AXLES
UNLADEN
WEIGHT
COMBINED
DECLARED
GROSS WEIGHT
ACTUAL
PURCHASE
PRICE
ORIGINAL
PURCHASE
PRICE OR
FACTORY PRICE
NUMBER OF IFTA DECALS IF REQUIRED?
OFFICE USE ONLY
NO. OF REG> MOS.
SUPP. NO.
DATE
INITIALS
15
16
PURCHASE LEASE DATE
DATE
17
18
LESSOR
STATE
TITLED
IF MORE THAN THE VEHICLES LISTED ABOVE PLEASE EXPLAIN
UNDER PENALTIES OF PERJURY, THE APPLICANT DECLARES THAT THE INFORMATION GIVEN IS TO THE BEST OF THE APPLICANT'S KNOWLEDGE TRUE, ACCURATE AND COMPLETE. THE APPLICANT AGREES TO COMPLY WITH REPORTING,
PAYMENT, RECORD KEEPING AND LICENSE DISPLAY REQUIREMENTS AS SPECIFIED IN THE INTERNATIONAL FUEL TAX AGREEMENT, THE INTERNATIONAL REGISTRATION PLAN, AND THE NEVADA REVISED STATUTES. THE APPLICANT
FURTHER AGREES THAT THE MOTOR CARRIER DIVISION MAY WITHHOLD ANY REFUNDS DUE IF THE APPLICANT IS DELINQUENT ON PAYMENT OF ANY FEES DUE THE DEPARTMENT OR FUEL TAXES DUE TO ANY MEMBER JURISDICTIONS.
FAILURE TO COMPLY WITH THESE PROVISIONS SHALL BE GROUNDS FOR REVOCATION OF LICENSE IN NEVADA AND ALL MEMBER JURISDICTIONS. THE APPLICANT UNDERSTANDS AND AGREES TO COMPLY WITH THE HAZARDOUS
MATERIAL AND MOTOR CARRIER SAFETY REGULATIONS. THE APPLICANT AGREES TO MAINTAIN INSURANCE PURSUANT TO NRS 485.185 AND 706.291 AND WILL COMPLY WITH THE MOTOR CARRIER SAFETY REGULATIONS.
Full Legal Name
Signature
Title
APPLICATION MUST BE SIGNED OR IT WILL BE RETURNED TO YOU
MC003 (08/2014)
Date
Telephone #
(
)