Inspector Of Structures Change printable pdf download

Inspector Of Structures Change

STATE OF NEVADA

DEPARTMENT OF BUSINESS AND INDUSTRY

REAL ESTATE DIVISION

2501 East Sahara Avenue, Suite 102 * Las Vegas, NV 89104-4137 * (702) 486-4033

e-mail: realest@red.nv.gov

INSPECTOR OF STRUCTURES CHANGE

COMPANY NAME CHANGE, COMPANY ADDRESS CHANGE, and PERSONAL NAME CHANGE

INSTRUCTIONS and FEE:

a) Fee $20.00 per section required. Cash in exact change; check or certified funds, made payable to the NRED, are accepted.

b) Attach the original certificate to this form.

c) Attach any other proof required noted in a specific section below.

*Only information deemed by law to be confidential shall be confidential (SSN, exam results). Most information provided by an applicant

for licensure is public information and must be provided upon request. By policy, the Real Estate Division shall post (via the web site) and

sell licensee lists which include the licensee’s name, business address (even if same as home address), and business telephone number.

FEE $20.00

Date:

Certificate #:

_____________________________

IOS._______________________

Name:

_____________________________________

Phone #: ________________________________

(First and Last)

Include area code

Home address:*_____________________________________________________________________________

Mail address:*______________________________________________________________________________

(Please do not complete this form for personal address updates. Email your personal address and license number to realest@red.nv.gov )

2. COMPANY NAME AND/OR ADDRESS CHANGE

: a) Attach the “Location of Records” Form 575. b)

Any change of company name must provide proof of E/O and General liability insurance. The insurance binder must include

the new company and your personal name as the insured.

Company Name:

Address:

(No. & Street, City, State, Zip Code)

Mailing Address (if applicable):

(P O Box, City, State, Zip Code)

Telephone number:

Email address:*

3. PERSONAL NAME CHANGE

Provide proof; such as a copy of a marriage certificate; divorce decree; or

court order.

From:

(First and Last)

To:

(

First and Last)

(List your full name as you wish it to appear on your certificate, license, permit, or registration.)

Revised: 06/09/11

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Inspector Of Structures Change

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