STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 * (702) 486-4033
e-mail: realest@red.nv.gov * http://red.nv.gov/
03/20/17 Page 1 of 1 571B
APPLICATION FOR AN ORIGINAL OR RENEWAL OF AN
APPRAISAL MANAGEMENT COMPANY BRANCH OFFICE
The Branch Office registration must be renewed at the corresponding renewal date of the Appraisal
Management Company.
Check One Box: New Branch Office - Fee: $100.00 Renewal – Fee: $100.00
Branch Office Physical Location:
Street City State Postal Code
Mailing Address (if different from office location):
P.O. Box/Street City State Postal Code
A Principal, Partner, Officer, Director, or Trustee designated to act on behalf of the Appraisal Management Company
must authorize the contact person for each branch office. Indicate the contact person below and provide your signature:
The named contact person is authorized by herein named Appraisal Management Company to act on behalf of the
company at this branch office.
Print Name:_________________________________
Title:__________________________________
(Signature of Designated Principal, Partner, Officer, Director, or Trustee )
