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/
03/20/2017 Page 1 of 2 760
APPLICATION FOR RENEWAL OF THE
ASSET MANAGER PERMIT
RENEWAL FEE: $75.00
Renewal will be accepted by postmark up to midnight of the below expiration date. Permit holders applying for
renewal after midnight of the below expiration date must re-apply with a new application.
Payment in the form of cash, check, or money order made payable to the Nevada Real Estate Division is accepted.
APPLICANT NAME (Please print) ________________________________________________________
PERMIT NUMBER: ASMP.________________________ EXPIRATION DATE: ______/______/______
CURRENT RESIDENT ADDRESS: (Information provided below will not update the business address on
your permit.)
__________________________________________________________________________________________
Street address unit # (if applicable)
__________________________________________________________________________________________
City, State, Zip Code
___________________________ ______________________________________________________
(Area Code) Telephone Number
Email Address: (Mandatory- For Real Estate Division use only)
QUESTIONS: Please check one box.
1. YES NO Have you been convicted of a misdemeanor, gross misdemeanor, or felony within your
renewal period? If the answer is yes, you are required to attach a written explanation and appropriate court
documents.
2. CHILD SUPPORT: Pursuant to NRS 645H.550, the following statement MUST be answered and
signed. Your application for the issuance or renewal of this license will be denied if you do not indicate on
the statements which of the provisions apply to you.
I AM NOT SUBJECT to a court order for the support of a child.
I AM SUBJECT to a court order for the support of one or more children and I am IN COMPLIANCE
with that order or a plan approved by the District Attorney or other public agency enforcing the order for
the repayment of the amount owed in that order.
I AM SUBJECT to a order for the support of one or more children and I am NOT IN COMPLIANCE
with that order or a plan approved by the District Attorney or other public agency enforcing the order for
the repayment of the amount owed in that order.
I herby certify under penalty of perjury that the answers contained in this statement are true and correct. I understand
that if I am subject to a court order for support of one or more children and I am not in compliance with that order or
a plan, my application for a renewal of the permit will be denied.
I further certify that I will faithfully comply with all the statutes and regulations of the State of Nevada pertaining to
the conduct of Asset Managers in the State of Nevada.
Signature of Applicant: ________________________________________ Date: ______/_____/______
