STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 / (702) 486-4033
realest@red.nv.gov / http://red.nv.gov
Revised 1/24/2020 Page 1 of 2 Form 630
APPLICATION FOR THE RENEWAL OF
A COMMUNITY MANAGER
Renewals postmarked up to midnight of the expiration date are accepted. Late renewals incur an additional $50.00 fee.
Complete and attach the “Consent to Service of Process” Form 656 if a non-Nevada resident status occurred during your
renewal period.
Acceptable forms of payment are cash (exact currency), check, cashier check or money order made payable to the Nevada Real
Estate Division. Credit cards are accepted for in person transactions.
Attach eighteen (18) hours of continuing education. Copies of the certificates are accepted.
NEW: Attach list of any gifts, incentives, gratuities, rewards or other items of value received worth over $15.
RENEWAL FEE: $200.00
Applicant Name (please print):
License Number: Expiration Date:
Current Status (check one box): Active Inactive
Company Name:
RESIDENCE ADDRESS
Home Address:
Number, street, apartment number, city, state, zip code
Mailing Address (if applicable):
Number, street, apartment number, city, state, zip code
Phone: Email Address:
REQUIRED FOR ALL LICENSEES:
Check one box in each 1 & 2 that applies to you:
1. Have you been convicted of a misdemeanor, gross misdemeanor, or felony within your renewal period? If you
answered yes, attach an explanation and appropriate court documents.
YES NO
2. Pursuant to NAC 116A.450, 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 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 an order for the support of one or more children and 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.
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 / (702) 486-4033
realest@red.nv.gov / http://red.nv.gov
Revised 1/24/2020 Page 2 of 2 Form 630
REPORT OF EXISTENCE OF NEVADA BUSINESS LICENSE
Pursuant to NRS 116A.435
All applicants MUST complete this section. Please select ONE option.
I have a Nevada business license number assigned by the Nevada Secretary of State upon compliance
with the provisions of NRS Chapter 76.
My Nevada business license number is:
I have applied for a Nevada business license with the Nevada Secretary of State upon compliance with
the provision of NRS Chapter 76 and my application is pending.
I do NOT have a Nevada business license number.
The Real Estate Division is not the arbiter of determining whether the applicant needs a business license.
Information about the Nevada business license can be found on the Secretary of State’s website at:
http://nvsos.gov/.
Receipt of Gift, Incentive, Gratuity, Reward, or Item of Value
Pursuant to NAC 116.482
No Community Manager shall receive, in the aggregate, any gift, incentive, gratuity, reward or other item of
value pursuant to NRS 116.31185 in any calendar year which exceeds the sum of $500.
No, I did not receive any gift, incentive, gratuity, reward, or other item of value.
Yes, I did receive a gift, incentive, gratuity, reward, or other item of value. If yes, attach a list of all
items over $15.
APPLICANT SIGNATURE
I hereby certify under penalty of perjury that the answers contained in this application 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 plan, my application for license, certification or renewal of a license or certification 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 timeshare representative in the State of Nevada.
Signature: Date: