Fillable REAL ESTATE DIVISION APPLICATION INSTRUCTIONS for ASSET MANAGEMENT (Nevada Real Estate Division)

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REAL ESTATE DIVISION APPLICATION INSTRUCTIONS for ASSET MANAGEMENT (Nevada Real Estate Division)

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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 12/18/2019 Page 1 of 4 Form 666
APPLICATION INSTRUCTIONS for ASSET MANAGEMENT PERMIT
INSTRUCTIONS
FEE: Attach a check or certified funds made payable to the Nevada Real Estate Division or cash in the exact
amount for in person delivery, of $75.00 per applicant. Individual applications must be completed for each
applicant, but application fees can be combined on one check if applications are submitted in one filing. (See
instruction #2 B regarding fingerprint fees.)
FINGERPRINTS: Attach verification of prints taken electronically by an approved vendor. The approved
vendor list is located on the NRED website, see Form 619.
PHOTOGRAPH: Attach a 2” x 2” head shot picture taken within the past 12 months.
CONSENT TO SERVICE OF PROCESS: If you are not a resident of the State of Nevada you must complete
the Consent to Service of Process.
FINGERPRINT BACKGROUND WAIVER: Complete the Nevada Department of Public Safety waiver form
attached to this application.
IMPORTANT NOTES:
• All required fees must accompany application.
• Only original applications are accepted.
• The registration is valid when the applicant receives the permit issued by the Nevada Real Estate Division. The
permit expires one year from the date of issuance.
• The application is a public record under Nevada Revised Statutes Chapter 239. Certain information is deemed by
law to be confidential. However, most information provided by an applicant is public information and must be
provided upon request to the Division.
Mailing Address (if applicable):
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 12/18/2019 Page 2 of 4 Form 666
APPLICATION for ASSET MANAGEMENT PERMIT
FEE: $75.00
1. APPLICANT:
Applicant Name:
Residence Address:
City: State: Zip Code:
City: State: Zip Code:
Home Phone: Cell Phone: Email Address:
Date of Birth: Last 4 of Social Security Number or Individual Taxpayer ID:
2. COMPANY INFORMATION: Location in which you will be conducting asset management services.
Company Name:
Company Address:
City: State: Zip Code:
Phone Number: Fax Number: Email Address:
3. CRIMINAL/BACKGROUND HISTORY: If your answer is YES to any of the following questions, attach the order
as a result of the proceedings. On an attached sheet give full details, including the administrative agency, court, and
title of the proceeding, disposition and any other pertinent information.
a. Have you had a professional or occupational license issued by any state, district or territory of
the United States or any foreign country suspended, revoked or voluntarily surrendered in lieu
of other discipline within the last ten (10) years?
Yes No
b. Have you had a license, certificate or registration issued pursuant to the provisions of this
chapter suspended, revoked, or voluntarily surrendered in lieu of other discipline within the
last ten (10) years?
Yes No
c. Have you ever been convicted of, or entered a plea of guilty or nolo contendere to, a felony or
any crime involving fraud, misrepresentation or moral turpitude?
Yes No
d. Have you ever been convicted of, or entered a plea of guilty or nolo contendere to, a felony
relating to the practice of real estate?
Yes No
4. REGULATION/SERVICES:
This applicant attests that he/she has read and understands the provisions of section 29.5 to 33, inclusive,
of Senate Bill Number 314 of the 2011 Legislative Session.
DIVISION USE ONLY: Date: Receipt Number: Processor Initials:
Yes
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 12/18/2019 Page 3 of 4 Form 666
5. CHILD SUPPORT DECLARATION (NRS 425.520)
Please indicate in the appropriate box below which one of the provisions apply to you. Your application for the
issuance of this license will be denied if you do not complete this section.
CHECK ONE BOX:
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 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 court order for the support of one or more children and NOT IN COMPLIANCE with that order
or plan approved by the district attorney or other public agency enforcing the order for the repayment of the
amount owed in that order.
6. ACKNOWLEDGEMENT: I hereby certify under penalty of perjury that the answers contained in this Asset
Management Permit Application Form 666 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 license,
certification or renewal of a license or certification will be denied.
Print Name: Signature:
Verification upon oath:
State of: } ss.
County of:
Signed and sworn to (or affirmed) before me on date, by .
Notary Seal
Signature of Notary
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 12/18/2019 Page 4 of 4 Form 666
REPORT OF EXISTENCE OF NEVADA BUSINESS LICENSE
Pursuant to NRS 645H
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/.
0505RCCD-003(07/2017rev)
Fingerprint Background Waiver Page 1 of 2
Fingerprint Background Waiver
As an applicant who is the subject of a Federal Bureau of Investigation (FBI) fingerprint-based
criminal history record check for a noncriminal justice purpose you have certain rights which are
discussed below.
1. You must be notified by the Nevada Real Estate Division (name of requesting agency)
that your fingerprints will be used to check the criminal history records of the FBI and the
State of Nevada.
2. If you have a criminal history record, the officials making a determination of your suitability
for the job, license or other benefit for which you are applying must provide you the
opportunity to complete or challenge the accuracy of the information in the record. You may
review and challenge the accuracy of any and all criminal history records which are returned
to the submitting agency. The proper forms and procedures will be furnished to you by the
Nevada Department of Public Safety, Records Bureau upon request. If you decide to challenge
the accuracy or completeness of you FBI criminal history record, Title 28 of the Code of
Federal Regulations Section 16.34 provides for the proper procedure to do so:
16.34 - Procedure to obtain change, correction or updating of identification
records. If, after reviewing his/her identification record, the subject thereof
believes that it is incorrect or incomplete in any respect and wishes changes,
corrections or updating of the alleged deficiency, he/she should make application
directly to the agency which contributed the questioned information. The subject of
a record may also direct his/her challenge as to the accuracy or completeness of any
entry on his/her record to the FBI, Criminal Justice Information Services (CJIS)
Division ATTN: SCU, Mod. D-2, 1000 Custer Hollow Road, Clarksburg, WV 26306.
The FBI will then forward the challenge to the agency which submitted the data
requesting that agency to verify or correct the challenged entry. Upon the receipt of
an official communication directly from the agency which contributed the original
information, the FBI CJIS Division will make any changes necessary in accordance
with the information supplied by that agency.
3. Based on 28 CFR § 50.12 (b), officials making such determinations should not deny the
license or employment based on information in the record until the applicant has been
afforded a reasonable time to correct or complete the record or has declined to do so.
4. You have the right to expect that officials receiving the results of the fingerprint-based
criminal history record check will use it only for authorized purposes and will not retain or
disseminate it in violation of federal or state statute, regulation or executive order, or rule,
procedure or standard established by the National Crime Prevention and Privacy Compact
Council.
0505RCCD-003(07/2017rev)
Fingerprint Background Waiver Page 2 of 2
5. I hereby authorize the Nevada Real Estate Division (name of requesting agency)
(name of requesting agency), to submit a set of my fingerprints to the Nevada Department
Public Safety, Records Bureau for the purpose of accessing and reviewing State of Nevada
and FBI criminal history records that may pertain to me.
In giving this authorization, I expressly understand that the records may include information
pertaining to notations of arrest, detainments, indictments, information or other charges for
which the final court disposition is pending or is unknown to the above referenced agency.
For records containing final court disposition information, I understand that the release may
include information pertaining to dismissals, acquittals, convictions, sentences, correctional
supervision information and information concerning the status of my parole or probation
when applicable.
6. I hereby release from liability and promise to hold harmless under any and all causes of legal
action, the State of Nevada, its officer(s), agent(s) and/or employee(s) who conducted my
criminal history records search and provided information to the submitting agency for any
statement(s), omission(s), or infringement(s) upon my current legal rights. I further release
and promise to hold harmless and covenant not to sue any persons, firms, institutions or
agencies providing such information to the State of Nevada on the basis of their disclosures. I
have signed this release voluntarily and of my own free will.
A reproduction of this authorization for release of information by photocopy, facsimile or similar
process, shall for all purposes be as valid as the original.
In consideration for processing my application I, the undersigned, whose name and signature
voluntarily appears below; do hereby and irrevocably agree to the above.
Applicant’s Name:
PLEASE PRINT
Last Name
First Name
Middle
ADDRESS:
PLEASE PRINT
Applicant’s Signature:
Date:
Submitting Agency:
Nevada Real Estate Division
Address:
3300 West Sahara Avenue #350
Las Vegas, NV 89102
Agency Representative:
PLEASE PRINT
Last Name
First Name
Middle
Date:
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REAL ESTATE DIVISION APPLICATION INSTRUCTIONS for ASSET MANAGEMENT (Nevada Real Estate Division)

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Completed 28 December 2021

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