Fillable REAL ESTATE DIVISION ASSET MANAGEMENT COMPANY REGISTRATION INSTRUCTIONS (Nevada Real Estate Division)

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REAL ESTATE DIVISION ASSET MANAGEMENT COMPANY REGISTRATION INSTRUCTIONS (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
e-mail: realest@red.nv.gov * http://red.nv.gov/
Effective 03/20/17 Page 1 of 4 Form 665
ASSET MANAGEMENT COMPANY REGISTRATION INSTRUCTIONS
FEE: Attach a check or certified funds made payable to the Nevada Real Estate Division or cash in the exact
amount for $2500.00 ($2000 application fee plus $500 initial registration fee).
LICENSE REVIEW: Attach your written procedure which sets forth the company’s process to verify
that each employee or independent contractor that performs services as directed by the asset
management company or an asset manager employed by or under contract with the asset management
company is the holder of a license or permit in good standing in the State of Nevada to perform the
services for which the asset management company will use the employee or independent contractor.
PROCEDURE REVIEW: Attach your written procedure which sets forth the company’s process to
review the work of each independent contractor that performs services as directed by the asset manager
employed by or under contract with the asset management company to ensure that those services are
conducted in accordance with all applicable laws and regulations of the State of Nevada.
PROOF OF INSURANCE: Attach proof that the company is covered under a policy of insurance or
possesses means to act as a self-insurer sufficient to reimburse real property owners for, without limitation,
any damage to real property in foreclosure, the wrongful disposal of property or wrongful eviction.
ADDITIONAL FORM:
665A: Registration of an Asset Management Company Principal
ASSET MANAGEMENT COMPANY REGISTRATION FORM
Fee: Please make check, money order, or cashier’s check payable to NRED or exact cash for $2500.00.
1.
COMPANY NAME: __________________________________________________________________________
FID (Required): _______________________________________________________________________________
Main location address: _________________________________________________________________________
____________________________________________________________________________________________
Mailing address (if different from location address): __________________________________________________
____________________________________________________________________________________________
Phone: (______)________________ Fax: (_____)_______________ Email:_______________________________
If the applicant is a natural person, also complete Form 665A. Each person who has an interest in the Asset
Management Company as a Principal, General Partner, Director, Officer, Trustee, Manager, or registered agent must
complete Form 665A as well.
Division use only: Reg. # ______________________ Issued date: __________________ Processor initials: __________
Date: _________________ Receipt number: _____________________ Processor Initials: __________
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/
Effective 03/20/17 Page 2 of 4 Form 665
Yes No
Does the Asset Management Company have a process in place to verify that each employee or
independent contractor providing your company services on property located in the State of Nevada
holds a current and active license or permit in the State of Nevada?
Yes No
Does the Asset Management Company have procedures in place to ensure that services performed on
property located in the State of Nevada are conducted in accordance with all applicable laws and
regulations of the State of Nevada?
Yes No
Does the Asset Management Company maintain a detailed record of each asset management service
request and the contractor who fulfilled the request?
2.
BRANCH OFFICE: Any office other than a principal office from which the company will conduct business within
the State of Nevada. List branch offices below or check the No Branch offices box: No branch offices
1.
ADDRESS
CITY
STATE
POSTAL CODE
(AREA CODE) PHONE
2.
1.
3.
2.
4.
3.
5.
Attach additional page if necessary.
3.
QUALIFIED EMPLOYEE: A Principal, General Partner, Director, Officer, Trustee, Manager, or Registered Agent
who is designated to act on behalf of the company
Name:
Title:
Business address:
COMPANY QUESTIONS: Please make an indicator next to questions a-e. For any answer of yes, provide a copy of the
judgment or order and a written statement explaining the circumstances surrounding the legal issue(s).
Yes No
Has the Asset Management Company ever had any judgments entered against the company?
Yes No
Has a receiver been appointed to take control of any assets of the Asset Management Company?
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/
Effective 03/20/17 Page 3 of 4 Form 665
5. List of Principals, General Partners, Officers, Directors, Trustees, Managers, and/or Registered Agent. Each
individual listed must complete Form 665A. Attach an additional page if needed.
Name:
Title
Position
Name:
Title
Position
Name:
Title
Position
Name:
Title
Position
Name:
Title
Position
6. DECLARATION: Signature of applicant (NRS 53.045)
I, (print name) ____________________________________________ hereby, under penalty of perjury, declare that the
answers contained in this application are true and correct; and that the Asset Management Company named herein, will
faithfully comply with all the statutes and regulations of the State of Nevada pertaining to the conduct of asset management
in accordance with the State of Nevada statutes and regulations and Senate Bill 314 (2011 Legislative session).
Signature (Must be signed in front of a registered Notary Public)
Position and date
STATE OF ____________________________
COUNTY OF __________________________
}ss
This instrument was acknowledged before me on ___________ date, in the possession of applicant (SIGNER’S NAME)
_______________________________________________________.
(Notary prints the name of person who takes oath and signs the document.)
seal
X
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
e-mail: realest@red.nv.gov * http://red.nv.gov/
Effective 03/20/17 Page 4 of 4 Form 665
7. CONSENT TO SERVICE OF PROCESS
Registrants who reside out-of-state locations must complete this form. Nevada residents leave blank.
Company name:
Hereinafter referred to as “Applicant,” hereby irrevocably constitutes and appoints the Administrator of the Division of Real Estate,
Department of Business & Industry, State of Nevada or his/her successor in office, to be his/her true and lawful agent within this state,
upon whom all legal process in any suit, action or proceeding arising under, or in any way connected with any provisions of Chapter
645, 645C, 645D, 119, 119A, 119B, 116, 116A, 116B of Nevada Revised Statutes, or any rule or order pursuant thereto, or based upon
any fraud, deceit, breach of contract or other thing connected with the sale or offer for sale, negotiation, appraisal or inspection of any
real estate, timeshare or campground membership, may be served upon said applicant, personally within the State of Nevada. Until the
applicant attests by affidavit to the Administrator that he/she is a bona fide resident of the State of Nevada, this appointment and the
authority of said attorney shall continue in force and effect so long as any such liability remains outstanding, and a copy of any process
served hereunder may be sent by certified mail, return receipt requested, addressed to:
Company address:
X
(Signature of person representing the AMC’s application to the notary)
STATE OF: ______________________
}ss
COUNTY OF: _____________________
This instrument was acknowledged before me on ___________ date, in the possession of signer,
_______________________________________________________.
(Notary prints the name of person signing this document)
seal
X
Notary Signature
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/
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Completed 28 December 2021

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