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/
03/20/17 577
INSPECTOR OF STRUCTURE
INACTIVE STATUS
TO BE COMPLETED BY LICENSEE ONLY IF HE/SHE IS GOING TO INACTIVATE THEIR CERTIFICATE.
RETURN ORGINIAL CERTIFICATE AND POCKET CARD.
Date:
Certificate :
Name:
Home Phone:
Home Address:
Street
City
State
Zip
Mailing Address:
P.O. Box
City
State
Zip
NOTIFY THE DIVISION OF ANY CHANGE IN THIS ADDRESS IMMEDIATELY
LOCATION OF RECORDS IS:
Street
City
State
Zip
Inactive certificates must be renewed every two years. Continuing education requirements are not
required when renewing on inactive status.
Date
Signature