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/
Revised 03/20/17 Page 3 of 4
Form 545
3. CHILD SUPPORT: 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. NRS 645.358
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.
4. DECLARATION: NRS 53.045
I ,(print name) ____________________________________________ hereby, under penalty of perjury, declare that the
answers contained in this application are true and correct; and 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;
That I will faithfully comply with all the statutes and regulations of the State of Nevada pertaining to the
conduct of real estate licensees in the State of Nevada;
That by signing this application I authorize any person or institution to which reference is made by me in
connection with the application to release or divulge to the Real Estate Division any information in the
possession of such person or institution regarding me.
5. DESIGNATED PROPERTY MANAGER and BROKER/PROPERTY MANAGER: The Real Estate
Broker or Designated Property Manager must complete the following information.
I, ____________________________________________ (broker name), declare, under penalty of perjury, that I
am a duly licensed Nevada Real Estate broker for ___________________________________________________
(company name), and all registrations and licenses are in good standing.
It is my present intent to employ or associate with me ________________________________________________
the within named applicant for a Nevada Property Manager permit.
By signing this document, I declare that I will exercise careful supervision over his/her real estate and property
management activities while he/she is associated with or employed by the company named above.
*PM #____________________________________ ________________________________________________
Signature of the Designated Property Manager (if applicable or write N/A)
#_____________________________________________ X_____________________________________________
Real Estate license number of the Nevada Real Estate Broker Original signature of Broker - required
*Enter the Real Estate license, and Property Manager permit number of the Broker. If the broker has designated a Broker Salesperson as
designated Property Manager, please enter their property manager information and obtain the designee’s signature in addition to your signature.