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 1 of 2 514
STATEMENT OF FACT
(Please Print or Type)
(Street) (City) ( State) ( Zip)
Email Address ____________________________________________________________________________________________ (Optional)
Please complete the following information concerning your complaint. Our ability to investigate the matter will depend
largely upon your giving us a complete and detailed sworn statement. ATTACH ALL PERTINENT PAPERS AND/OR
DOCUMENTS TO COPIES OF THIS FORM. Keep originals for your file. A copy of this statement may be offered
to the party against whom you make this complaint.
Where is the real property located?
Did you seek legal counsel?
If “Yes,” state name and address
Is any legal action pending?
CONSIDER THE FOLLOWING CAREFULLY
This Division is not empowered to compel anyone to accede to demands of any kind, i.e., we cannot compel
cancellation of listing agreements, purchase contracts, etc., or refunds of any kind. In this regard, we suggest
that you seek private counsel to protect your interests, as we are not authorized to give legal advice.
We will investigate the matter to determine whether the available evidence warrants administrative action
against a licensee or subdivider. You will be advised of our conclusions when drawn. If it is determined
that administrative action is warranted it may be necessary for you to appear and testify.
Do not delay any civil action you might be considering in the matter, as considerable time will be required to
complete our investigation and any subsequent action due to workload and time required to develop
supporting evidence.
If a court judgment has been obtained against a licensee for fraud, misrepresentation or deceit, a Real Estate
Education, Research and Recovery Fund is available for petition if the judgment has not been satisfied.
I declare under penalty of perjury under law of the State of Nevada that the foregoing attached statement
pages is true and correct.
