Fillable REAL ESTATE TERMINATION FROM COMPANY OR BROKER (Nevada Real Estate Division)

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REAL ESTATE TERMINATION FROM COMPANY OR BROKER (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/
Revised 03/20/2017 Page 1 of 2 Form 505
REAL ESTATE TERMINATION FROM COMPANY OR BROKER
FOR THE REAL ESTATE SALESPERSON and BROKER-SALESPERSON LICENSES,
THE BUSINESS BROKER and PROPERTY MANAGER PERMITS
BROKER OR DEVELOPER: The Broker, Broker-Salesperson/Sales-Manager of a Developer, or Authorized Broker-
Salesperson/Office-Manager of the Real Estate company is required to complete and place their original handwritten
signature on the Real Estate termination Form 505. You are required to complete a separate form for each license or permit.
TERMINATION FROM COMPANY/BROKER: The license holder acknowledges the termination date with his/her
original signature. In lieu of licensee’s signature, the Broker or Authorized Broker Salesperson must attach a COPY (Mail
or deliver the original to the licensee) of the notification sent to the licensee. The letter must include the name and license
number of licensees, name and license number of the broker, company name, and date of termination.
ATTACHMENTS: The return of the original license or permit is required. Please attach the license or permit to this form.
In the case of a lost or misplaced license or permit, the division accepts a letter of explanation signed by the Broker or
Authorized Broker Salesperson. Include a promise to return the license or permit if found.
DELIVERY: It is the responsibility of the broker or developer to deliver this form to the Nevada Real Estate Division either
by mail or hand delivery. Salespersons and Broker Salespersons require permission from the Broker to deliver their real
estate license directly to the division. The Broker or Authorized Broker Salesperson may grant permission to any person
named in the “Hand Delivery Permission” located in section 5.
DEADLINE: The thirty (30) day deadline begins with the termination date written on the Form 505. The Division must
receive the Form 505 within ten (10) calendar days. Post-marked dates are not accepted.
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 03/20/2017 Page 2 of 2 Form 505
REAL ESTATE TERMINATION FORM
All sections must be completed by broker or authorized signer except for item 4.
Form will be voided and returned to the broker if all sections are not completed.
All signatures must be original.
1. LICENSEE INFORMATION:
Termination Date:
(MM/DD/YYYY)
Name of Licensee:
(Please print)
Residence Address:
Phone:
Cell:
2. REASON FOR TERMINATION OF EMPLOYMENT:
CIRCUMSTANCES: ________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
DECEASED: Date of deceased required _________________ and attach a copy of an obituary or the certificate of death.
3. SIGNATURE OF BROKER, DEVELOPER OR AUTHORIZED SALESMANAGER
Name of Business:______________________________________________________________ License No.:________________________________
Name (Print your name): _____________________________________ X_________________________________________________
(Required) (Original signature required)
4. SIGNATURE OF LICENSED SALESPERSON OR BROKER SALESPERSON:
X______________________________________________ Date:_______________________
(Original Signature of licensee named in section 1.)
5. HAND DELIVERY PERMISSION:
_______________________________________________ has permission to hand carry license to the Real Estate Division.
Signature: _______________________________________________________
(Broker authorized Broker salesperson)
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REAL ESTATE TERMINATION FROM COMPANY OR BROKER (Nevada Real Estate Division)

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Completed 28 December 2021

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