Fillable FORM COMPLETION: Complete only the areas that apply (Nevada Real Estate Division)

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FORM COMPLETION: Complete only the areas that apply (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 / realest@red.nv.gov / http://red.nv.gov/
Revised 12/3/2020 Page 1 of 5 504
REAL ESTATE LICENSE or PERMIT CHANGE
FORM 504 INSTRUCTIONS
FORM COMPLETION: Complete only the areas that apply to this change. Incomplete paperwork will be
returned for completion. Applicants are required to answer the questions located in section 8.
REQUIREMENTS: Attach to the Termination Form 505 your real estate license or permit. The termination process must
be complete and received by the Nevada Real Estate Division (NRED) before submitting the Form 504. For the Nevada
real estate license, the Form 504 is accepted within 30 days from disassociation date. Permits must complete this form for
any association with a new Broker any time after the Form 505 has been received.
Submit Form 544 (reinstatement form) when a real estate license has been inactive for more than 30 days.
FEES: Fees are listed for each section, in each section of the form. The payment options are check, money-order, or a
cashier’s check made payable to NRED; cash in the exact amount; and credit cards for in person counter transactions.
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102
(702) 486-4033 / realest@red.nv.gov / http://red.nv.gov/
Revised 12/3/2020 Page 2 of 5 504
REAL ESTATE LICENSE or PERMIT CHANGE FORM
For Broker Salesperson, Salesperson, Property Manager, and Business Broker
Real Estate License Number: Property Manager Permit Number:
Business Broker Permit Number:
First Name: Middle Name: Last Name:
Residence Address:
City: State: Zip:
Mailing Address (if different from Residence Address):
City: State: Zip:
Email Address: Phone Number:
1. $20 CHANGE OF BROKER/EMPLOYER/COMPANY (Submit a $20.00 fee per permit if applicable)
Broker’s First Name: Broker’s Last Name: Broker’s License Number:
Company Name: Business Phone Number:
Company Address:
City: State: Zip:
2. $20 PERSONAL NAME CHANGE
Submit a copy of a court document (i.e. divorce decree or marriage certificate/court name change).
Submit your original license and/or original permit.
New First Name: Middle Name: Last Name:
3. $20 STATUS CHANGE
BROKER to BROKER SALESPERSON
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102
(702) 486-4033 / realest@red.nv.gov / http://red.nv.gov/
Revised 12/3/2020 Page 3 of 5 504
4. $20 PROFESSIONAL CORPORATION OR LLC STATUS (Submit your original license)
ADD REMOVE
INSTRUCTIONS: Your registered company name with the Nevada Secretary of State must be your legal individual
name indicated on your Nevada Real Estate license. You may choose to file Chapter 86 or 89.
Limited Liability Company 86
Submit a copy of the filed:
1. Articles of organization
2. List of managers/members
Professional Corporation 89
Submit a copy of the filed:
1. Articles of incorporation
2. List of corporate officers
5. $20 STATUS CHANGE – OFFICE MANAGER OR SALES MANAGER
Check one box here and one below: ADD STATUS REMOVE STATUS
Broker Salesperson - OFFICE MANAGER (for a Brokerage)
Authority NO Authority
Broker Salesperson - SALES MANAGER (for an owner/developer)
Broker Signature: Date:
ADD: Submit the original license and the Experience Verification (Form 509). Form 509 is not required for those who have held
a Nevada Broker license. To qualify - the Experience Verification must show 2 years active licensed experience within the 4 years
immediately preceding the date of application.
REMOVE: Submit the original license and termination forms of all licensees or a letter of replacement.
REPLACE: Follow the instructions for the “add” or “remove” above and attach a dated letter signed by the Real Estate broker
stating the specific Broker-salesperson that will replace the current Broker-salesperson and attach to both 504 forms. To avoid
interruption of business the dates must match, and both license and forms must arrive to the Division at the exact same time.
6. $20 DESIGNATED STATUS CHANGE
Check one box here and one below: ADD STATUS REMOVE STATUS
DESIGNATED PROPERTY MANAGER DESIGNATED BUSINESS BROKER
ADD: Submit the original permit and the Experience Verification (Form 509A or 509B). To qualify - the Experience Verification
must show 2 years active licensed experience within the 4 years immediately preceding the date of application in conducting
property manager or business broker activities.
REMOVE: Submit the original permit and termination form for all permits associated with you or a letter of replacement.
REPLACE: Follow the instructions for the “add” or “remove” above and attach a dated letter signed by the Real Estate broker
stating the specific Broker-salesperson that will replace the current Broker-salesperson and attach to both 504 forms. To avoid
interruption of business the dates must match, and both license and forms must arrive to the Division at the exact same time.
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102
(702) 486-4033 / realest@red.nv.gov / http://red.nv.gov/
Revised 12/3/2020 Page 4 of 5 504
7. $20 PERMIT STATUS CHANGE FOR NEW LICENSE (Submit the original permit and a $20.00 fee per permit.)
Property Manager Business Broker
8. REQUIRED FOR ALL LICENSEES
a. Have you had any disciplinary sanctions imposed by any real estate regulatory agency or commission since the
last renewal of your real estate license?
YES NO
b. Have you been convicted of, or entered a plea of guilty, guilty but mentally ill or nolo contendere to a
misdemeanor, gross misdemeanor, or felony since the last renewal of your real estate license?
YES NO
If you answered YES, you are REQUIRED to attach a written explanation and the final court issued disposition
document OR a brief written explanation of the discipline imposed by any real estate regulatory agency or
commission on an attached sheet.
9. APPLICANT SIGNATURE
I, (print name) by signing below, under the penalty of perjury,
affirm that the information provided herein is honest and trustworthy. I pledge to comply with the NRS and
NAC 645 statutes and regulations that govern the Nevada Real Estate license in the State of Nevada.
Signature Required: Date:
10. BROKER
This is to verify that I, , am a duly licensed Broker, Owner/Developer, Sales
Manager, or Office Manager registered in Nevada with the Department of Business and Industry, Real Estate
Division. It is my present intent to employ or associate with me the licensed Salesperson or Broker
Salesperson, . I will exercise careful supervision over his/her
real estate activities while he/she is associated with or employed by me.
Signature of Broker, Office Manager or Sales Manager required.
Signature: Date:
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 12/3/2020 Page 5 of 5 504
REPORT OF EXISTENCE OF NEVADA BUSINESS LICENSE
Pursuant to NRS 645
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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FORM COMPLETION: Complete only the areas that apply (Nevada Real Estate Division)

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Completed 28 December 2021

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