Approved Nevada Real Estate Division 525A
Replaces all previous versions Revised 11/7/16
SUPPLEMENTAL LIST OF LICENSEES PARTY TO THE
DUTIES OWED BY A NEVADA REAL ESTATE LICENSEE
This form does not constitute a contract for services nor an agreement to pay compensation.
Licensee: ______________________________, is acting for ______________________________
Broker: ______________________________________
Additional licensees on this transaction, listed below, are subject to NRS 645.252, NRS 645.254, and the Duties
Owed By A Nevada Real Estate Licensee:
NAME LICENSE NUMBER
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I/We acknowledge receipt of a copy of this Supplemental List of Licensees.
Seller/Landlord: ______________________________________ Date: _______________________ Time: ___________________
Seller/Landlord: ______________________________________ Date: _______________________ Time: ___________________
OR
Buyer/Tenant: _______________________________________ Date: _______________________ Time: ___________________
Buyer/Tenant: _______________________________________ Date: _______________________ Time: ___________________