Form 634 "Provisional Community Manager Certificate Disassociation Form" - Nevada

What Is Form 634?

This is a legal form that was released by the Nevada Department of Business and Industry - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 13, 2019;
  • The latest edition provided by the Nevada Department of Business and Industry;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 634 by clicking the link below or browse more documents and templates provided by the Nevada Department of Business and Industry.

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Download Form 634 "Provisional Community Manager Certificate Disassociation Form" - Nevada

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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/
PROVISIONAL COMMUNITY MANAGER CERTIFICATE
DISASSOCIATION FORM
FORM TO BE DATED AND SIGNED BY SUPERVISING COMMUNITY MANAGER AS REGISTERED WITH THE
STATE OF NEVADA. ACKNOWLEDGEMENT OF THE PROVISIONAL COMMUNITY MANAGER IS
REQUIRED. ORIGINAL SIGNATURES ARE REQUIRED. THE DIVISION MUST RECEIVE THIS FORM WITHIN
10 BUSINESS DAYS AFTER THE DISSASSOCIATION OCCURS. NAC 116A.340.
Disassociation Date:
Provisional certificate number:
Name of Provisional Community Manager
Provisional Community Manager: Update your address, contact phone number, and email information below
Residence Address:
Street
City
State
Zip
Mailing address:
P.O. Box Number
City
State
Zip
Phone:
Email:
Employment was considered:
Full-Time
Part-Time
Company name on Supervising Community Manager’s
Supervising Community Manager certificate number
Certificate
I hereby acknowledge that I have notified the Provisional Community Manager of this action pursuant to the
provisions of NAC 116A.
Signature of Supervising Community Manager
Signature of Provisional Community Manager
ATTACH THE ORIGINAL PROVISIONAL CERTIFICATE AND POCKET CARD.
2/13/2019
Form 634
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/
PROVISIONAL COMMUNITY MANAGER CERTIFICATE
DISASSOCIATION FORM
FORM TO BE DATED AND SIGNED BY SUPERVISING COMMUNITY MANAGER AS REGISTERED WITH THE
STATE OF NEVADA. ACKNOWLEDGEMENT OF THE PROVISIONAL COMMUNITY MANAGER IS
REQUIRED. ORIGINAL SIGNATURES ARE REQUIRED. THE DIVISION MUST RECEIVE THIS FORM WITHIN
10 BUSINESS DAYS AFTER THE DISSASSOCIATION OCCURS. NAC 116A.340.
Disassociation Date:
Provisional certificate number:
Name of Provisional Community Manager
Provisional Community Manager: Update your address, contact phone number, and email information below
Residence Address:
Street
City
State
Zip
Mailing address:
P.O. Box Number
City
State
Zip
Phone:
Email:
Employment was considered:
Full-Time
Part-Time
Company name on Supervising Community Manager’s
Supervising Community Manager certificate number
Certificate
I hereby acknowledge that I have notified the Provisional Community Manager of this action pursuant to the
provisions of NAC 116A.
Signature of Supervising Community Manager
Signature of Provisional Community Manager
ATTACH THE ORIGINAL PROVISIONAL CERTIFICATE AND POCKET CARD.
2/13/2019
Form 634