Form 504 "Real Estate License or Permit Change Form for Broker Salesperson, Salesperson, Property Manager, and Business Broker" - Nevada

What Is Form 504?

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 March 20, 2017;
  • 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;

Download a fillable version of Form 504 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 504 "Real Estate License or Permit Change Form for Broker Salesperson, Salesperson, Property Manager, and Business Broker" - 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/
REAL ESTATE LICENSE or PERMIT CHANGE
FORM 504 INSTRUCTIONS
FORM COMPLETION: Complete only the areas that apply to this change. Completion of this form is required before
presenting to the Division. Incomplete or improper paperwork will be returned for completion.
Applicants are required to answer the questions located in section 8 and original signatures are required from the Nevada
licensee and broker.
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.
Make copies in advance for your records. Thank you.
Revised 03/20/2017
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Form 504
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/
REAL ESTATE LICENSE or PERMIT CHANGE
FORM 504 INSTRUCTIONS
FORM COMPLETION: Complete only the areas that apply to this change. Completion of this form is required before
presenting to the Division. Incomplete or improper paperwork will be returned for completion.
Applicants are required to answer the questions located in section 8 and original signatures are required from the Nevada
licensee and broker.
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.
Make copies in advance for your records. Thank you.
Revised 03/20/2017
1 of 4
Form 504
_________________________________________________
______________________
license #:
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/
REAL ESTATE LICENSE or PERMIT CHANGE FORM
For Broker Salesperson, Salesperson, Property Manager, and Business Broker
Real Estate License #:
Property Manager Permit #: ______________ Business Broker Permit #: ______________
Name on license: (Please print)
First
Middle
Last
Home address:
Mailing address:
Email address:
_______________________________________
Phone:
___________________________________
1. $20
CHANGE OF BROKER/EMPLOYER/COMPANY
Submit a $20.00 fee per permit if applicable.
Print Broker’s name:
Broker license:
Company name:
Business Phone:
Company address:
PERSONAL NAME CHANGE
2. $20
Submit a copy of a court document (i.e. divorce decree or marriage certificate/court name change).
Submit your original license or original permit.
New Name:
First
Middle
Last
3. $20
STATUS CHANGE
 BROKER to BROKER SALESPERSON
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
Professional Corporation
Submit a copy of the filed:
Submit a copy of the filed:
1. Articles of organization.
1. Articles of incorporation.
2. List of managers/members.
2. List of corporate officers.
Revised 03/20/2017
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Form 504
STATUS CHANGE – OFFICE MANAGER OR SALES MANAGER
5. $20
 ADD STATUS
 REMOVE STATUS
Check one box here and one below:
 Broker Salesperson-OFFICE MANAGER (for a Brokerage)
 Authority
 NO Authority
 Broker Salesperson-SALES MANAGER (for an owner/developer)
X__________________________________________________________
Date_____________
(Original Signature of Broker required)
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
 ADD STATUS
 REMOVE STATUS
Check one box here and one below:
 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.
7. $20
PERMIT STATUS CHANGE FOR NEW LICENSE
Submit the original permit and a $20.00 fee per permit.
 Property Manager
 Business Broker
8. APPLICANT
1.
Have you had any disciplinary sanctions imposed by any real estate regulatory agency or commission within the past 5 years?
NO
YES
2.
Have you been convicted of a misdemeanor, gross misdemeanor, or felony since the last renewal of your Real Estate license?
NO
YES
If you answered Yes, licensees are REQUIRED to attach a written explanation and the final court issued disposition document
OR a brief written explanation if the discipline was imposed by the Nevada Real Estate Commission on an attached sheet.
X________________________________________________________
Date_____________
(Original Signature of Salesperson or Broker Salesperson required)
9. 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 (print name)______________________________________________.
I will exercise careful supervision over his/her real estate activities while he/she is associated with or employed by me.
X__________________________________________________________
Date_____________
(Original Signature of Broker, Office Manager or Sales Manager required)
Revised 03/20/2017
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Form 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/
Revised 03/20/2017
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Form 504
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