Form BLOE ""other" Notice of Exemption - Application or Renewal (Nrs 76)" - Nevada

What Is Form BLOE?

This is a legal form that was released by the Nevada Secretary of State - 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 July 17, 2017;
  • The latest edition provided by the Nevada Secretary of State;
  • 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 BLOE by clicking the link below or browse more documents and templates provided by the Nevada Secretary of State.

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Download Form BLOE ""other" Notice of Exemption - Application or Renewal (Nrs 76)" - Nevada

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Nevada State
BARBARA K. CEGAVSKE
Application
Secretary of State
Business License
202 North Carson Street
"Other"
Carson City, Nevada 89701-4201
(775) 684-5708
Renewal
Website: www.nvsos.gov
Exemption
USE BLACK INK ONLY - DO NOT HIGHLIGHT
PRINT LEGIBLY OR TYPE ALL INFORMATION
Completing this form DOES NOT relieve you of any statutory or regulatory requirements relating to your business. You may be
required to complete a Nevada Business Registration form with the Nevada Department of Taxation and Department of Employment,
Training and Rehabilitation. Please check with these and other state/local government agencies for additional licensing requirements.
* Asterisks indicate required information. Incomplete forms will be rejected.
INSTRUCTIONS:
1. This form is for a business that is not a sole proprietor, partnership or that is not required to organize pursuant to Title 7 of Nevada Revised
Statutes and claims an exemption for the State Business License provisions of NRS 76.020.
2. If you are exempt from the requirements of the State Business License pursuant to NRS 76.020 enter the applicable code in Section 4:
001 - A governmental entity
002 - 501(c) Nonprofit Entity
006 - Insurance company doing business pursuant to NRS 680B.020 that does not conduct any
business that is not incidental to Title 57 (Div. of Ins. Authority).
newfilings@sos.nv.gov
3. Return the completed form to the Secretary of State by fax to (775) 684-5725; by email to
; or, by mail to 202
North Carson Street, Carson City, Nevada 89701-4201.
4. The person claiming exemption from the State Business License requirement must sign the application.
FORM WILL BE RETURNED IF UNSIGNED.
1*
Signature must be that of a responsible party.
I declare under penalty of perjury that the information provided is true, correct and complete to the best of my knowledge and
belief and acknowledge that pursuant to NRS 239.330, it is a category C felony to knowingly offer any false or forged instrument
for filing in the Office of the Secretary of State. I declare that I am exempt from the provisions of the State Business License
pursuant to NRS 76.020.
First Name
Middle (Optional)
Last Name
Suffix
Title
X
Signature of Responsible Party
Date
2
(Required if you have a current Nevada State Business License or had one issued after
NV Business ID #
October 1, 2009)
3*
Entity Name
4*
I am exempt from the requirements of the State Business License. Cite exemption code
(See instructions for code)
If claiming 001 exemption: I declare that this entity is an incorporated or unincorporated agency of instrumentality of the U.S. government
or any state government; a corporation wholly owned by the U.S. government, or county, city, district, or other political subdivision of a
state.
If claiming 006 exemption provide Nevada Division of Insurance License #
5*
Physical Address
Physical Street Address
City
State
Zip Code
6
Mailing Address
(if different)
PO Box or Street Address
State
Zip Code
City
7
(
)
Entity Phone
8
Email Address
Nevada Secretary of State BL Exemption Other
Form: BLOE
Revised: 7-17-17
RESET
PRINT
Nevada State
BARBARA K. CEGAVSKE
Application
Secretary of State
Business License
202 North Carson Street
"Other"
Carson City, Nevada 89701-4201
(775) 684-5708
Renewal
Website: www.nvsos.gov
Exemption
USE BLACK INK ONLY - DO NOT HIGHLIGHT
PRINT LEGIBLY OR TYPE ALL INFORMATION
Completing this form DOES NOT relieve you of any statutory or regulatory requirements relating to your business. You may be
required to complete a Nevada Business Registration form with the Nevada Department of Taxation and Department of Employment,
Training and Rehabilitation. Please check with these and other state/local government agencies for additional licensing requirements.
* Asterisks indicate required information. Incomplete forms will be rejected.
INSTRUCTIONS:
1. This form is for a business that is not a sole proprietor, partnership or that is not required to organize pursuant to Title 7 of Nevada Revised
Statutes and claims an exemption for the State Business License provisions of NRS 76.020.
2. If you are exempt from the requirements of the State Business License pursuant to NRS 76.020 enter the applicable code in Section 4:
001 - A governmental entity
002 - 501(c) Nonprofit Entity
006 - Insurance company doing business pursuant to NRS 680B.020 that does not conduct any
business that is not incidental to Title 57 (Div. of Ins. Authority).
newfilings@sos.nv.gov
3. Return the completed form to the Secretary of State by fax to (775) 684-5725; by email to
; or, by mail to 202
North Carson Street, Carson City, Nevada 89701-4201.
4. The person claiming exemption from the State Business License requirement must sign the application.
FORM WILL BE RETURNED IF UNSIGNED.
1*
Signature must be that of a responsible party.
I declare under penalty of perjury that the information provided is true, correct and complete to the best of my knowledge and
belief and acknowledge that pursuant to NRS 239.330, it is a category C felony to knowingly offer any false or forged instrument
for filing in the Office of the Secretary of State. I declare that I am exempt from the provisions of the State Business License
pursuant to NRS 76.020.
First Name
Middle (Optional)
Last Name
Suffix
Title
X
Signature of Responsible Party
Date
2
(Required if you have a current Nevada State Business License or had one issued after
NV Business ID #
October 1, 2009)
3*
Entity Name
4*
I am exempt from the requirements of the State Business License. Cite exemption code
(See instructions for code)
If claiming 001 exemption: I declare that this entity is an incorporated or unincorporated agency of instrumentality of the U.S. government
or any state government; a corporation wholly owned by the U.S. government, or county, city, district, or other political subdivision of a
state.
If claiming 006 exemption provide Nevada Division of Insurance License #
5*
Physical Address
Physical Street Address
City
State
Zip Code
6
Mailing Address
(if different)
PO Box or Street Address
State
Zip Code
City
7
(
)
Entity Phone
8
Email Address
Nevada Secretary of State BL Exemption Other
Form: BLOE
Revised: 7-17-17
RESET
PRINT