Forms and Other Documents

All applications, renewals and processing of licenses should be directed to the Carson City office.  All fees will be processed only by the Carson City office and should be mailed directly to that office at:

Mortgage Lending Division
400 W King Street, Suite 101
Carson City NV 89703
(775) 684-7060 Fax: (775) 684-7061.

(Most forms on this page may be filled out online in Adobe Acrobat, then printed,
or you can save the blank interactive form to your computer.  These forms indicate they are interactive.
Be sure to tab from field to field in interactive forms.)
complaint forms

Complaint Forms

(**Please 'right-click' on the following file and choose 'Save Target As...' to save the blank interactive form to your computer **)

Consumer Complaint Form (Interactive-pdf)

Forma de la queja de consumidor (Interactive-pdf) - Español

Mortgage Agent License Application (Interactive-pdf)

Agent License Renewal (Interactive-pdf)

Change of Broker Form (Interactive-pdf)

Agent Termination Form (pdf)

Child Support Statement - required for all applicants (Interactive-pdf)

Personal History Record - required for all applicants (Interactive-pdf)

Personal Disclosure Form (pdf) (NOTE: Used for renewal purposes only)

Intent to Employ Agent (Interactive-pdf)

Suggested Mortgage Agent PC/LLC Affidavit (pdf)

Pre-Licensing Information for Mortgage Bankers (pdf)

Pre-Licensing Information for Mortgage Brokers (pdf)

Mortgage Broker License Application (Interactive-pdf)

Mortgage Banker License Application (Interactive-pdf)

Mortgage Broker/Banker Branch Office Application (Interactive-pdf)

Mortgage Banker Principal Location License Renewal (pdf)

Mortgage Banker Branch License Renewal (pdf)

Mortgage Broker Principal Location License Renewal (pdf)

Mortgage Broker Branch License Renewal (pdf)

Designation of Qualified Employee (Interactive-pdf)

Change of Address Form (Broker/Banker and Branches) (Interactive-pdf)

Personal History Record - required for all applicants (Interactive-pdf)

Non-Personal History Records (Interactive-pdf)

Child Support Statement - required for all applicants (Interactive-pdf)

Application for Change of Control (Interactive-pdf)

Application for Exemption Certificate (Interactive-pdf)

Personal Disclosure Form (Interactive-pdf)

Application to Change Company License Type (Interactive-pdf)

Personal Financial Questionnaire (Interactive-pdf) - Must be submitted along with or in lieu of financial statement

Personal History Record (Interactive-pdf) - required for all natural persons affiliated with broker/banker application

Non-Personal History Records (Interactive-pdf) - required for other than natural persons affiliated with broker/banker application

Home Based Business Affidavit (Interactive-pdf)

Request for Temporary Inactivation of License (pdf)

Non-Personal Disclosure Form (Interactive-pdf)

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