Forms and Other Documents

All applications and renewal packages, including fees,
should be mailed to the Carson City office at:
 
Division of Mortgage Lending
1830 College Parkway, Suite 100
Carson City, NV 89706
(775) 684-7060 Fax: (775) 684-7061

General Forms and Correspondence 

Mortgage Broker and Mortgage Banker – Other

• Mortgage Broker Bond Form Example (pdf)

• Mortgage Banker Bond Form Example (pdf)

• Exempt Company Bond Form Example (pdf)

Escrow Agency – Application

• Application for Escrow Agency License and Checklist (Principal Location) (pdf)
  (includes Child Support Statement, Personal History Record – Escrow Agency (Submit For Natural Persons), Non-Personal History Record – Escrow Agency (Submit For Other Than Natural Persons), Personal Financial Questionnaire (Escrow Agency and Escrow Agent) and Application for Escrow Agent License and Checklist)

• Application for Escrow Agency License (Branch Office) (pdf)
  (includes Child Support Statement, Personal History Record – Escrow Agency (Submit For Natural Persons) and Application for Escrow Agent License and Checklist)

Escrow Agency – Renewal

• Application for Renewal of Escrow Agency License and Checklist (Principal Location) (pdf)
  (includes Child Support Statement, Personal Disclosure Form – Escrow Agency (For Renewal Purposes Only) and Non-Personal Disclosure Form – Escrow Agency (Submit For Other Than Natural Persons)

• Application for Renewal of Escrow Agency License and Checklist (Branch Office) (pdf)
  (includes Child Support Statement and Personal Disclosure Form – Escrow Agency (For Renewal Purposes Only)

Escrow Agent – Application

• Application for Escrow Agent License and Checklist (Interactive pdf)
  (includes Child Support Statement, Personal History Record – Escrow Agent and Personal Financial Questionnaire (Escrow Agency and Escrow Agent)

Escrow Agent – Renewal

• Application for Renewal of Escrow Agent License and Checklist (pdf)
  (includes Child Support Statement and Personal Disclosure Form – Escrow Agent (For Renewal Purposes Only)

Escrow Agency and Escrow Agent – Other

• Affiliated Business or Relationship Disclosure Statement (pdf)

• Escrow Agency/Agent Bond (pdf)

• Instrument in Lieu of Surety Bond (NRS 100.065) (I-pdf)

Private Investor Loans

• Mortgage Investment Initial Disclosure Form (pdf)

• Mortgage Broker Disclosure, Before Loan is Made (pdf)

• Investor’s Acknowledgment of Receipt of Documents NAC 645B.080 (pdf)

• Mortgage Broker Disclosure, Before Loan is Assigned (pdf)

• Investor’s Acknowledgment of Receipt of Documents NAC 645B.215 (pdf)

• Special Power of Attorney (I-pdf)

• Financial Statement Prescribed Forms (pdf)

• Private Investor’s Minimum Financial Requirements (pdf)

• Authorization to Release Financial Statement (pdf)

Credit Service Organizations

• Application (pdf)

• Business Practice Questionnaire (pdf)

• CSO Surety Bond form (pdf)

• CSO Letter of Credit (pdf)

• CSO CD Letter (pdf)

• Renewal Application for Credit Service Organization – Registration (pdf)

Independent Licensee - Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider

• Independent Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Application for License and Checklist (Principal Office) (pdf)

Independent Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Renewal

• Independent Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Application for Renewal of License and Checklist (pdf)

Associated Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Application

• Associated Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Application for License and Checklist (pdf)

Associated Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Renewal

• Associated Licensee – Loan Modification Consultant, Foreclosure Consultant and Covered Service Provider – Application for Renewal of License and Checklist (pdf)

Associated Licensee and Independent Licensee – Other

• Associated Licensee – Notice of Termination of Affiliation With Independent Licensee (pdf)

• Independent Licensee Bond Form Sample (pdf)

• Independent Licensee - Notice of Termination of Affiliation With Associated Licensee (pdf)

Loan Servicer Registration

• Loan Servicer Registration (pdf)