Required REGULATED BUSINESS Application Forms

Regulated Licensing Application Packet
Regulated Licensing Application Packet forms are required for all regulated licenses: The Nevada Business Registration Form (NBR), Business License Supplement Form, Fire Department's Permit Survey Form, Affirmation of Compliance (Industrial Insurance) Form, Compliance/Exemption Form (SB356).

1. Nevada Business Registration Form
   The Nevada Business Registration Form (NBR) is the main part of the application and must be completed. An advantage of this form is that it is also utilized by most state agencies; therefore you do not have to repeat all the pertinent information to each agency. The NBR has specific directions; please be sure to read it carefully and completely fill out the document.
2. Business License Supplement Form
   The Business License Supplement is a form for the Business License Department and must also be completed.
3. Fire Department Permit Survey Form
   Completion of the Clark County Fire Department's Permit Survey Form is required of all applicants.
4. Instructions for Scheduling Fire Department Inspections Online
   The Instructions for Scheduling Fire Department Inspections will enable Business License applicants to schedule their Fire Department inspection online. 
5. Worker’s Compensation
   Industrial Insurance requires an Affirmation of Compliance with Mandatory Industrial Insurance Requirements, which indicates you have complied with industrial insurance coverage requirements in Nevada (NRS616). The form needs to be completed; "signed in the presence of a business license technician”; and submitted to the Business License Office prior to the issuance of a business license. If this form is mailed or faxed to our office, it must have the signature notarized. If you have questions or need more information regarding this form, contact the State of Nevada, Department of Business & Industry, Division of Industrial Relations, Industrial Insurance Regulation Section, 1301 North Green Valley Parkway, Suite 200, Henderson, NV 89104, (702) 486-9000.
6. Child Support Documents
   The Compliance/Exemption Forms (SB356) are required by Clark County Business License Department to ensure that business license applicants are in compliance with court orders dealing with child support payments. This must be completed in order to process your business license application.

Business License Waiver
The Business License Waiver is required, due to the high volume of investigations completed by the Department of Business License and Las Vegas Metropolitan Police Department. We are unable to predict when an applicant’s determination of suitability will be completed and ready for presentation to the Liquor and Gaming Licensing Board for action. Nevada state law requires that applicants be notified, in writing, at least 21 working days prior to being included on a public agenda.  In most cases, the Department and Metro are prepared to present cases to the Board under that 21-day window, so we ask that applicants waive that 21-day window so as to better serve their interest and enable us to place their item on the next available agenda.

Required LV Metropolitan Police Department (LVMPD) Forms

Metro Application Memo/Instructions
The Metro Application packet contains information from the Las Vegas Metropolitan Police Department on completing their required forms (Personal History and Personal Financial Questionnaires), fingerprinting requirements, and alcohol awareness training locations.

Authorization to Release Information
TWO original and two (2) copies of signed and notarized Las Vegas Metropolitan Police Department Authorization to Release Information forms are required.

Birth Certificate
A certified copy and a copy of a birth certificate or naturalization paper for each applicant is required. A passport will not be accepted in lieu of a birth certificate or naturalization paper.

Color Photos
Two (2) recent, passport size color photographs are required.

Driver’s License
Two (2) copies of a driver's license (front and back) is required for each individual applicant. A passport will not be accepted in lieu of a driver's license.

Passport
Two (2) copies of the applicant's passport is required, if the applicant has one.

Personal History Questionnaire
Each applicant for a regulated business license will be required to complete a form detailing their personal history, including personal references, legal history, family connections and history, and past residence information. This form requires notarized signatures in several places. Please provide one original and 1 copy of the LVMPD Personal Financial Questionnaire.

1. Long Form Application Instructions
2. Short Form Application Instructions

1. Personal Financial Questionnaire
   You must provide one original and one (1) copy of the Las Vegas Metropolitan Police Department Personal Financial Questionnaire once completed, with notarized signatures. Provide documents showing source and availability of your personal funds invested and loan documents, if applicable. Documentation of secured funding must be available at the time of application. Letters of Intent will not be accepted and will delay the processing of your application. Two (2) copies of the applicant’s past three (3) years of federal income tax filings and last three (3) months of bank statements are required for each person.
2. Corporate Financial Questionnaire
   Any privileged and/or certain regulated businesses that are owned by an entity registered with the Secretary of State will be required to complete a form detailing the financial history, including bank accounts, investments and past income tax information. This form requires notarized signatures in several places. A copy of the entities past three (3) years of federal income tax filings and last three (3) months of bank statements are required to be attached to this form.

Required Application Forms for Other Types of
REGULATED Business Licenses

Application for Auction Permit
Instructions and application for Auction Permit are included in this link.

Application for Massage Establishment/Business: Applicant/Owner is not a Massage Therapist
If you will be owning/operating massage business or massage establishment and not personally administering massage, you must sign an affidavit and have it properly notarized. It is unlawful to administer massage in unincorporated Clark County unless or until you have been issued a work identification card for massage therapy by the LVMPD.

Application Permit for Rock Musical Concert
Application Permit for Rock Musical Concert is required for each concert staged within an unincorporated area of Clark County.

Supplement to Application for “Rock” Musical Concert Promoter License
A completed Supplement to Application for Rock Concert Promoter Addendum is required per Clark County Code Section 6.65.

Other REGULATED BUSINESS Forms

Change Forms
Change Forms packet includes: Checklist for Change of Business License; Application for Change of Business License (including Applicable License Changes and Fees) and Fire Permit Survey are included in this packet.

Complaint Form
All complaints must be received in writing.  The complaint form contains all the information we need to investigate a complaint including a return address and a fax number.

Fictitious Firm Name Form
Need to file a Fictitious Firm Name? Read about the County Clerk requirements if you plan to officially "name" your business. There is some excellent information for you on their website and you will have all the information you need to file your fictitious firm name. This form needs to be filed prior to applying for a Business License.

Out of Business Form
Complete the Out of Business form to notify Clark County Business License that your business is no longer operating.

Request for Duplicate License Form
Obtaining a duplicate license can be accomplished by completing the Request for Duplicate License Form.  License reprint fee $5.00.

Request for Public Records
Request for Public Records can be obtained by completing the Public Records Request Form.

Request for Refund Form
Request for monies to be refunded can be accomplished by completing the Request for Refund Form.

Request to Surrender Regulated Business License Form
Surrender of your regulated business license can be accomplished by completing the Request to Surrender Business License Form.