Nevada State Board of Equalization
Nevada Department of Taxation
Request for Appraiser’s Certification Examination and Application
for Property Tax Appraiser’s Certification
Return this form to:
Division of Local Government Services
1550 College Parkway
Carson City, Nevada 89706
Please Print or Type:
Part A. APPLICANT INFORMATION
|NAME OF APPLICANT |TITLE |
| | |
|BUSINESS MAILING ADDRESS (STREET ADDRESS OR P.O. BOX) |EMAIL ADDRESS |
| | |
|CITY |STATE |ZIP CODE |DAYTIME PHONE |ALTERNATE PHONE |FAX NUMBER |
| | | |( ) |( ) |( ) |
|SPONSORING TAX AGENCY |DATE OF HIRE BY SPONSORING TAX AGENCY |
| | |
|TAX AGENCY CONTACT NAME |CONTACT PHONE NUMBER |
| | |
|DUTIES OF THE POSITION |
| |
Part B. EXAM REQUEST - CHECK ALL THAT APPLY (Please indicate preference for date and location of examination.)
1st Quarter of the Year ( General Exam ( Real Property Exam ( Personal Property Exam(
2nd Quarter of the Year ( General Exam ( Real Property Exam ( Personal Property Exam(
3rd Quarter of the Year ( General Exam ( Real Property Exam ( Personal Property Exam(
4th Quarter of the Year ( General Exam ( Real Property Exam ( Personal Property Exam(
Northern Nevada ( Southern Nevada (
Part C. PROFESSIONAL DESIGNATION
1. I have earned a professional designation and hereby request the Department to waive the requirement to take the following exams: Real Property Exam ( Personal Property Exam ( Not Applicable (
(Supporting documentation must be enclosed.)
2. Do you have a state business license? Yes ( No (
If yes, what is your state business license number? _________________________
Part D. SIGNATURES
( _________________________
Applicant Signature (Use blue ink) Date
VERIFICATION OF EMPLOYMENT, TO BE COMPLETED BY HIRING AUTHORITY:
By my signature below, I verify the applicant is currently an appraiser of the sponsoring tax agency named above and the job duties specified and date of hire are true and correct.
( _________________________
Hiring Authority Representative (Assessor or Department) Title Date
-----------------------
For Department Use Only
|EXAMINATION DATE |SCORE |PROOF OF DESIGNATION ATTACHED |DATE OF PERSONAL PROPERTY CERTIFICATION |DATE OF REAL PROPERTY CERTIFICATION |
| | | | | |
| | | | | |
Verified by:
( _________________________
Division of Local Government Services Title Date
................
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