ࡱ> _ ;bjbj bb1 tt8Z4 r/""L/4141414141414$6L9U4) ))U4j4<-<-<-)/4<-)/4<-<-)2*T63p5:r*S34404g38:l+N:(3:3|#$&<-%&###U4U4,###4)))):#########t :    FUNERAL SELLER AND/OR CEMETERY SELLER PERMIT APPLICATION INSTRUCTIONS GENERAL INFORMATION: All Business Entities: Business entity refers to a corporation, limited liability company, limited liability partnership and associations or other legal forms of organization. A business entity that is required to be licensed in this state, that transacts insurance without a license, is subject to an administrative fine of not more than $1,000 per act or violation. Name Approval: Applicants must contact the Division of Insurance (Division) for a verbal name approval prior to completing any articles of incorporation, articles of organization or amendments with the Secretary of States (SOS) office, or prior to filing any DBA/Fictitious Firm Name filings with the appropriate Nevada County Clerks office. Division Phone: (775) 687-0700 Division General E-mail:  HYPERLINK "mailto:insinfo@doi.state.nv.us" insinfo@doi.state.nv.us Corporations, Limited Liability Companies, Limited Liability Partnerships and Associations, etc.: Contact the  HYPERLINK "http://sos.state.nv.us/" Nevada Secretary of State (SOS) to obtain forms, instructions and applicable fees. SOS Phone: (775) 684-5708 SOS Web site:  HYPERLINK "http://www.nvsos.gov/business/forms/index.asp" www.nvsos.gov/business/forms/index.asp Articles of Incorporation (Articles) Purpose Clause: Business entities whos purpose is to engage in the business of insurance are required to file with the SOS and must include the following statement within the purpose clause of the entitys Articles of Incorporation: To engage in the business of insurance in all lines of authority permitted under the license issued in compliance with Nevada Revised Statutes (NRS) and Nevada Administrative Codes (NAC). The articles or amendment must be forwarded to the Division prior to being filed with the SOS by either of the following methods: Mail the Articles or amendment to the Divisions address with the fee for the SOS in a separate sealed envelope labeled Secretary of State or SOS. Fax the Articles or amendment to the Divisions office. Upon approval of the Articles or amendment, the Division will fax the information to the fax number provided by the applicant for filing with the SOS. The Divisions fax number is (775) 687-0787. Upon the Divisions approval of the Articles or amendment, the Division will forward its approval to the SOS for its consideration. When the SOS completes its review and approval process, the business entity will be required to furnish a filed copy of the approved Articles or amendment. Sole-Proprietorships: Sole proprietors must file a DBA/Fictitious Firm Name with each county clerks office where they intend to conduct business. A copy of the filing must be provided to the Division along with the licensing application. Contact the appropriate County Clerks office for filing instructions. Refer to  HYPERLINK "http://www.leg.state.nv.us/NRS/NRS-602.html" \l "NRS602Sec010" Chapter 602 of NRS for information on doing business under an assumed or fictitious name. The Division has provided a checklist that must be incorporated into the application packet. The application must be tabbed as indicated or the application will be returned to the applicant without the application being reviewed by the Division. FORMS PROVIDED IN THIS PACKET: CHECK LIST Must be incorporated into application packet APPLICATIONS Application for a certificate of authority for funeral seller or cemetery sellers permit and licensing application for individuals and business entity FINGERPRINT CARDS Each individual obtaining a license must go through a background check BOND Sample bond Our laws and regulations are available on the internet at  HYPERLINK "http://www.doi.nv.gov" www.doi.nv.gov All applications for a funeral/cemetery seller must be tabbed and cross-referenced or they will be returned to you without being reviewed.  FORMCHECKBOX FEES: Payable to the Division of Insurance Firm Fees Individual Fees Funeral Seller $185.00 Funeral Agent $235.00 Cemetery Seller $185.00 Cemetery Agent $235.00 Producer $195.00 Producer $255.00 Additional locations $10.00 each  FORMCHECKBOX  Application for Certificate of Authority for Funeral/Cemetery Sellers Permit  FORMCHECKBOX  Business Entity License Application  FORMCHECKBOX  Certified Copy of your Articles of Incorporation  FORMCHECKBOX  Certified Copy of your Bylaws  FORMCHECKBOX  A copy of your license issued by the Nevada State Board of Funeral Directors and Embalmers.  FORMCHECKBOX  A copy of your proposed trust agreement tabbed and cross-referenced.  FORMCHECKBOX  A copy of your contract tabbed and cross-referenced.  FORMCHECKBOX  A copy of the existing or proposed contract between the seller and performers (if any).  FORMCHECKBOX  An original statement signed by a corporate officer pertaining to NRS 452 (cemetery seller only).  FORMCHECKBOX  Original Surety Bond in the amount of $50,000 in favor of the State of Nevada with the Power of Attorney. The bond must have a 30-day cancellation clause and must be countersigned by a resident agent. An additional bond is required if you will be selling crypts or niches before they are constructed. See NRS 452.410.  FORMCHECKBOX  Individual License application for the individuals who will be selling the prepaid contracts along with fees outlined above.  FORMCHECKBOX  Provide receipt or copy of money order showing background check has been requested for each individual being licensed. TRUST AGEEMENT CROSS-REFERENCE Tab and cross-reference your agreement with all statutory requirements or it will be returned without being reviewed. Complete the cross-reference form as indicated listing where the requirements are located in your agreement. You can access the laws and regulations on our web site.  HYPERLINK "http://www.doi.nv.gov" www.doi.nv.gov Statute Topic Location in agreement NRS 689.315 (funeral) NRS 689.560 (cemetery) Trust Fund (1) (2) (3) (4)  NRS 689.325 (funeral) NRS 689.565 (cemetery)  Disbursement of Trust Funds (1) (2) (3) (4) (5) (6)  NRS 689.345 (funeral) Refund of Purchase Price NRS 689.570 (cemetery)Payments from Trust Funds (1) (2) (3)NRS 689.355 (funeral) NRS 689.575 (cemetery)Contract Termination (1) (2)  CONTRACT CROSS-REFERENCE Tab and cross-reference your contract with all statutory requirements or it will be returned without being reviewed. Complete the cross-reference form as indicated listing where the requirements are located in your contract. You can access the laws and regulations on our web site.  HYPERLINK "http://www.doi.nv.gov" www.doi.nv.gov Statute Topic Location in agreement NRS 689.275 (funeral) NRS 689.560 (cemetery) Contract Provisions (1) (a) (b) (c) (d) (f) (g) (h) (i) (j) (2) (3) NRS 689.355 (funeral) NRS 689.575 (cemetery)Contract Termination (1) (2) NRS 689.365 (funeral) NRS 689.580 (cemetery)Contract Termination by Seller (1) (2) Uniform Application for Business Entity,  HYPERLINK "http://doi.state.nv.us/form-doc325naic.pdf" Form 325: Amendment to Licensing Application for a Certificate of Authority for Funeral and Cemetery Seller (enclosed in this application packet) Uniform Application for Individual Insurance Producer License,  HYPERLINK "http://doi.state.nv.us/form-doc327naic.pdf" Form 327: If applying as a producer: Nevada Approved Prelicensing Education Sponsors,  HYPERLINK "http://doi.state.nv.us/Form-PL-DOC343-05-14-09.pdf" Form 343, and Applicant Information for the State Insurance Examination,  HYPERLINK "http://doi.state.nv.us/Form-PL-DOC352_A.pdf" Form 352: A resident applicant must take and successfully pass the state insurance exam administered through the Nevada Division of Insurance (Division) insurance exam vendor,  HYPERLINK "http://pearsonvue.com/" Pearson VUE (formerly known as Promissor), in the line(s) of authority for which the applicant is applying. The original Prelicensing Education Certificate of Completion and the original Pearson VUE test examination score reports must be provided with the application. Residents Requirements for Criminal History Search,  HYPERLINK "http://doi.state.nv.us/Form-PL-DOC324.pdf" Form 324: All individuals applying for a resident license with the Division must furnish a complete set of fingerprints which the Commissioner may forward to the Central Repository for Nevada Records of Criminal History and the Federal Bureau of Investigation. Applicants must pay the applicable processing and agency fee for this service. Applicants may have their fingerprints taken by a law enforcement agency or authorized vendor. The applicant must submit the fingerprint cards to the Division along with a completed license application. A money order or cashiers check in the amount of $48.50, made payable to the Department of Public Safety (DPS), must accompany the fingerprint cards. LiveScan Digital Fingerprinting services are also available through Pearson VUE. Applicants may register to have their fingerprints taken at the same time they register for the state exam. The LiveScan fingerprinting fee is $37.50 plus the vendors processing fee. Applicants will be provided a receipt which indicates the date the fingerprints were submitted to the Nevada Criminal History Records Repository. The applicants must provide the receipt in place of the physical fingerprint cards when applying for a license. Appointment Requirements: A producer contracted with an insurer must be appointed within 15 days after the contract is executed or within 15 days of the license being issued by the Division. The date of issuance will be available on the NAIC Producer Database. The appointment must include the lines of authority under which the license is issued. The Division will accept electronic or paper appointments. The appointment fee is $15 and renews annually on July 1. Questions: Contact the Divisions Producer Licensing Section in Carson City at (775) 687-0700, option 1, in Las Vegas at (702) 486-4595 or anywhere in Nevada toll free at (800) 992-0900. Title 57 of the Nevada Revised Statutes (NRS) governs the business of insurance. Nevadas laws and regulations are available online at  HYPERLINK "http://www.leg.state.nv.us" www.leg.state.nv.us or  HYPERLINK "http://www.doi.nv.gov" www.doi.nv.gov. Producer Licensing Section forms can be found by logging on to  HYPERLINK "http://www.doi.nv.gov" www.doi.nv.gov.    AMENDMENT TO LICENSING APPLICATION FOR A CERTIFICATE OF AUTHORITY FOR FUNERAL AND CEMETERY SELLER 1. ________________________________________________________________ Business Name (Print entire Name) Fictitious Name: ______Yes ______No 1)______________________________________________ 2)______________________________________________ 3)______________________________________________ 4)______________________________________________ 5)______________________________________________ 6)______________________________________________ 2. Business Address: ________________________________________________________________ Street State Zip Code ________________________________________________________________ County Business Phone No Other Locations: 4. Trustee Information: ___________________________________________________________________ Name ___________________________________________________________________ Physical Address Phone No. 5. Performers: ___________________________________________________________________ Name ___________________________________________________________________ Address Phone No. 6. Endowment Trustees: __________________________________________________________________ Name ___________________________________________________________________ Address Phone No. I hereby certify under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge and belief. I also hereby agree to the disclosure and release of any information pertinent to this application held by any person or any educational, law enforcement, governmental or business entity. __________________________________ _______________________ Applicants Original Signature Date __________________________________ Printed Name Title NDOI-1400 DOC _____Funeral Cemetery Instructions (rev DRAFT)4.4.12     Department of Business and Industry Nevada Division of Insurance 1818 E. College Pkwy, Suite 103, Carson City, Nevada 89706 Phone: (775) 687-0700 Fax: (775) 687-0797 Web: doi.nv.gov Department of Business and Industry Nevada Division of Insurance 1818 E. 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