City of North Las Vegas
CANCELLATION REQUEST FORM
2250 N. Las Vegas Boulevard, Suite 110, North Las Vegas, NV, 89030 (702-633-1520)

Name

Email

Role

Owner

Officer

Authorized Party*

Business Name

Address

License Number

License Classification Value is not selected

The business has/was

closed.

relocated outside of North Las Vegas and will not conduct any business within the City that requires a business license.

restructured and requires new licensing..

sold.

Signature

Title

Date

Letter of authorization

*Please note: An individual acting as an authorized party must provide a letter of authorization on company letterhead or a notarized letter signed by an owner/officer to act on behalf of the company.

This request for cancellation is limited to licenses issued by the City of North Las Vegas.

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BL - Cancellation Request Form