Nevada State Contractors Board

Report Unlicensed Contracting

**This form is to report UNLICENSED Contracting**
To report Licensed Contractors, please contact the Contractors Board.

I hereby make the following free and voluntary statement. No threats or promises have been made to persuade me to make this statement, and I understand any statement I make may be used as evidence by any Court of Law.

Type of Unlicensed Contracting Being Performed (Please enter a brief description):

A value is required.

Suspect's Information:

Suspect's Company Name: A value is required.

Suspect's Name: A value is required.

Suspect's Address: A value is required.

City: A value is required. Zip: A value is required.

Suspect's Phone: A value is required.

Did the person or company you contracted with indicate to you either verbally or in writing that they were a
LICENSED CONTRACTOR? Please select a valid item.Please select an item.

Your best description of individual:

Age: A value is required. Height: A value is required. Weight: A value is required.

Hair: A value is required. Eyes: A value is required. Race: A value is required. Sex: A value is required. Please select a valid item.Please select an item.

Location of work completed:

A value is required.

Your Contact Information:

Contact Name: A value is required. Phone Number: A value is required.Invalid format.