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Nevada Pharmacy Licensing Form Guide
The current Nevada Pharmacy Application is used for Nevada and out-of-Nevada pharmacy facilities, including certain new licenses and ownership, location, service, or name changes. The application contains several certifications and original-signature requirements, but only one section contains a printed notarial certificate.
Section 10, Affidavit for Pharmacy License, is labeled for pharmacies not currently performing sterile compounding. It uses “subscribed and sworn” wording, making the notarial act a jurat. The authorized signer must personally appear before the notary, take an oath or affirmation, and sign that affidavit in the notary's presence.
Lake Mead Mobile Notary can perform the Section 10 jurat when the application has been selected and completed by the pharmacy or its authorized adviser. We do not determine whether Section 10 applies, prepare licensing answers, select the authorized signer, verify pharmacy operations, or guarantee approval by the Nevada State Board of Pharmacy.
Official Board Form
The current application is a ten-page Board form revised June 11, 2024. It covers Nevada and out-of-Nevada facilities and separates the required sections by facility location, application type, ownership structure, pharmacy type, and services.
The application distinguishes a Nevada facility from an out-of-Nevada pharmacy that will ship pharmaceutical products into Nevada. Supporting records and managing-pharmacist sections are not identical for both groups.
The current form includes selections for a new pharmacy and certain ownership, location, service, or name changes. The Board determines which application and supporting materials apply to a particular transaction.
Publicly traded companies, non-publicly traded entities, partnerships, and sole owners complete different ownership sections while sharing several general and certification sections.
Retail, hospital, internet, nuclear, controlled-substance, compounding, mail-order, long-term-care, and other services may trigger different supporting records or Board review.
Review the Nevada State Board of Pharmacy business applications page for the current Pharmacy Application and related business forms.
Signature Requirements
An original-signature requirement is not the same as a notarial requirement. The current application contains several original certifications, while Section 10 is the section with the printed “subscribed and sworn” notarial certificate.
An authorized person signs an original statement concerning ownership responsibility and pharmacy-law obligations. The printed section does not contain a notarial certificate.
This section contains the jurat and is the signature normally presented to the notary. It is labeled for pharmacies not currently performing sterile compounding.
This section is identified for Nevada-located pharmacy applicants and requires the managing pharmacist's original signature. It does not display a notarial certificate.
The authorized person submitting the application signs an original certification under penalty of perjury. The current printed signature block is not a notary block.
Jurat Requirement
The words “subscribed and sworn to” identify a jurat. The affiant must personally appear, swear or affirm that the statements are true, and sign while the notary is present.
The authorized affiant must appear before the notary. A courier, coworker, application preparer, or corporate contact cannot present the signed page for an absent person.
The signer must answer the notary directly and swear or affirm that the assertions in the affidavit are true and correct to the best of the signer's knowledge and belief.
Leave the Section 10 signature blank. Unlike an acknowledgment, a jurat requires the notary to witness the affiant sign after the oath or affirmation is administered.
Lake Mead Mobile Notary requires acceptable original, current physical identification for an in-person appointment. A photograph, screenshot, scan, or photocopy is not accepted.
Authorized Signers
The application uses different signer roles. The notary can verify the identity of the Section 10 affiant but cannot decide who has organizational or regulatory authority.
Section 9 requires an authorized person who can speak on the pharmacy's behalf and make the printed responsibility acknowledgements.
The signer states a title and certifies authority to speak on behalf of the named pharmacy. The pharmacy must decide who has enough authority and knowledge to make the sworn statements.
Section 11 is assigned to the managing pharmacist for a Nevada-located pharmacy applicant. It should not be reassigned to another signer merely for scheduling convenience.
The final certification states that a partnership or corporation must use the signer identified by the printed instruction. The applicant should confirm the correct person before execution.
Facility Location
The same current application begins both routes, but facility location changes which sections and supporting records apply.
A Nevada facility may be subject to a pre-opening inspection after application approval and uses the managing-pharmacist section identified for Nevada-located applicants.
A pharmacy outside Nevada that will dispense to patients in Nevada must follow the out-of-state licensing route and provide the Board records identified for non-Nevada applicants.
Section 10 is labeled for pharmacies not currently performing sterile compounding. A pharmacy providing sterile compounded drugs should confirm the current questionnaire, appearance, and approval requirements with the Board.
Internet pharmacy services, controlled substances, and other specialized operations can trigger separate certifications, registrations, or reporting requirements outside the notary's role.
Appointment Preparation
Bring the current Board application rather than an isolated signature page. The full document helps preserve the context of the affidavit and the pharmacy identified by the signer.
Complete the affiant's printed name, title, pharmacy name, and other non-signature information before the appointment, but leave the jurat signature blank.
The affiant must personally appear with an original, current physical government-issued identification document acceptable to the notary.
The applicant should confirm the signer's title, authority, and knowledge of the sterile-compounding statements before the appointment.
Keep the pharmacy's licensing professional, attorney, or Board contact available for questions about sections, supporting documents, ownership, services, or regulatory statements.
For an in-person Lake Mead Mobile Notary appointment, the affiant must be physically present at the agreed Nevada location. Contact us before booking when the signer is outside Nevada.
Booking Guidance
Book after the pharmacy has confirmed that Section 10 applies and has assigned the authorized affiant.
Select this when one pharmacy application contains the only Section 10 affidavit requiring notarization and one authorized signer will appear in Nevada with acceptable identification.
Select this when two to four separate prepared pharmacy, licensing, corporate, or supporting documents require notarization during the same appointment.
Call or text (702) 748-7444 before booking when several pharmacy applications, several authorized representatives, or more than four notarized documents are involved.
Contact us before selecting an appointment. The signer's location, available notarial method, and the Board's acceptance requirements must be confirmed first.
Do not schedule yet when the pharmacy is unsure whether Section 10 applies, who may sign, whether sterile compounding is planned, or which application and supporting materials the Board requires.
Regulatory Decision
A lawful jurat satisfies only the notarial portion of Section 10. The Nevada State Board of Pharmacy independently evaluates the complete application and supporting records.
The Board determines whether the application uses the correct form, contains the required signatures and attachments, and provides enough information for review.
The current application states that some applicants or representatives may need to appear before the Board. Notarization does not replace that appearance.
Application deadlines and meeting dates are controlled by the Board, and submission before a deadline does not itself guarantee placement on a particular agenda.
Approval, required inspections, supporting documentation, fees, and other Board requirements must be completed before a license is issued.
Review the official Board meeting schedule for current application deadlines and meeting dates.
Common Questions
No blanket conclusion should be made. The current Section 10 affidavit is labeled for pharmacies not currently performing sterile compounding. Applicants with sterile-compounding or other specialized operations should confirm the required route with the Board.
Section 10, Affidavit for Pharmacy License, contains the printed jurat. Other sections require original signatures or certifications but do not display a notarial certificate on the current form.
No. The printed certificate is a jurat. The affiant must take an oath or affirmation and sign Section 10 while personally appearing before the notary.
The form requires a person who states a title and certifies authority to speak on the pharmacy's behalf. The pharmacy, Board, or legal counsel—not the notary—must determine the proper affiant.
The current Section 11 requires the managing pharmacist's original signature for Nevada-located pharmacy applicants but does not display a notarial certificate. Follow the printed form and any Board instructions rather than adding an unnecessary notarization.
Not automatically. The application identifies different roles for the authorized person, Section 10 affiant, managing pharmacist, partner, or corporate officer. The applicant must assign each signature correctly.
No. Lake Mead Mobile Notary requires acceptable original, current physical identification for an in-person appointment. A photograph, screenshot, scan, or photocopy is not accepted.
No. The notary administers the oath or affirmation, identifies the affiant, witnesses the signature, and completes the jurat. The notary does not investigate or certify the truth of the pharmacy's regulatory statements.
No. The Board separately reviews the entire application, applicant qualifications, supporting records, services, ownership, inspections, deadlines, and any required appearance.
Choose Mobile Notary – 1 Document when one current application contains the only Section 10 affidavit requiring notarization and one authorized affiant will appear in Nevada with acceptable identification.
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