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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your ESD Employer Account Number and Federal Employer Identification Number at the top of the form.
  3. Fill in your name and address, ensuring all details are accurate for proper identification.
  4. List all Nevada contracts by providing the names and locations in the designated section.
  5. Authorize the release of information by printing your name and title, then signing where indicated. Include your telephone number and date.
  6. Complete the certification section regarding the subcontractor's financial obligations, indicating whether contracts have been completed or not.
  7. Finally, ensure that both you and the prime contractor sign and date the form before submission.

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