Nebraska Real Estate Commission                                                                       Phone: (402) 471-2004
P.O. Box 94667                                                                                                     Fax: (402) 471-4492
Lincoln, Nebraska  68509-4667                                                       Website:

Order Form

Contact Person: Phone: ()
Company Name: Fax: ()
Mailing Address:

(Street/PO Box)                             (City)                 (State)    (Zip)     

Date Ordered:
Amount Submitting: $
Requester's Name:

Licensee information is available for purchase in printed or electronic format from the Nebraska Real Estate Commission. Information can be printed on mailing labels ($50.00), printed in roster format ($15.00), put on diskette and mailed ($15.00), or e-mailed ($10.00). Prices include any applicable tax. Please place your order as close as possible to your mailing date. Licensee information is extremely time-sensitive because continuing education information is included, and because licenses are issued and transferred daily.

Mailing labels include the name and business address for each licensee, and can be printed on self-adhesive labels with 30 on each page. Rosters include the name, business address, license type, and status for each licensee. Check the blanks below to indicate whether you want mailing labels or a roster; what format you choose; which categories you wish to include; whether you need them divided by license type and/or status; which jurisdictions you want included in your set; and whether you want them in zip code or alphabetical order. If you want only those licensees who need continuing education before renewal, check that blank and indicate whether you want them in zip code or alphabetical order.

Mailing labels OR Roster
Email (Format desired: ) OR Diskette OR Printed
Active Salespersons Inactive Salespersons Active Brokers Inactive Brokers
Run as one set OR Divided by License Type AND/OR License Status
Nebraska Only OR All States OR Specific States (list):

Zip Code Order OR Alphabetical Order
Mailing labels for all licensees who need continuing education before renewal

For Office Use Only

Date Payment Received: _____________ Receipt #: ______________ Date order was sent: ____________

FEES ARE NOT REFUNDABLE.  If you have any questions, please contact Monica at (402) 471-2004 or  

Credit Card Information
Visa, Discover or MasterCard
(Please note: Debit cards are not accepted)
Address 1:
Address 2:
City: State: Zip:
Card Number:
Expiration Date

All personal and financial information is safe on our secure servers.